Medicine or Surgery (Ms)

A randomized clinical trial comparing hysterectomy and medical treatment in premenopausal women with abnormal uterine bleeding

R. Edward Varner, Christine C. Ireland, Robert L. Summitt, Holly E. Richter, Lee A. Learman, Eric Vittinghoff, Miriam Kuppermann, Eugene Washington, Stephen B. Hulley

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Hysterectomy may be overused as treatment for abnormal uterine bleeding due to benign causes in reproductive women. Medical therapies are an alternative, and there is a need for randomized trials comparing the outcomes of these approaches. Women of reproductive age who continued to have bothersome abnormal uterine bleeding after cyclic hormonal treatment with medroxyprogesterone acetate (MPA; 10-20 mg for 10-14 days/month) for 3-5 months were invited to participate in a randomized trial of hysterectomy versus other medical therapies. Participating gynecologists were free to choose the particular surgical (transabdominal or transvaginal) or medical (generally oral contraceptives and/or a prostaglandin synthetase inhibitor) approaches. Outcomes during 2 years of follow-up include quality of life (primary), sexual function, clinical effectiveness and cost. We screened 1557 women to find 413 who began 3-5 months of MPA; 215 completed this treatment, of whom 102 still had bothersome symptoms, and of these 38 consented to be randomized. Another 25 women with bothersome symptoms after a documented history of 3 months of cyclic MPA were also randomized, for a total of 63. The average age of randomized women was 41; 54% were African-American, and they reported uterine bleeding 12 days/month on average, heavy bleeding 6 days/month. Anemia (hematocrit30), and associated with a longer duration of symptoms (12 vs. 4 years for BMI

Original languageEnglish (US)
Pages (from-to)104-118
Number of pages15
JournalControlled Clinical Trials
Volume25
Issue number1
DOIs
StatePublished - Feb 2004
Externally publishedYes

Fingerprint

Uterine Hemorrhage
Hysterectomy
Randomized Controlled Trials
Medicine
Therapeutics
Prostaglandin Antagonists
Medroxyprogesterone Acetate
Prostaglandin-Endoperoxide Synthases
Complementary Therapies
Oral Contraceptives
African Americans
Anemia
Quality of Life
Hemorrhage
Costs and Cost Analysis

Keywords

  • Abnormal uterine bleeding
  • Hysterectomy
  • Medroxyprogesterone acetate
  • Quality of life
  • Randomized trial
  • Sexual function

ASJC Scopus subject areas

  • Pharmacology

Cite this

Medicine or Surgery (Ms) : A randomized clinical trial comparing hysterectomy and medical treatment in premenopausal women with abnormal uterine bleeding. / Varner, R. Edward; Ireland, Christine C.; Summitt, Robert L.; Richter, Holly E.; Learman, Lee A.; Vittinghoff, Eric; Kuppermann, Miriam; Washington, Eugene; Hulley, Stephen B.

In: Controlled Clinical Trials, Vol. 25, No. 1, 02.2004, p. 104-118.

Research output: Contribution to journalArticle

Varner, RE, Ireland, CC, Summitt, RL, Richter, HE, Learman, LA, Vittinghoff, E, Kuppermann, M, Washington, E & Hulley, SB 2004, 'Medicine or Surgery (Ms): A randomized clinical trial comparing hysterectomy and medical treatment in premenopausal women with abnormal uterine bleeding', Controlled Clinical Trials, vol. 25, no. 1, pp. 104-118. https://doi.org/10.1016/j.cct.2003.08.008
Varner, R. Edward ; Ireland, Christine C. ; Summitt, Robert L. ; Richter, Holly E. ; Learman, Lee A. ; Vittinghoff, Eric ; Kuppermann, Miriam ; Washington, Eugene ; Hulley, Stephen B. / Medicine or Surgery (Ms) : A randomized clinical trial comparing hysterectomy and medical treatment in premenopausal women with abnormal uterine bleeding. In: Controlled Clinical Trials. 2004 ; Vol. 25, No. 1. pp. 104-118.
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