{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:36:31Z","timestamp":1761561391732},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":395,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Objective.<\/jats:italic> The purpose of this study was to evaluate the changes in lower abdominal pain and back pain among women with menorrhagia treated by hysterectomy or levonorgestrel\u2010releasing intrauterine system (LNG\u2010IUS). <jats:italic>Design.<\/jats:italic> A randomized controlled trial. <jats:italic>Setting.<\/jats:italic> Five university hospitals in Finland. <jats:italic>Sample.<\/jats:italic> A total of 236 women, aged 35\u201349 years. <jats:italic>Methods.<\/jats:italic> Women were randomly assigned to treatment by hysterectomy (<jats:italic>n<\/jats:italic> = 117) or LNG\u2010IUS (<jats:italic>n<\/jats:italic> = 119). <jats:italic>Main outcome measures.<\/jats:italic> Frequency and intensity of lower abdominal pain and back pain were evaluated by questionnaires at baseline and after 6 months, 12 months and 5 years. <jats:italic>Results.<\/jats:italic> By six months, women in both groups had less frequent back pain than before treatment (<jats:italic>p<\/jats:italic> &lt; 0.001). Lower abdominal pain decreased only in the hysterectomy group (<jats:italic>p<\/jats:italic> = 0.02) with significant differences between the groups. Between 12 months and 5 years, frequency of lower abdominal pain (<jats:italic>p<\/jats:italic> = 0.05) and back pain (<jats:italic>p<\/jats:italic> = 0.002) decreased more in the LNG\u2010IUS group than in the hysterectomy group. Between baseline and five years, the lower abdominal pain score (including frequency and intensity of pain) decreased in both groups (<jats:italic>p<\/jats:italic> &lt; 0.001, <jats:italic>p<\/jats:italic> = 0.01). Back pain score decreased only in the LNG\u2010IUS group and the difference between the groups was significant (<jats:italic>p<\/jats:italic> = 0.02). However, some women experienced more pain after both treatments than before treatment. In multivariate analyses, LNG\u2010IUS use was associated with a decrease in lower abdominal pain and back pain. <jats:italic>Conclusions.<\/jats:italic> In the treatment of menorrhagia, both hysterectomy and LNG\u2010IUS decrease lower abdominal pain. LNG\u2010IUS use, but not hysterectomy, has beneficial effects on back pain.<\/jats:p>","DOI":"10.3109\/00016340903297150","type":"journal-article","created":{"date-parts":[[2009,12,7]],"date-time":"2009-12-07T06:23:11Z","timestamp":1260166991000},"page":"1389-1396","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The effect of hysterectomy or levonorgestrel\u2010releasing intrauterine system on lower abdominal pain and back pain among women treated for menorrhagia: a five\u2010year randomized controlled trial"],"prefix":"10.1111","volume":"88","author":[{"given":"SATU","family":"HELI\u00d6VAARA\u2010PEIPPO","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KAROLIINA","family":"HALMESM\u00c4KI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RITVA","family":"HURSKAINEN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JUHA","family":"TEPERI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SEIJA","family":"GRENMAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AARRE","family":"KIVEL\u00c4","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ERKKI","family":"KUJANSUU","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MARJO","family":"TUPPURAINEN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SIRKKU","family":"VUORMA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MERJA","family":"YLISKOSKI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JORMA","family":"PAAVONEN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,12,31]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"359","article-title":"An epidemiological survey of symptoms of menstrual loss in the community","volume":"54","author":"Shapley M","year":"2004","journal-title":"Br J Gen Pract"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(01)01909-4"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-32434"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.12.1456"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07285-6"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03615-1"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2001-18643"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(02)00329-3"},{"key":"e_1_2_7_10_2","first-page":"CD002126","article-title":"Progesterone or progestogen\u2010releasing intrauterine systems for heavy menstrual bleeding","volume":"4","author":"Lethaby AE","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2007.01.009"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1074-3804(05)60158-2"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(03)00608-3"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh650"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh869"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.12.008"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb11542.x"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000124272.22072.6f"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2007.01552.x"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199404000-00012"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2005.04.005"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000220706.96724.76"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(91)90078-T"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0010-7824(94)90109-0"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)56455-3"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000265161.39932.e8"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.2217\/14750708.3.4.509"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.3109%2F00016340903297150","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.3109\/00016340903297150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T22:53:18Z","timestamp":1697064798000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.3109\/00016340903297150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2009,12]]}},"alternative-id":["10.3109\/00016340903297150"],"URL":"https:\/\/doi.org\/10.3109\/00016340903297150","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12]]},"assertion":[{"value":"2010-12-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}