In a recent editorial, Miriam Santer highlights what little we know about quality of life and patient satisfaction following treatment for heavy menstrual bleeding. She points in particular to the paucity of relevant data comparing the levonorgestrel-releasing intrauterine system (LNG-IUS or Mirena~R) with other medical treatments. Therefore, we agree that the recommended ranking in recent NICE guidelines, suggesting Mirena coil as the first option for heavy menstrual bleeding, seems premature,

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The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.