Dydrogesterone versus levonorgestrel-releasing intrauterine system for abnormal uterine bleeding: a propensity score-matched analysis of long-term efficacy and recurrence

LNG-IUS offers superior short-term bleeding control and sustained long-term recurrence prevention, especially for structural AUB. Dydrogesterone effectively manages nonstructural etiologies but carries higher systemic adverse event rates. Treatment selection should be etiology-guided, balancing immediate symptom control versus recurrence prevention and individualized safety considerations.