The evaluation of the effectiveness of an intrauterine-administered progestogen (levonorgestrel) in the symptomatic treatment of endometriosis and in the staging of the disease.

Abstract

BACKGROUND:

Medical treatment of endometriosis, a condition which significantly affects the quality of life in approximately 10-15% of women in the reproductive years, remains problematic. Although oral progestogens are effective and cheap, their efficacy is significantly influenced by poor compliance and systemic side effects. A progestogen (levonorgestrel) administered via an intrauterine system (Lng-IUS) has been demonstrated to improve symptoms of endometriosis; however, its effect on the staging of the disease has not been evaluated. The aims of this study were therefore to investigate the effectiveness of Lng-IUS in the symptomatic relief of minimal to moderate endometriosis and in the staging of the disease.

METHODS:

This was a prospective non-comparative observational study in which 34 women with clinically suspected and laparoscopically confirmed symptomatic minimal to moderate endometriosis had Lng-IUS inserted for 6 months. The symptom profile and stage of the disease before, during and after 6 months of treatment and patients' satisfaction with treatment and willingness to retain the device at the end of the study period were used to assess response to treatment.

RESULTS:

Of the 34 women recruited, 29 (85%) completed the study; five discontinued, for personal reasons (one), side effects of worsening of acne (one) and lower abdominal/ pelvic pain (three). Significant (P<0.05) improvements in severity and frequency of pain and menstrual symptoms as well as staging were achieved, with 68% (23) of cases electing to continue with the device after 6 months of therapy.

CONCLUSION:

The levonorgestrel intrauterine system is an effective hormonal option for treating symptomatic endometriosis (minimal to moderate). It also alters the American Fertility Society staging of disease. With a continuation rate of 68% after 6 months, it has the potential for providing long-term therapy in a substantial number of sufferers, although this would require further study and verification.

• Authors: F B Lockhat, J O Emembolu, J C Konje
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 19 Issue 1 Pg. 179-84 (Jan 2004) ISSN: 0268-1161 [Print] England
• PMID: 14688179 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Progestins
• Levonorgestrel

Topics

• Adult
• Cohort Studies
• Endometriosis (drug therapy, pathology, physiopathology)
• Female
• Humans
• Intrauterine Devices, Medicated
• Levonorgestrel (administration & dosage, adverse effects)
• Menstruation Disturbances (physiopathology)
• Palliative Care
• Progestins (administration & dosage, adverse effects)
• Severity of Illness Index
• Treatment Outcome