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Levonorgestrel-releasing intrauterine system use in premenopausal women with symptomatic uterine leiomyoma: a systematic review.

Abstract
A systematic review is done to determine the efficacy and safety of levonorgestrel-releasing intrauterine systems as a treatment using in premenopausal women with symptomatic uterine leiomyoma. We searched the Medline, Central and ICTRP databases for all articles published from inception through July 2013 that examined the following outcomes: uterine volume, uterine leiomyoma volume, endometrial thickness, then menstrual blood loss, blood haemoglobin, ferritin and hematocrit levels, treatment failure rate, device expulsion rate, hysterectomy rate and side effects. From 645 studies, a total of 11 studies met our inclusion criteria with sample sizes ranging from 10 to 104. Evidence suggested that levonorgestrel-releasing intrauterine systems could decrease uterine volume and endometrial thickness, significantly reduce menstrual blood loss, and increase blood haemoglobin, ferritin and hematocrit levels. There was no evidence for decreasing uterine leiomyoma volume. There were no adverse effects on the ovarian function except for ovarian cysts. Device expulsion rates were low, which associated with leiomyoma size (larger than 3cm) but not with leiomyoma location. Irregular bleeding/spotting was observed at the beginning of the follow-up period and then decreased progressively. Results of this systematic review indicate that levonorgestrel-releasing intrauterine systems may be effective and safe treatment for symptomatic uterine leiomyoma in premenopausal women.
AuthorsWenxiao Jiang, Qi Shen, Miaomiao Chen, Ying Wang, Qingfeng Zhou, Xuejie Zhu, Xueqiong Zhu
JournalSteroids (Steroids) Vol. 86 Pg. 69-78 (Aug 2014) ISSN: 1878-5867 [Electronic] United States
PMID24832215 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Antineoplastic Agents, Hormonal
  • Drug Implants
  • Levonorgestrel
Topics
  • Antineoplastic Agents, Hormonal (administration & dosage, therapeutic use)
  • Drug Implants
  • Drug Screening Assays, Antitumor
  • Female
  • Humans
  • Intrauterine Devices, Medicated
  • Leiomyoma (drug therapy, pathology)
  • Levonorgestrel (administration & dosage, therapeutic use)
  • Premenopause
  • Uterine Neoplasms (drug therapy, pathology)
  • Uterus (metabolism)

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