Levonorgestrel-releasing intrauterine device versus dydrogesterone for management of endometrial hyperplasia without atypia.

Abstract

OBJECTIVE:

To compare the efficacy and safety of the levonorgestrel-releasing intrauterine device (LNG-IUD) with dydrogesterone applied for the same duration in patients having endometrial hyperplasia (EH) without atypia.

MATERIALS AND METHODS:

One hundred thirty eight women aged between 30 and 50 years with abnormal uterine bleeding and diagnosed as EH by transvaginal ultrasound were randomized to receive either LNG-IUD or dydrogesterone for 6 months. Primary outcome measures were regression of hyperplasia after 6 months of therapy. Secondary outcome measures were occurrence of side effects during treatment or recurrence of hyperplasia during follow-up period.

RESULTS:

After 6 months of treatment, regression of EH occurs in 96% of women in the levonorgestrel-releasing intrauterine system (LNG-IUS) group versus 80% of women in the oral group (P < .001). Adverse effects were relatively common with minimal differences between the 2 groups. Intermenstrual vaginal spotting and amenorrhea were more common in the LNG-IUD group (P value .01 and .0001). Patient satisfaction was significantly higher in the LNG-IUS group (P value .0001). Hysterectomy rates were lower in the LNG-IUS group than in the oral group (P = .001). Recurrence rate was 0% in the LNG-IUD group compared to 12.5% in the oral group.

CONCLUSION:

In management of EH without atypia, LNG-IUS achieves a higher regression and a lower hysterectomy rate than oral progesterone and could be used as a first-line therapy.

• Authors: Manal M El Behery, Hend S Saleh, Moustafa A Ibrahiem, Ebtesam M Kamal, Gamal A Kassem, Mohamed El Sayed Mohamed
• Journal: Reproductive sciences (Thousand Oaks, Calif.) (Reprod Sci) Vol. 22 Issue 3 Pg. 329-34 (Mar 2015) ISSN: 1933-7205 [Electronic] United States
• PMID: 25001020 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: © The Author(s) 2014.

Chemical References

• Levonorgestrel
• Dydrogesterone

Topics

• Administration, Oral
• Adult
• Dydrogesterone (administration & dosage, adverse effects)
• Egypt
• Endometrial Hyperplasia (diagnosis, drug therapy)
• Endometrium (diagnostic imaging, drug effects)
• Female
• Humans
• Hysterectomy
• Intrauterine Devices, Medicated (adverse effects)
• Levonorgestrel (administration & dosage, adverse effects)
• Middle Aged
• Patient Satisfaction
• Recurrence
• Remission Induction
• Time Factors
• Treatment Outcome
• Ultrasonography