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Efficacy of Levonorgestrel-Releasing Intrauterine System Versus Oral Progestins in Treatment of Simple Endometrial Hyperplasia Without Atypia

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Abstract

Objective

To evaluate the efficacy of 3 progestin treatment regimens in the management of simple endometrial hyperplasia without cytological atypia in premenopausal women.

Study Design

Prospective randomized comparative study. The study included 90 premenopausal women with histological diagnosis of simple endometrial hyperplasia (EH) without atypia, during the period from January 2010 to March 2012, at TAIBA Hospital in Kuwait. Patients were randomly allocated to 3 groups of 30 patients each receiving medroxyprogesterone acetate (MPA, 10 mg/d; group I), norethisterone (NET, 15 mg/d; group II) for 10 days per cycle, or insertion of levonorgestrel-releasing intrauterine system (LNG-IUS; group III). Patients were reevaluated after 3 months of treatment. Patients with regression and persistence were offered the same medication they were using for another 3 months. The primary outcome of the study was the proportion of patients requiring further treatment for another 3 months.

Results

Patients in the LNG-IUS group showed the highest resolution rate (66.67%). Patients in MPA group had a resolution rate of 36.66% where the resolution rate was 40% in patients of NET group. The patients having LNG-IUS showed a regression rate of 33.3%, whereas patients receiving MPA and NET showed a regression rate of 60% and 56.67%, respectively. There was a statistically significant difference between the 3 groups regarding the proportion of patients requiring further treatment for another 3 months (χ2 = 6.501; P = .0387).

Conclusion

The LNG-IUS appears to represent an effective superior convenient treatment option for simple EH without atypia.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt

    Mohamed Taha Ismail MD

  2. Department of Radiology, Mansoura University, Mansoura, Egypt

    Dalia M. Fahmy MD

  3. Department of Anesthesiology, Tanta University, Tanta, Egypt

    Nagat S. Elshmaa MD

Authors
  1. Mohamed Taha Ismail MD
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  2. Dalia M. Fahmy MD
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  3. Nagat S. Elshmaa MD
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Correspondence to Mohamed Taha Ismail MD.

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Ismail, M.T., Fahmy, D.M. & Elshmaa, N.S. Efficacy of Levonorgestrel-Releasing Intrauterine System Versus Oral Progestins in Treatment of Simple Endometrial Hyperplasia Without Atypia. Reprod. Sci. 20, 45–50 (2013). https://doi.org/10.1177/1933719112459243

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