Analysis of the levonorgestrel-releasing intrauterine system in women with endometriosis

Shen Lan, Lan Shen, Liu Ling, Zhao Jianhong, Jianhong Zhao, Xijing Jiang, Jiang Xijing, Lihui Wang, Wang Lihui
The Journal of international medical research · 2013 · vol. 41(3) , pp. 548–558 · doi:10.1177/0300060513479865 · PMID:23660087 · W2153360804
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Both levonorgestrel-releasing intrauterine systems and GnRH analogues reduced pain and endometriosis severity, with the LNG-IUS showing potential advantages and reducing LDL cholesterol.

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Abstract

OBJECTIVES: To compare the efficacy, safety and other clinical benefits of the levonorgestrel-releasing intrauterine system (LNG-IUS) and gonadotropin-releasing hormone analogues (GnRH-a) in women with endometriosis. METHODS: A systematic search was carried out using the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE™ and EMBASE databases for all randomized controlled trials (RCTs) that evaluated the use of the LNG-IUS and GnRH-a in premenopausal women with endometriosis. RESULTS: Five RCTs studies were identified. A meta-analysis showed that, in women with endometriosis, both the LNG-IUS and GnRH-a reduced pain visual analogue scale scores (weighted mean difference [WMD] 0.03 [95% confidence interval [CI] -0.53, 0.59]), serum levels of CA125 (WMD -12.29 [95% CI -29.90, 3.32]), and American Society of Reproductive Medicine staging scores (WMD 1.10 [95% CI -27.98, 30.18]). Psychological and general wellbeing index scores were increased (WMD 1.50 [95% CI -6.19, 9.19]). Levels of low-density lipoprotein cholesterol were also significantly reduced in patients treated with the LNG-IUS (WMD 39.30 [95% CI 6.74, 71.86]). CONCLUSIONS: The LNG-IUS had clinical efficacy equivalent to that of GnRH-a but may have some clinical advantages over GnRH-a in the treatment of endometriosis-associated symptoms. These observations will require further verification in additional studies employing larger patient populations.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Contraceptive Agents, Female Endometriosis Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Intrauterine Devices, Medicated Levonorgestrel CA-125 Antigen CA-125 Antigen Cholesterol, LDL Cholesterol, LDL Contraceptive Agents, Female Databases, Bibliographic Endometriosis Endometriosis Endometriosis Female Gonadotropin-Releasing Hormone Humans Levonorgestrel Membrane Proteins

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (49)

Cited by (32)

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