Levonorgestrel‐releasing intrauterine system (Mirena ® ) and Depot medroxyprogesterone acetate (Depoprovera) as long‐term maintenance therapy for patients with moderate and severe endometriosis: A randomised controlled trial

Alice Yuen Kwan Wong, Lawrence Chang Hung Tang, Lawrence C.H. Tang, Robert Chin, Robert Kien Howe Chin
The Australian & New Zealand journal of obstetrics & gynaecology · 2010 · vol. 50(3) , pp. 273–279 · doi:10.1111/j.1479-828x.2010.01152.x · PMID:20618247 · W2100586204
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This randomized trial found that levonorgestrel-releasing intrauterine systems were effective for endometriosis symptom control and recurrence prevention, demonstrating better compliance and bone mineral density maintenance compared to depot medroxyprogesterone acetate over three years.

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Abstract

BACKGROUND: Progestogen therapy has been found to be useful in controlling endometriosis. For patients after conservative surgery, long-term medical maintenance therapy should be sought to prevent recurrence and control symptoms. Levonorgestrel-releasing intrauterine system (LNG-IUS) may be a useful form of prolonged progestogen therapy for endometriosis. AIMS: To evaluate and compare the efficacy and safety of LNG-IUS to depot medroxyprogesterone acetate (MPA) for patients with moderate or severe endometriosis following conservative surgery, in terms of symptoms control, recurrence prevention and patients' acceptance. METHODS: A total of 30 patients after conservative surgery for endometriosis underwent randomisation. Of these patients, 15 received LNG-IUS and 15 had three-monthly depot MPA for three years. Their symptom control, recurrence, compliance and change in bone mineral density (BMD) were compared. The data were analysed using student's t-test and chi-square test. RESULTS: Symptoms and recurrence were controlled by both therapies. The compliance was better in LNG-IUS Group with 13 patients staying on their therapy versus seven patients in Depot MPA Group. LNG-IUS users had a significantly better change in BMD (+0.023, +0.071 g/cm(2)) than Depot MPA users (-0.030, -0.017 g/cm(2)) in both hip and lumbar regions. CONCLUSIONS: Levonorgestrel-releasing intrauterine system was effective in symptom control and prevention of recurrence. LNG-IUS users showed a better compliance. After three years, bone gain was noted with LNG-IUS, but bone loss with depot MPA.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Contraceptive Agents, Female Endometriosis Levonorgestrel Medroxyprogesterone Acetate Adult Contraceptive Agents, Female Endometriosis Endometriosis Female Humans Levonorgestrel Medroxyprogesterone Acetate

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