The aim of this study was to compare the efficacy and effect on the menstrual pattern of the levonorgestrel releasing intrauterine device versus oral progesterone for treatment in patient having simple endometrial hyperplasia (EH) without atypia. Patients who underwent endometrial sampling with abnormal uterine bleeding history and received simple EH without atypia were included in this study between 1 December 2015 and 31 March 2016, retrospectively. Twenty-two patients were treated with the levonorgestrel-releasing intrauterine device (LNG-IUD) and 47 with oral progesterone. Primary outcome measures were regression of hyperplasia after 3 months of therapy. Secondary outcome measures were effect on menstruel pattern during treatment, or rates of hysterectomy and recurrence within a 12 month period. After 3 months of treatment, regression of EH occurred in all of women in LNG-IUD group versus 93% of women in the oral progesterone group (p=0.226). Hb values were increased at the 3th month measurement in both of groups. Endometrial thickness was significantly decreased at the end of the 3th month (p
___
Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87-108.
Lacey JV, Jr, Chia VM. Endometrial hyperplasia and the risk of progression to carcinoma. Maturitas. 2009;63(1):39-44.
Randall TC, Kurman RJ. Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol. 1997;90(3):434-40.
Speroff L, Darney P. A Clinical Guide for Contraception. 5th ed. Philadelphia, PA: Lippincott Williams; 2010.
Wildemeersch D, Dhont M. Management of patients with non-atypical and atypical endometrial hyperplasia with a levonorgestrel-releasing intrauterine system. Am J Obstet Gynecol. 2003;188(5):1297-8.
Scully RE. Definition of precurseus in gynecologic cancer; 1981;48:531–7.
Reed SD, Newton KM, Clinton WL, Epplein M, Garcia R, Allison K, Voigt LF, Weiss NS. Incidence of endometrial hyperplasia. Am J Obstet Gynecol. 2009;200(6):678,1-6.
Epplein M, Reed SD, Voigt LF, Newton KW, Holt VL, Weiss NS. Endometrial hyperplasia risk in relation to characteristics and exposures that influence endogenous hormone levels. Am J Epidemiol. 2008;168(6):563-70.
Clark TJ, Neelakantan D, Gupta JK. The management of endometrial hyperplasia: an evaluation of current practice. Eur J Obstet Gynecol Reprod Biol. 2006;125(2):259-64.
Bese T, Vural A, Ozturk M, Dagistanli F, Demirkiran F, Tuncdemir M, Arvas M, Sanioglu C, Kosebay D. The effect of long-term use of progesterone therapy on proliferation and apoptosis in simple endometrial hyperplasia without atypia. Int J Gynecol Cancer. 2006;16(2):809-13.
Chandra V1,2, Kim JJ3, Benbrook DM1, Dwivedi A2, Rai R4 Therapeutic options for management of endometrial hyperplasia. J Gynecol Oncol. 2016;27(1):8.
Reed SD, Voigt LF, Newton KM, Garcia RH, Allison HK, Epplein M, Jordan D, Swisher E, Weiss NS. Progestin therapy of complex endometrial hyperplasi with and without atypia. Obstet Gynecol. 2009;113(3):655-2.
Ozdegirmenci O, Kayikcioglu F, Bozkurt U, Akgul MA, Haberal A. Comparison of the Efficacy of Three Progestins in the Treatment of Simple Endometrial Hyperplasia without Atypia Gynecol Obstet Invest. 2011;72:10-4
Vereide AB, Arnes M, Straume B, Maltau JM, Orbo A. Nuclear morphometric changes and therapy monitoring in patients with endometrial hyperplasia: a study comparing effects of intrauterine levonorgestrel and systemic medroxyprogesterone. Gynecol Oncol. 2003;91(3):526-33.
Gallos ID, Shehmar M, Thangaratinam S, Papapostolou TK, Coomarasamy A, Gupta JK. Oral progestogens vs levonorgestrel-releasing intrauterine system for endometrial hyperplasia: a systematic review and metaanalysis. Am J Obstet Gynecol. 2010;203(6):547,1-547.e10.
Orbo A, Arnes M, Hancke C, Vereide AB, Pettersen I, Larsen K. Treatment results of endometrial hyperplasia after prospective D-score classification: a follow-up study comparing effect of and oral progestins versus observation only. Gynecol Oncol. 2008;111(1):68-73.
Nilsson CG, Haukkamaa M, Vierola H, Luukkainen T. Tissue concentrations of levonorgestrel in women using a levonorgestrel-releasing IUD. Clin Endocrinol (Oxf). 1982;17(6):529-36.
Lethaby AE, Cooke I, Rees M. Progesterone/progestogen releasing intrauterine systems versus either placebo or any other medication for heavy menstrual bleeding. Cochrane Database Syst Rev. 2000;(2):CD002126.
El Behery MM, Saleh HS, Ibrahiem MA, Kamal EM, Kassem GA, Mohamed Mel S. Levonorgestrel releasing intrauterine device versus dydrogesterone for management of endometrial hyperplasia without atypia. Reprod Sci. 2015;22(3):329-34.