Treatment of endometrial hyperplasia without atypia in peri- and postmenopausal women with a levonorgestrel intrauterine device.
OBJECTIVE
To assess the effectiveness of the Mirena levonorgestrel-releasing intrauterine system (LNG-IUS) in peri- and postmenopausal women with endometrial hyperplasia without atypia.


METHODS
All consecutive women with histologically documented endometrial hyperplasia without atypia recruited during a 1-year period participated in an open, prospective, single-center study. They were followed for at least 2 years after levonorgestrel-releasing intrauterine system insertion. The pattern of uterine bleeding was evaluated on a 4-point qualitative scale (1 = amenorrhea, 2 = scarce, 3 = normal, 4 = abundant).


RESULTS
The study population consisted of 15 women with a mean (SD) age of 49 (2.7) years. Compared with baseline, bleeding decreased quantitatively from a mean score of 3 at baseline (normal bleeding) to 2 (scarce) at 3and 6 months, and 1 (amenorrhea) at 24 months. Endometrial biopsies performed at 12 months revealed atrophicendometrium in 14 women (93.3%) and secretory endometrium in 1 (6.7%) (P < 0.001). At 24 months, endometrial atrophy was documented in 100% of women.


CONCLUSIONS
The levonorgestrel-releasing intrauterine system seems to be an effective and safe alternative in the treatment of peri- and postmenopausal women with (simple) endometrial hyperplasia without atypia.
Haimovich
Sergio
S
Department of Obstetrics and Gynecology, Hospital Universitari del Mar, Autonomous University of Barcelona, Barcelona, Spain.
Checa
Miguel A
MA
Mancebo
Gemma
G
Fusté
Pere
P
Carreras
Ramón
R
D000328:Adult; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D004714:Endometrial Hyperplasia / Q000188:drug therapy*; D004717:Endometrium / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000627:therapeutic use*; D008598:Menstruation / Q000187:drug effects; D008875:Middle Aged; D047648:Perimenopause; D017698:Postmenopause; D011446:Prospective Studies; D013030:Spain; D016896:Treatment Outcome
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel