title: Efficacy of levonorgestrel-releasing intrauterine system versus oral progestins in treatment of simple endometrial hyperplasia without atypia.
abstract: OBJECTIVE
  To evaluate the efficacy of 3 progestin treatment regimens in the management of simple endometrial hyperplasia without cytological atypia in premenopausal women.
  
  
  METHODS
  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 (χ(2) = 6.501; P = .0387).
  
  
  CONCLUSIONS
  The LNG-IUS appears to represent an effective superior convenient treatment option for simple EH without atypia.
authors.affiliation: Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt. drmohamed_taha@yahoo.com
authors.forename: Mohamed Taha
authors.initials: MT
authors.lastname: Ismail
authors.forename: Dalia M
authors.initials: DM
authors.lastname: Fahmy
authors.forename: Nagat S
authors.initials: NS
authors.lastname: Elshmaa
mesh_terms: D000284:Administration, Oral; D000328:Adult; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D004714:Endometrial Hyperplasia / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D011372:Progestins / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D011372:Progestins; D016912:Levonorgestrel