title: Analysis of the levonorgestrel-releasing intrauterine system in women with endometriosis.
abstract: OBJECTIVE
  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.
authors: Department of Obstetrics and Gynaecology, The Red Cross Hospital of Hangzhou, Huanchengdonglu 208, Hangzhou 31003, China. shenlan_xcn@hotmail.com
authors: Shen
authors: S
authors: Lan
authors: Liu
authors: L
authors: Ling
authors: Zhao
authors: Z
authors: Jianhong
authors: Jiang
authors: J
authors: Xijing
authors: Wang
authors: W
authors: Lihui
mesh_terms: D018394:CA-125 Antigen / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D016206:Databases, Bibliographic; D004715:Endometriosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000627:therapeutic use*; D008565:Membrane Proteins / Q000097:blood; D010147:Pain Measurement; D017697:Premenopause; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D018394:CA-125 Antigen; D008078:Cholesterol, LDL; D003271:Contraceptive Agents, Female; C451759:MUC16 protein, human; D008565:Membrane Proteins; D007987:Gonadotropin-Releasing Hormone; D016912:Levonorgestrel
keywords: Endometriosis; gonadotropin-releasing hormone analogue; levonorgestrel-releasing intrauterine system; meta-analysis