title: LNG-IUS treatment of non-atypical endometrial hyperplasia in perimenopausal women: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) and oral norethisterone acetate (NET) for treatment of non-atypical endometrial hyperplasia in perimenopausal women.
  
  
  METHODS
  One hundred and twenty perimenopausal women with non-atypical endometrial hyperplasia were selected in this randomized controlled trial. Patients received LNG-IUS (n=59) or NET (n=61; 15 mg/day for 3 weeks/cycle) for 3-6 months. Outpatient follow-up with endometrial biopsies were undertaken at 3, 6, and 12 months intervals after treatment. Outcome measures were; the regression rate, the time to regression and hysterectomy rate.
  
  
  RESULTS
  A significantly higher regression rate was noted in the LNG-IUS group than in NET group at the 3rd, 6th and 12th month follow-up visits using intention-to-treat analysis (67.8% vs. 47.5%, relative risk [RR], 1.42; 79.7% vs. 60.7%, RR, 1.31; and 88.1% vs. 55.7%, RR, 1.58, respectively). However, no significant difference was found regarding the median time to regression (3 months). The hysterectomy rate during the follow-up period was significantly higher in the NET group (57.4% vs.22%, p<0.001).
  
  
  CONCLUSIONS
  LNG-IUS treatment of non-atypical endometrial hyperplasia in perimenopausal women is more effective than NET for achieving disease regression for the majority within 1 year. Moreover, it can reduce the number of hysterectomies performed.
authors: Department of Obstetrics and Gynecology, Mansoura University, Faculty of Medicine, Mansoura, Egypt.
authors: Hatem
authors: H
authors: Abu Hashim
authors: Abdelhady
authors: A
authors: Zayed
authors: Essam
authors: E
authors: Ghayaty
authors: Mohamed
authors: M
authors: El Rakhawy
keywords: Abnormal uterine bleeding; Endometrial hyperplasia; Levonorgestrel-releasing intrauterine system; Non-atypical; Norethisterone acetate
references: Contraception. 2008 Jan;77(1):22-9
references: 18082662
references: Anticancer Res. 2012 Mar;32(3):1037-43
references: 22399629
references: Fertil Steril. 2002 Sep;78(3):628-31
references: 12215345
references: Contraception. 2007 Jun;75(6 Suppl):S93-8
references: 17531624
references: Gynecol Oncol. 2012 May;125(2):477-82
references: 22245711
references: Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):176-9
references: 21741152
references: Acta Obstet Gynecol Scand. 2010 Nov;89(11):1438-46
references: 20955098
references: Br J Obstet Gynaecol. 1977 Oct;84(10):763-8
references: 921913
references: Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):305-7
references: 21658836
references: J Gynecol Oncol. 2010 Jun;21(2):102-5
references: 20613900
references: Int J Gynecol Cancer. 2006 Mar-Apr;16(2):809-13
references: 16681766
references: J Clin Pathol. 2003 Apr;56(4):305-7
references: 12663645
references: Clin Endocrinol (Oxf). 1982 Dec;17(6):529-36
references: 6819901
references: Best Pract Res Clin Obstet Gynaecol. 2001 Jun;15(3):393-405
references: 11476561
references: Contraception. 2012 Mar;85(3):224-34
references: 22067761
references: Cancer. 2006 Feb 15;106(4):812-9
references: 16400639
references: Int J Gynecol Cancer. 2004 Mar-Apr;14(2):348-53
references: 15086736
references: Cancer. 1985 Jul 15;56(2):403-12
references: 4005805
references: Am J Obstet Gynecol. 2010 Dec;203(6):547.e1-10
references: 20934679
references: Gynecol Oncol. 2008 Oct;111(1):68-73
references: 18684496
references: J Minim Invasive Gynecol. 2012 Jan-Feb;19(1):3-10
references: 22196255
references: Am J Obstet Gynecol. 1989 Jan;160(1):126-31
references: 2912075
references: Obstet Gynecol Clin North Am. 2007 Dec;34(4):717-37, ix
references: 18061866
references: Gynecol Obstet Invest. 2012;73(1):38-42
references: 22056948
references: Am J Obstet Gynecol. 2009 Jun;200(6):678.e1-6
references: 19393600
references: Minerva Ginecol. 2010 Oct;62(5):433-45
references: 20938428
references: Menopause. 2008 Sep-Oct;15(5):1002-4
references: 18451744
references: Contraception. 2009 Apr;79(4):247-58
references: 19272494
references: Obstet Gynecol Surv. 2004 May;59(5):368-78
references: 15097798
references: Arch Gynecol Obstet. 2012 Nov;286(5):1277-82
references: 22766754
references: Eur J Gynaecol Oncol. 2000;21(2):131-4
references: 10843470
references: Maturitas. 2009 May 20;63(1):39-44
references: 19285814
references: Obstet Gynecol. 2009 Mar;113(3):655-662
references: 19300331
references: Eur J Obstet Gynecol Reprod Biol. 2008 Aug;139(2):169-75
references: 18440693
references: Jpn J Clin Oncol. 2011 Jun;41(6):817-9
references: 21478178
references: Obstet Gynecol. 2012 Nov;120(5):1160-75
references: 23090535