Levonorgestrel-impregnated Intrauterine device reduces occurrence of hyperplastic polyps: a population-based follow-up cohort study.
BACKGROUND
The main objective was to investigate if occurrence of hyperplastic polyps was reduced by use of the levonorgestrel-impregnated intrauterine system (LNG-IUS, Mirena®; Bayer) and if the LNG-IUS was more effective compared to oral medroxyprogesterone acetate (MPA) or observation-only.


METHODS
Patients (N=59) with hyperplastic polyps were given LNG-IUS, 10 mg oral MPA taken 10 days per cycle, or had observation-only for six months. Diagnosis of histological specimens was performed by light microscopy according to the WHO classification and D-score prior to and after six months therapy.


RESULTS
No polyps were found in women treated with LNG-IUS (18/18). Five women treated with cyclic MPA (5/20, 25%) and two (2/21, 9%) with observation had normal endometrium without polyps after six months.


CONCLUSIONS
No former study has shown that LNG-IUS is effective at reducing the occurrence of hyperplastic endometrial polyps. The effect is superior to that of oral progestin and observation-only.
Department of Clinical Pathology, University Hospital of North Norway, N-9038 Tromsø, and Research group for Gynaecologic Cancer, Department of Medical Biology, Faculty of Health Sciences, University of Tromsø, N-9037 Tromsø, Norway. anne.orbo@uit.no.
Marit
M
Arnes
Bodil
B
Hvingel
Anne
A
Orbo
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004714:Endometrial Hyperplasia / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged; D011127:Polyps / Q000188:drug therapy*; D014591:Uterine Diseases / Q000188:drug therapy*
D003271:Contraceptive Agents, Female; D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate
Hyperplastic endometrial polyps; intrauterine device; levonorgestrel; progestin therapy