title: Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy?
abstract: We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and the patient satisfaction with each technique. No previously reported studies have compared TCRP and LNG-IUD as treatment for HMB in premenopausal women with an endometrial polyp. Likewise, no studies are available on LNG-IUD as a treatment for HMB in the presence of an endometrial polyp. Several studies have found the LNG-IUD to be an effective treatment option for HMB, with high patient satisfaction rates. Evidence of the effectiveness of TCRP as treatment of HMB is scarce. Patient satisfaction is reported relatively good, although persistent or recurrent symptoms appear to be frequent. We conclude that no evidence is available on LNG-IUD as treatment for HMB in women with an endometrial polyp. We hypothesize that LNG-IUD could be a good alternative to TCRP for treating HMB in premenopausal women with a polyp; however, further evidence is needed, and a randomized controlled trial should be performed.
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: m.m.vandijk@amc.uva.nl.
authors.forename: Myrthe M
authors.initials: MM
authors.lastname: van Dijk
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, University of Maastricht, Maastricht, The Netherlands.
authors.forename: Nehalennia
authors.initials: N
authors.lastname: van Hanegem
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Maria E
authors.initials: ME
authors.lastname: de Lange
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Anne
authors.initials: A
authors.lastname: Timmermans
mesh_terms: D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000627:therapeutic use*; D008595:Menorrhagia / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D017060:Patient Satisfaction; D011127:Polyps / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications* / Q000188:drug therapy / Q000601:surgery
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: Endometrial polyp; Heavy menstrual bleeding; Hysteroscopic polypectomy; Levonorgestrel-releasing intrauterine device