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Cited by 134Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementMenstrual Health and Disorders

Postoperative medical treatment of chronic pelvic pain related to severe endometriosis: levonorgestrel-releasing intrauterine system versus gonadotropin-releasing hormone analogue

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Bayoglu Tekin, Yesim, Dilbaz, Berna, Altinbas, Sadiman Kiykac, Dilbaz, Serdar·2011·Fertility and Sterility
DOI 10.1016/j.fertnstert.2010.08.042
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Abstract

Objective To compare efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena) with depot GnRH analogue (GnRH-a; gosareline acetate; Zoladex) on endometriosis-related chronic pelvic pain (CPP) in patients with severe endometriosis during 12 months.Design Prospective, randomized, controlled study.Setting The reproductive endocrinology unit of a tertiary, research and education hospital.Patient(s) Forty women with severe endometriosis (revised The American Fertility Society [AFS] classification >40) and endometriosis-related CPP and control groups were enrolled in the study.Intervention(s) The patients were treated with either LNG-IUS (n = 20) or GnRH-a (n = 20). The GnRH-a dose was repeated every 4 weeks for 24 weeks.Main outcome measure(s) Scores of CPP were evaluated using a visual analogue scale (VAS) and total endometriosis severity profile (TESP).Result(s) The TESP score decreased in the LNG-IUS group at first, third, and sixth month follow-up visits, whereas at the 12th month follow-up visit, the TESP scores were increased to values similar to pretreatment values. Although the VAS score had no significant alteration during the follow-up period in the LNG-IUS group, the GnRH-a group showed a significant decrease in the VAS score and TESP score at the end of 1 year. The LNG-IUS treatment showed a lower patient satisfaction.Conclusion(s) Both treatment modalities showed comparable effectiveness in the treatment of CPP-related endometriosis.

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  • LNG-IUS use after surgery is associated with a significantly lower dysmenorrhea recurrence rate compared to expectant management.

    “In fact, LNG-IUS use after surgery was associated with a significantly lower dysmenorrhea recurrence rate compared to with expectant management [231–233].”

    From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [232]

    The Discussion’s Table 2 summarizes a postoperative study comparing LNG-IUS with expectant management and reports a reduced risk of dysmenorrhea. It does not state that the difference in dysmenorrhea recurrence was statistically significant; its separate finding of lower disease recurrence does not establish that point. (LLM, conf=0.85)

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Research works printed but not linked: 5

  1. [5]5. Silverberg SG, Haukkamaa M, Arko H, Nilsson CG, Luukkainen T. Endometrial morphometry of women during long term use of levonorgestrel intrauterine system. Int Gynaecol Pathol 1986;5:235-41.
  2. [6]6. Maruo T, Laoag-Fernandez JB, Pakarinen P, Murakoshi H, Spitz IM, Johansson E. Use of a levo- norgestrel intrauterine system on proliferation and apoptosis in the endometrium. Hum Reprod 2001;16:2103-8.
  3. [8]8. Wildemeersch D, Rowe PJ. Assesment of menstrual blood loss in women with idiopathic menorrhagia us- ing the frameless levonorgestrel-releasing intrauter- ine system. Contraception 2004;70:165-8.
  4. [9]9. Fedele L, Bianchi S, Zanconato G, Portuese A, Raffaelli R. Use of a levonorgestrelreleasing intra- uterine device in the treatment of rectovaginal endo- metriosis. Fertil Steril 2001;75:485-8.
  5. [14]14. Lockhat FB, Emembolu JO, Konje JC. The evalua- tion of the effectiveness of intrauterine adminis- tered progesterone (levonorgestrel) in the symptomatic treatment of endometriosis and in the staging of the disease. Hum Reprod 2004;19: 179-84.

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Authors
Bayoglu Tekin, Y., Dilbaz, B., Altinbas, S. K., & Dilbaz, S.
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2011-02
Volume
95
Issue
2
Pages
492-496
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2010.08.042
OpenAlex
W2131027406
Cited by
133
References
29
Citations by year
2026: 5 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 7 · 2019: 6 · 2018: 13 · 2017: 18 · 2016: 8 · 2015: 14 · 2014: 12 · 2013: 15 · 2012: 5
FWCI
8.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Keywords
endometriosis, chronic pelvic pain, levonorgestrel-releasing intrauterine system, GnRH analogues, goserelin, endometriosis severity, patient satisfaction
MeSH terms
Adult, Chronic Disease, Delayed-Action Preparations, Endometriosis, Female, Fertility Agents, Female, Follow-Up Studies, Humans, Intrauterine Devices, Medicated, Gonadotropin-Releasing Hormone, Pain, Postoperative, Postoperative Pain, Gynecologic Surgical Procedures, Uterine Diseases, Treatment Outcome, Levonorgestrel, Goserelin, Pelvic Pain

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