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Cited by 166Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementGynecological conditions and treatments

The efficacy, side-effects and continuation rates in women with symptomatic endometriosis undergoing treatment with an intra-uterine administered progestogen (levonorgestrel): a 3 year follow-up

Lockhat, Farhana B., Emembolu, Joseph O., Konje, Justin C.·2005·Human Reproduction
DOI 10.1093/humrep/deh650
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Abstract

BACKGROUND: Side-effects and choice of drugs influence compliance during treatment for endometriosis. Progestogen administered by a device with a 5-year lifespan, has been shown to be an effective medical alternative with several advantages. The aims of this study were to investigate its efficacy, continuation rates and side-effects in women with endometriosis over a 3-year period. METHODS: Thirty-four women with laparoscopically confirmed minimal to moderate symptomatic endometriosis offered insertion of an intrauterine device at diagnostic laparoscopy were followed up at 1, 3 and 6 months, and then every 6 months for 3 years. A symptom diary for side-effects, documentation of symptoms on a visual analogue scale (VAS), a verbal rating scale (VRS) and quantified menstrual loss using the pictorial blood loss chart was used to assess response to treatment. RESULTS: The continuation rates were respectively 85%, 68%, 62% and 56% at, 6, 12, 24 and 36 months. Discontinuation rates were highest at <12 months, and most of these were for irregular and intolerable bleeding and persistent pain. An improvement in symptoms was observed throughout the 36 months. The greatest changes in pain assessed by either the VAS or VRS were between the pretreatment scores and those after 12 months (7.7 +/- 1.3 versus 3.5 +/- 1.8 for VAS, P < 0.001; and 25 +/- 13.8 versus 14 +/- 9.4 for VRS, P < 0.002). The monthly quantified blood loss fell from 204 (196) pretreatment to 60 (50) at 12 months (P < 0.001) and then to 70 (30) after 36 months. The most common side-effects were bleeding irregularities (14.7%), one-sided abdominal pain (11.8%) and weight gain (8.8%). CONCLUSIONS: Intrauterine progestogen is effective in symptom control throughout the 3 years on the device, and discontinuation is greatest between 3 and 6 months. For those patients with improvement in symptoms, it is an acceptable long-term alternative.

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  • A retrospective study showed that LNG-IUS provided symptom control throughout a 3-year study period.

    “The long-term efficacy of LNG-IUS in the management of endometriosis has been evaluated in a retrospective study [85], that showed the ability of the device in providing symptoms control throughout a 3-year study period.”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [85]

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Authors
Lockhat, F. B., Emembolu, J. O., & Konje, J. C.
Affiliations
Leicester Royal Infirmary (GB)
Corresponding author
Lockhat, Farhana B.
ORCID
Konje, Justin C.
Venue
Human Reproduction
Publisher
Oxford University Press (OUP)
Published
2005-03-01
Volume
20
Issue
3
Pages
789-793
ISSN
  • 0268-1161 (ISSN-L)
  • 1460-2350
DOI
10.1093/humrep/deh650
OpenAlex
W2147299801
Cited by
166
References
34
Citations by year
2026: 3 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 9 · 2018: 10 · 2017: 6 · 2016: 2 · 2015: 8 · 2014: 10 · 2013: 6 · 2012: 10
FWCI
9.42
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction (publishedVersion)
  • PubMed (publishedVersion)
  • Leicester Research Archive (University of Leicester) (submittedVersion)
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 › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords
levonorgestrel, long-term treatment efficacy, treatment continuation rate, treatment side effects, dysmenorrhea, menstrual blood loss, irregular bleeding, abdominal pain, weight gain, medication adherence
MeSH terms
Adult, Endometriosis, Female, Follow-Up Studies, Humans, Intrauterine Devices, Medicated, Pain Measurement, Progestins, Treatment Outcome, Levonorgestrel, Pelvic Pain

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