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Cited by 82Endometriosis Research and TreatmentReproductive Health and ContraceptionEctopic Pregnancy Diagnosis and Management

Levonorgestrel‐releasing intrauterine system (Mirena ® ) and Depot medroxyprogesterone acetate (Depoprovera) as long‐term maintenance therapy for patients with moderate and severe endometriosis: A randomised controlled trial

WONG, Alice Yuen Kwan, TANG, Lawrence Chang Hung, CHIN, Robert Kien Howe·2010·Australian and New Zealand Journal of Obstetrics and Gynaecology
DOI 10.1111/j.1479-828x.2010.01152.x
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Abstract

Background: Progestogen therapy has been found to be useful in controlling endometriosis. For patients after conservative surgery, long‐term medical maintenance therapy should be sought to prevent recurrence and control symptoms. Levonorgestrel‐releasing intrauterine system (LNG‐IUS) may be a useful form of prolonged progestogen therapy for endometriosis. Aims: To evaluate and compare the efficacy and safety of LNG‐IUS to depot medroxyprogesterone acetate (MPA) for patients with moderate or severe endometriosis following conservative surgery, in terms of symptoms control, recurrence prevention and patients’ acceptance. Methods: A total of 30 patients after conservative surgery for endometriosis underwent randomisation. Of these patients, 15 received LNG‐IUS and 15 had three‐monthly depot MPA for three years. Their symptom control, recurrence, compliance and change in bone mineral density (BMD) were compared. The data were analysed using student’s t ‐test and chi‐square test. Results: Symptoms and recurrence were controlled by both therapies. The compliance was better in LNG‐IUS Group with 13 patients staying on their therapy versus seven patients in Depot MPA Group. LNG‐IUS users had a significantly better change in BMD (+0.023, +0.071 g/cm 2 ) than Depot MPA users (−0.030, −0.017 g/cm 2 ) in both hip and lumbar regions. Conclusions: Levonorgestrel‐releasing intrauterine system was effective in symptom control and prevention of recurrence. LNG‐IUS users showed a better compliance. After three years, bone gain was noted with LNG‐IUS, but bone loss with depot MPA.

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Crossref · 10.1111/j.1479-828x.2010.01152.x

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  • In a RCT of 30 patients after conservative surgery for endometriosis, intramuscular DMPA and LNG-IUS were both effective in management of pain symptoms through three years; no recurrences of lesions detected at transvaginal ultrasound in both groups.

    “Both treatments were effective in the management of pain symptoms through the study period.”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [52]

  • In that RCT, drop-out rate was higher in DMPA group (53% vs 13%).

    “The drop-out rate was higher in DMPA group (53% versus 13%).”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [52]

  • In the RCT of Wong et al., no endometrioma recurrences were identified.

    “In the RCT of Wong et al. [52] no recurrences were identified; however, the sample size was small ( n =15) and the number of patients that continued the study throughout the whole followup period was even minor ( n = 13).”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [52]

  • An RCT comparing LNG-IUS with DMPA for 36 months in patients with moderate and severe endometriosis found results in line with the retrospective study.

    “These results are in line with those obtained in a RCT [52] that compared LNG-IUS with DMPA in the long-term treatment (36 months) of patients with moderate and severe endometriosis.”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [52]

  • In the RCT of Wong et al., the sample size was small (n=15) and the number of patients who continued throughout the whole follow-up period was even smaller (n=13).

    “In the RCT of Wong et al. [52] no recurrences were identified; however, the sample size was small ( n =15) and the number of patients that continued the study throughout the whole followup period was even minor ( n = 13).”

    From Oral and depot progestin therapy for endometriosis: towards a personalized medicine (2017) · cites this paper as [52]

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Authors
WONG, A. Y. K., TANG, L. C. H., & CHIN, R. K. H.
Affiliations
Kwong Wah Hospital (CN)
Corresponding author
WONG, Alice Yuen Kwan
Venue
Australian and New Zealand Journal of Obstetrics and Gynaecology
Publisher
Wiley
Published
2010-06
Volume
50
Issue
3
Pages
273-279
ISSN
  • 0004-8666 (ISSN-L)
  • 1479-828X
DOI
10.1111/j.1479-828x.2010.01152.x
OpenAlex
W2100586204
Cited by
82
References
30
Citations by year
2026: 3 · 2025: 5 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 9 · 2017: 6 · 2016: 8 · 2015: 6 · 2014: 4 · 2013: 6 · 2012: 5
FWCI
6.44
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Australian and New Zealand Journal of Obstetrics and Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
endometriosis, levonorgestrel-releasing intrauterine system, depot medroxyprogesterone acetate, progestin therapy, conservative surgery, recurrence prevention, symptom management, medication adherence, bone mineral density, bone loss
MeSH terms
Adult, Contraceptive Agents, Female, Endometriosis, Female, Humans, Levonorgestrel, Medroxyprogesterone Acetate

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