Efficacy of levonorgestrel releasing intrauterine system as a postoperative maintenance therapy of endometriosis: A meta-analysis
Systematic review / meta-analysis
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This meta-analysis evaluated the efficacy of levonorgestrel-releasing intrauterine systems in maintaining the postoperative treatment of endometriosis.
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Abstract
OBJECTIVE: To compare the efficacy of levonorgestrel releasing intrauterine system (LNG-IUS) with other treatments as a postoperative maintenance therapy for endometriosis in terms of pain reduction, recurrence prevention, side effects and patients' satisfaction.
STUDY DESIGN: We searched MEDLINE, EMBASE, and the Cochrane Library from January 1986 until February 2018. Two evaluators independently extracted and reviewed prospective and retrospective articles based on pre-determined selection criteria. Outcomes were expressed as mean difference (MD), risk ratios (RR) or odds ratios (OR) in a meta-analysis model, using Revman software.
RESULTS: Among the 962 studies, 7 studies were selected: 7 studies included 4 randomized controlled trials with 212 patients, 1 prospective cohort study with 88 patients, and 2 retrospective studies with 191 patients. A meta-analysis showed that LNG-IUS was significantly effective in reducing pain after surgery (MD = 12.97, 95% confidence interval (CI): 5.55-20.39), with a comparable effect to gonadotropin-releasing hormone analogues (MD = -0.16, 95% CI: -2.02 to 1.70). LNG-IUS was also effective in decreasing the recurrence rate (RR = 0.40, 95% CI: 0.26-0.64), with an effect comparable to OC (OR = 1.00, 95% CI: 0.25-4.02) and danazol (RR = 0.30, 95% CI: 0.03-2.81). Furthermore, patients' satisfaction with LNG-IUS was significantly higher than that with OC (OR = 8.60, 95% CI: 1.03-71.86). However, vaginal bleeding was significantly higher in the LNG-IUS group than in the gonadotropin-releasing hormone analogue group (RR = 27.0, 95% CI: 1.71-425.36).
CONCLUSION: Our meta-analysis found a positive effect of LNG-IUS as a postoperative maintenance therapy for endometriosis on pain relief, prevention of dysmenorrhea recurrence, and patients' satisfaction.
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Cited by (15)
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- Clinical Guidance Paper VVOG: Pharmacological treatment of endometriosis-related pain 2025
- Safety of current strategies to manage moderate to severe pain in patients with endometriosis 2025
- Levonorgestrel-Releasing Intrauterine Device: An Effective Treatment for Symptoms of Persistent Pelvic Pain 2025
- Safety and efficacy of pharmacotherapies for pelvic inflammatory disease and endometriosis 2024
- Thai Interest Group for Endometriosis (TIGE) consensus statement on endometriosis-associated pain 2022
- Clinical practice guidelines for endometriosis in Japan (The 3rd edition) 2022
- Treatment of endometriosis: a review with comparison of 8 guidelines 2021
- Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment 2021
- The recurrence rate of ovarian endometrioma in women aged 40-49 years and impact of hormonal treatment after conservative surgery 2020
- Endometriosis: Diagnosis and treatment 2019
- Endometriosis: Diagnosis and treatment 2019
- Intrauterine Devices: Effective Contraception with Noncontraceptive Benefits for Adolescents 2019
- Is Scientific Medical Literature Related to Endometriosis Treatment Evidence-Based? A Systematic Review on Methodological Quality of Randomized Clinical Trials 2019
- EFFICIENCY OF MEDICATION THERAPY IN THE COMPLEX TREATMENT OF ENDOMETRIOSIS: RETROSPECTIVE ANALYSIS OF DATA 2019
Source provenance
- europepmc
- last seen: 2026-10-17T06:09:56.316927+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-08T21:23:18.497579+00:00
- unpaywall
- last seen: 2026-10-17T06:24:38.187582+00:00
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