Long-term efficacy and safety of levonorgestrel releasing intrauterine system in the treatment of adenomyosis: evidence mapping

Jinghua Shi, Zhiyue Gu, Yushi Wu, Xiaoyan Li, Jing Zhang, Chenyu Zhang, Hailan Yan, Yi Dai, Jinhua Leng
Archives of gynecology and obstetrics · 2024 · vol. 310(1) , pp. 55–67 · doi:10.1007/s00404-024-07546-7 · PMID:38836931 · W4399363674
review OA: closed CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-08 ⓘ

This review maps evidence for levonorgestrel-releasing intrauterine systems in adenomyosis treatment, finding combined GnRH-a and LNG-IUS improved dysmenorrhea and suggesting potential postoperative benefits of LNG-IUS.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This evidence-mapping scoping review assessed studies in MEDLINE, Cochrane Library, EMBASE, and Chinese databases evaluating levonorgestrel-releasing intrauterine system (LNG–IUS) for women with adenomyosis, most often compared against conservative drug regimens or postoperative management strategies. Across 39 comparative studies, the combination of GnRH agonist plus LNG–IUS reduced dysmenorrhea intensity more than LNG–IUS alone at 6 months in patients with an enlarged uterus and moderate-to-severe dysmenorrhea, while postoperative studies (32) reported lower 1-year VAS pain scores with excision plus LNG–IUS versus excision alone. The authors explicitly note the need for large, well-designed studies to confirm efficacy outcomes such as uterine volume at 6 months and to better characterize long-term effects (3 and 5 years), including endometrial thickness, quality of life, and adverse events. This paper is centrally about endometriosis and/or adenomyosis—specifically, it maps evidence on LNG–IUS for adenomyosis treatment and postoperative care.

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Outcome instruments

VAS-pain

Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Dysmenorrhea Dysmenorrhea Dysmenorrhea Dysmenorrhea Dysmenorrhea Intrauterine Devices, Medicated Intrauterine Devices, Medicated Intrauterine Devices, Medicated Intrauterine Devices, Medicated Levonorgestrel Levonorgestrel Levonorgestrel Levonorgestrel Levonorgestrel Contraceptive Agents, Hormonal

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