Dual Progestin System (DPS) via levonorgestrel-releasing intrauterine system (LNG-IUS) and etonogestrel subdermal implant (ESI) for severe, refractory endometriosis-associated pain: A retrospective case series report

Cecilia Ng, Moamar Al‐Jefout, Ian Stewart Fraser
In: Journal of Endometriosis and Uterine Disorders · 2025 · vol. 14 , pp. 100150 · doi:10.1016/j.jeud.2025.100150 · W7117725969
article OA: diamond CC0 ⤵ 1 in-corpus citation
🔓 Open OA copy View on OpenAlex View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A dual progestin system combining a levonorgestrel-releasing intrauterine system and an etonogestrel implant significantly reduced severe endometriosis pain for over 85% of patients in a retrospective case series.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

• Dual Progestin System (DPS) using LNG-IUS + ESI provides strong pain relief in severe, refractory endometriosis. • Significant reduction in VAS pain scores observed within 3–6 months, sustained long-term. • DPS offers combined local and systemic progestin exposure to overcome partial progesterone resistance. • High continuation rates and only mild, well-tolerated side effects reported. • Represents a promising alternative to repeated surgery and hypoestrogenic GnRH therapies. To evaluate the clinical effectiveness of a dual progestogen-delivery system (DPS) using a levonorgestrel-releasing intrauterine system (LNG-IUS) combined with an etonogestrel subdermal implant (ESI) in women with severe, refractory endometriosis-associated pelvic pain. A retrospective analysis of 105 patients treated with simultaneous LNG-IUS and ESI for durations ranging from 24 to 102 months. Tertiary referral centers and university-affiliated hospitals. Women with surgically confirmed endometriosis and persistent pelvic pain unresponsive to standard care (medical and/or surgical management). Pain relief (measured by VAS), continuation rates, treatment duration, and reported adverse events. The mean treatment duration was 28.1 months. Significant pain reduction was reported in 85% of patients, with VAS scores decreasing from a baseline mean of 9/10 to 3/10 (SD ± 1.04) by 3 months, and to minimal or no pain by 6 months. Most patients (n = 90/105, 85%) sustained symptom relief throughout therapy. Mild adverse effects were reported in 50% of patients, though primarily mild and non-disruptive. The DPS represents a promising, alternative, long-term therapeutic option for managing severe, refractory endometriosis-related pain, offering both uterine and systemic suppression of endometriotic activity.

My notes (saved in your browser only)

Outcome instruments

VAS-pain

Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (23)

Cited by (1)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK