Vaginal micronized progesterone versus the levonorgestrel‐releasing intrauterine system for treatment of non‐atypical endometrial hyperplasia: A randomized controlled trial

Şener Gezer, Emre Köle, Lale Aksoy
In: International Journal of Gynecology & Obstetrics · 2022 · vol. 161(2) , pp. 661–666 · doi:10.1002/ijgo.14632 · PMID:36527262 · W4311823872
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Vaginal micronized progesterone and the levonorgestrel-releasing intrauterine system demonstrated similar regression rates for non-atypical endometrial hyperplasia, with progesterone showing a slight advantage in reducing perceived blood loss.

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Abstract

OBJECTIVE: To compare the efficiency of vaginal micronized progesterone (VMP) with the levonorgestrel-releasing intrauterine system (LNG-IUS) in patients with non-atypical endometrial hyperplasia. A validated Menorrhagia Impact Questionnaire (MIQ) was used to assess the quality of life before and after the procedure. METHODS: In this prospective trial, 144 women were randomly assigned to the VMP or LNG-IUS group. The primary endpoint was the regression rate of endometrial hyperplasia after 3 months of treatment. The protocol was approved by the institutional ethics committee and registered at ClinicalTrials.gov (NCT03992937). RESULTS: In all, 138 patients were analyzed. The regression rate was not significantly different between the groups (95.8% with LNG-IUS vs. 90.8% with VMP; P = 0.194). Differences between pre- and post-treatment MIQ scores were similar, except that better scores were obtained in the VMP group for the perception of the amount of blood loss (P = 0.035). CONCLUSION: VMP is as effective as the LNG-IUS as a local treatment of endometrial hyperplasia without atypia. TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT03992937.

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