Efficacy of Combined Levonorgestrel-Releasing Intrauterine System with Gonadotropin-Releasing Hormone Analog for the Treatment of Adenomyosis

Peihai Zhang, Kun Song, Li Li, Kazunori Yukuwa, Beihua Kong
Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2013 · vol. 22(5) , pp. 480–483 · doi:10.1159/000351431 · PMID:23796720 · PMC5586783 · W2066926833
article OA: gold CC0 ⤵ 40 in-corpus citations
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Abstract

OBJECTIVES: To evaluate the clinical outcomes of gonadotropin-releasing hormone analog (GnRHa) combined with implantation of a levonorgestrel-releasing intrauterine system (LNG-IUS) in adenomyosis patients with significantly enlarged uteruses. SUBJECTS AND METHODS: Twenty-one adenomyosis patients whose uterine volumes were greater in size than at 12 weeks' gestation were recruited for the study. Subcutaneous injection of GnRHa was administrated at an interval of 28 days for a total of 3-4 cycles when uterine length was determined to be less than 10 cm by ultrasound measurement. At 3, 6 and 12 months after LNG-IUS implantation, follow-up was performed to document the clinical values such as uterine volume, degree of dysmenorrhea and menstrual flow. RESULTS: Twelve months after implantation, the menstrual flow was significantly lower than baseline values (53.8 ± 11.7 vs. 100, p = 0.03). The degree of dysmenorrhea (pain) was relieved 12 months after implantation (58.2 ± 11.5 vs. 93.7 ± 0.2, p = 0.005). Uterine volume was also below pre-GnRHa levels after implantation (276.6 ± 32.1 vs. 311.4 ± 32.3, p = 0.005). LNG-IUS was expelled in 3 patients, giving an expulsion rate of 14%. Side effects of GnRHa combined with LNG-IUS implantation were few. CONCLUSION: The findings indicate that combined GnRHa and LNG-IUS treatment was efficacious in patients with enlarged adenomyosis.

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Condition tags

dysmenorrheaadenomyosis

MeSH descriptors

Adenomyosis Goserelin Intrauterine Devices, Medicated Levonorgestrel Progestins Adenomyosis Drug Delivery Systems Dysmenorrhea Dysmenorrhea Female Goserelin Goserelin Humans Levonorgestrel Levonorgestrel Organ Size Pain Pain Progestins Progestins

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