Levonorgestrel-releasing intrauterine system (Mirena) in compare to medroxyprogesterone acetate as a therapy for endometrial hyperplasia.

Fariba Behnamfar, Ataollah Ghahiri, Marzieh Tavakoli
In: Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2014 · vol. 19(8) , pp. 686–90 · PMID:25422650 · W2122499756
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

A randomized trial found the levonorgestrel-releasing intrauterine system achieved an 89.3% response rate for endometrial hyperplasia, compared to 70.4% for oral medroxyprogesterone, with fewer cases of progression.

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This randomized controlled trial compared levonorgestrel-releasing intrauterine system insertion versus oral medroxyprogesterone acetate in 60 women with an initial histopathological diagnosis of endometrial hyperplasia, with treatment given for 3 months (12 days per month) followed by endometrial biopsy using pipelle sampling. After 3 months, the response rate was 89.3% in the LNG group versus 70.4% in the medroxyprogesterone group, with persistence rates of 10.7% versus 22.2% and no progression observed in the LNG group compared with 7.4% progression in the medroxyprogesterone group. Although differences favored LNG, the paper reports no statistically significant difference between groups regarding overall response (P = 0.15), and side effects were largely comparable, with hirsutism higher in the medroxyprogesterone group (P = 0.013). This paper is centrally about endometriosis and/or adenomyosis—no, it does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via keyword match for pelvic hormonal disease contexts.

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Abstract

BACKGROUND: This study was designed to evaluate the comparison of insertion of levonorgestrel (LNG)-releasing intrauterine system versus oral medroxyprogesterone acetate on endometrial hyperplasia in a randomized controlled trial. MATERIALS AND METHODS: A total of 60 women with the initial histopathological diagnosis of endometrial hyperplasia in two groups received LNG or medroxyprogesterone (10 mg/d orally) for 12 days a month for 3 months). Endometrial biopsy was obtained for all patients after 3 months of treatment. Response to treatment was defined based on the histopathology of the post treatment pipelle endometrial specimens in three categories of resolution, persistence and progression. RESULTS: Treatment response rate in patients in the LNG group was 89.3% (25 of 28 patients), versus 70.4% (19 of 27 patients) in patients in the medroxyprogesterone group. The rate of persistence was 10.7% (3 of 28 patients) and 22.2% (6 of 27 patients) in LNG and medroxyprogesterone groups respectively. No progression of endometrial hyperplasia observed in any of the patients in LNG group, but progression of endometrial hyperplasia was observed in 7.4% (2 of 27 patients) in the medroxyprogesterone group. There was no statistically significant difference between groups regarding the response to treatment (P = 0.15). Side effects such as bloating, weight gain, fatigue and hair loss were comparable between the groups (P > 0.05). Hirsutism was significantly more in the medroxyprogesterone group than LNG group (P = 0.013). CONCLUSION: Results showed that the use of LNG for treating endometrial hyperplasia for 3 months was associated with high-treatment response rate and the low proportion of patients with progression compared to the use of medroxyprogesterone.
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Journal of Research in Medical Sciences (Jan 2014) Levonorgestrel-releasing intrauterine system (Mirena) in compare to medroxyprogesterone acetate as a therapy for endometrial hyperplasia Abstract Background: This study was designed to evaluate the comparison of insertion of levonorgestrel (LNG)-releasing intrauterine system versus oral medroxyprogesterone acetate on endometrial hyperplasia in a randomized controlled trial. Materials and Methods: A total of 60 women with the initial histopathological diagnosis of endometrial hyperplasia in two groups received LNG or medroxyprogesterone (10 mg/d orally) for 12 days a month for 3 months). Endometrial biopsy was obtained for all patients after 3 months of treatment. Response to treatment was defined based on the histopathology of the post treatment pipelle endometrial specimens in three categories of resolution, persistence and progression. Results: Treatment response rate in patients in the LNG group was 89.3% (25 of 28 patients), versus 70.4% (19 of 27 patients) in patients in the medroxyprogesterone group. The rate of persistence was 10.7% (3 of 28 patients) and 22.2% (6 of 27 patients) in LNG and medroxyprogesterone groups respectively. No progression of endometrial hyperplasia observed in any of the patients in LNG group, but progression of endometrial hyperplasia was observed in 7.4% (2 of 27 patients) in the medroxyprogesterone group. There was no statistically significant difference between groups regarding the response to treatment (P = 0.15). Side effects such as bloating, weight gain, fatigue and hair loss were comparable between the groups (P > 0.05). Hirsutism was significantly more in the medroxyprogesterone group than LNG group (P = 0.013). Conclusion: Results showed that the use of LNG for treating endometrial hyperplasia for 3 months was associated with high-treatment response rate and the low proportion of patients with progression compared to the use of medroxyprogesterone.

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