Endometrial hyperplasia treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens
- VernacularTitle:Умайн салстын хэт зузааралтай эмэгтэйчүүдийг даавар агуулсан ерөндөг болон прогестагенаар эмчилж, судалсан үр дүн
- Author:
Khaliun U
1
;
Munkhtsetseg D
2
;
Bolorchimeg B
2
Author Information
1. The First Maternity Hospital
2. Mongolian National University of Medical Science
- Publication Type:Journal Article
- Keywords:
heavy menstrual bleeding;
endometrial hyperplasia;
LNG-IUD;
oral progestin;
menorrhagia
- From:Innovation
2021;15(1):24-27
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:To investigate relapse rates after the successful treatment of patients with non-atypical endometrial hyperplasia (EH) either a levonorgestrel impregnated intrauterine system
(LNG-IUS; MIRENA®) or two regimens of oral dydrogesterone (DGS) after primary histological
response. Currently, the incidence of EH is indistinctly reported to be around 200,000 new EH cases
per year in Western countries.
Methods:Patients were at their choice assigned to one of the following three treatment arms:
LNG-IUS; 10 mg of oral DGS administered for 10 days per cycle for 6 months; or 10 mg of oral DGS
administered daily for 6 months. The women were followed for 6 months after ending therapy.
[Figure2] Women aged 25-55 years with low or medium risk endometrial hyperplasia met the
inclusion criteria, and 35 completed the therapy.
Results:Histological relapse was observed in 55/ (41%) women who had an initial complete
treatment response. The relapse rates were similar in the three therapy groups (P = 0.66). In our
study involved 25-55 (mean 42.2±1.61) aged 35 women. Among them had reproductive aged
31.43% (n= 11) premenopausal women 42.86 % (n= 15) postmenopausal women 25.71% (n= 9).
Their mean body mass index had 28.8±1.15 kg/m², and normal weight 34.29% (n=12), overweight
34.29% (n=12), obese 17.14% (n=6), extremely obese 14.29 % (n=5). [Figure3] Types of obesity had
normal 37.14% (n=13), android 25.71% (n=9), gynecoid 37.14% (n=13). Mean parity had 1.8±0.19 to
nulliparous 14.29% (n=5), primiparous 60% (n=21), multiparous 25.71% (n=9). Smoke 17.14% (n=6).
Non combined disease had 65.7% (n=23), diabetes mellitus 17.14% (n=6), PCOS 14.29% (n=5),
cardiovascular disease had 2.86% (n=1). [Table1] Mean endometrial thickness of TVUS had (
16.0±0.91mm). Smoke (p=0.0391), types of obesity (p=0.0436) and myoma of the uterus (p=0.0187)
seen affected the endometrial thickness. LNG-IUD group had after treatment’s menstrual period
11.11% heavy 80ml (n=1), 88.89% light 5ml (n=8). DGS (5-25 day) group had after treatment’s
menstrual period 9.09% heavy =80ml (n=1), 90.91% light5ml (n=10), DGS (16-25 day) group after
treatment menstrual period 40% heavy 80ml (n=6), 46.67% normal 5-80ml (n=7), 13.33% light 5ml
(n=2) байв. Therefore between the three treatment groups had no differences. But treatment’s
before and after result had statistics probability differences (P= 0.4064). [Figure4]
Conclusions:Finally, given the long natural history of menorrhagia, study outcomes need to be
assessed over a period that is longer than 2 years. In conclusion, our study showed that both the
LNG-IUD, oral progestin treatment reduced the adverse effect of menorrhagia on women’s lives
over the course of two years. LNG-IUD was the more effective first choice, as assessed impact of
bleeding on the women’s quality of life.
- Full text:Innovation-2021-15(1);24-27.pdf
