Levonorgestrel-releasing intrauterine system compared to low dose combined oral contraceptive pills for idiopathic menorrhagia: a randomized clinical trial

Shabaan, Mamdouh M.; Zakherah, Mahmoud S.; El-Nashar, Sherif A.; Sayed, Gamal

doi:10.1016/j.contraception.2010.06.011

Cited by 100 publications

(80 citation statements)

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“…9 In another 1 year follow up study by Shaban et al comparing LNG-IUS with low dose OCP for idiopathic menorrhagia reported a reduction of 86.6±17% in PBAC scores. 10 In present study 86% of cases achieved PBAC Scores <100 after 6 months in group A whereas in group B only 36% of cases achieved the desired effect. The results obtained were comparable to those achieved by B. Chattopadhyaya (73.6%) in similar study.…”

Section: Discussionmentioning

confidence: 77%

Managing dub with progesterone - locally or orally which is a better option?

Pathak

Singh

Agarwal

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONAbnormal uterine bleeding (AUB) is the commonest reason for women of all ages to consult their gynaecologist, particularly those at the extremes of their reproductive years and the problem has a considerable impact on health status and the quality of life of women it is second most common indication for hysterectomy after uterine leiomyoma.1 Abnormal uterine bleeding affects 10-30% of reproductive aged women and up to 50% of premenopausal women.2 Abnormal uterine bleeding (AUB) is sometimes mistaken as dysfunctional uterine bleeding(DUB) but AUB includes both organic and nonorganic causes of uterine bleeding whereas DUB is irregular uterine bleeding that occurs in the absence of recognizable pelvic pathology, general medical disease, or pregnancy.DUB is believed to occur in more than half of all women at least once during their reproductive age period. Up to 25% of women suffer at least one episode of DUB during their reproductive span.Patients who experience repetitive episodes might experience significant consequences-carries the risk for iron deficiency anemia. Flow can be copious enough to Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background:The levonorgestrel intrauterine system (LNG-IUS) is a safe and effective form of contraception used by millions of people worldwide. Other than this, it has many non-contraceptive benefits-treatments for dysfunctional uterine bleeding (DUB), fibroid uterus, endometriosis and endometrial hyperplasia. Methods: A prospective longitudinal comparative study was carried out at department of obstetrics and gynaecology S.N. Medical College, Agra, Uttar Pradesh, India including 100 women of 20-45 years of age group (comparable in all aspects), with DUB. All cases were subjected to detailed history, examination and baseline investigationsHemoglobin (Hb), endometrial aspiration, histopathology and ultrasound pelvis (along with endometrial thickness) and PBAC scoring before starting the treatment. Then cases were randomly allocated in two equal groups. In group A LNG-IUS was inserted. In group B cases were prescribed oral medroxy progesterone acetate 10 mg bd from 5 th and 25 th day of menstrual cycle. Cases were followed at 1 month, 3 months and 6 months after starting treatment. At each follow-up visit primary outcome in terms of subjective assessment by patient, PBAC scores and secondary outcome as Hb levels and side-effects were recorded. Results: Reduction in PBAC Scores, improvement in Hb and reduction in endometrial thickness were seen with both treatment modalities but results were significantly (p <0.0001) better with LNG-IUS group as compared to MPA. LNG-IUS was found to be more effective in endometrial hyperplasia and proliferative type of endometrium. Conclusions: LNG-IUS i...

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Section: Discussionmentioning

confidence: 77%

Managing dub with progesterone - locally or orally which is a better option?

Pathak

Singh

Agarwal

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…Kau and Ertan (2008) reported that the efficacies of oral and intramuscular medroxyprogesterone acetate in the treatment of menorrhagia were comparable to each other; however, the efficacy of LNG-IUS was superior to both. Also, Sayed et al (2011) and Shabaan et al (2011) found out that LNG-IUS was more effective in reducing MBL than the combined oral contraceptives in women with fibroidrelated and idiopathic menorrhagia, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The obtained data is in line with the study of Zapata et al (2010) who found out that most women with uterine fibroids are likely to have less MBL and higher serum levels of hemoglobin, hematocrit and ferritin after insertion of an LNG-IUD. Sayed et al (2011) andShabaan et al (2011) compared the efficacy of LNG-IUS versus a low-dose combined oral contraceptive in reducing fibroidrelated and idiopathic menorrhagia, respectively, and reported significant reduction of MBL and lost days with significantly increased hemoglobin levels in the LNG-IUS group.…”

Section: Discussionmentioning

confidence: 99%

Levonorgestrel-releasing intrauterine device for management of tamoxifen-induced menorrhagia in breast cancer patients

Elnory¹,

El-Habbaa²,

Rageh³

2014

J. Cancer Res. Exp. Oncol.

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This study aimed to evaluate the therapeutic yield of levonorgestrel-releasing intrauterine device (LNG-IUD) for management of tamoxifen induced menorrhagia in women who had mastectomy for treatment of breast cancer. This study included 34 patients who had breast cancer, underwent mastectomy, were maintained on tamoxifen post-operatively for at least 6 months, and had also newly developed menorrhagia throughout their follow-up period. All the patients underwent clinical examination for determination of duration and heaviness of menstrual blood loss (MBL), transvaginal ultrasonography (TVU) and endometrial biopsy for exclusion of abnormal pathology, estimation of blood iron indices and quality of life (QoL) scoring. Baseline endometrial biopsy detected simple endometrial hyperplasia (EH) in 4 patients and 30 patients had proliferative endometrium. Three patients were excluded and 31 patients completed the follow-up period without the need for shift to hysterectomy. Both mean duration and heaviness of MBL showed significant progressive decrease throughout the observation period as compared to baseline data. At the end of follow-up period, 5 women became amenorrheic, 2 women had moderate MBL and 24 women had mild MBL. Iron indices studies showed significant improvement at the end of follow-up as compared to baseline indices and total QoL scoring recorded at 6 and 12 months after enrollment were significantly higher as compared to baseline scores with significantly higher scores at 12 months. LNG-IUD could be considered as an appropriate therapeutic modality for tamoxifen-induced menorrhagia in patients who had mastectomy for breast cancer with significant reduction of duration and severity of MBL and improved QoL and iron indices.

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“…An updated review identified seven further randomised trials, [38][39][40][41][42][43][44] involving only 718 women in total, which compared the LNG-IUS with non-hormonal and hormonal treatments. In an industry-sponsored review, 45 reduction in menstrual blood loss was achieved in only 230 women, from five studies, 33,38,43,44,46 in which the LNG-IUS was administered.…”

Section: Introductionmentioning

confidence: 99%

“…50 An updated review identified seven further randomised trials [38][39][40][41][42][43][44] which compared the LNG-IUS with non-hormonal treatments, but none was considered cost-effective.…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial

Gupta

Daniels

Middleton

et al. 2015

Health Technol Assess

324

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A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial Janesh K Gupta, 1,2 Jane P Daniels, 3 * Lee J Middleton, 3 Helen M Pattison, 4 Gail Prileszky, 5 Tracy E Roberts, 6 Sabina Sanghera, 6 Pelham Barton, 6 Richard Gray 7 and Joe Kai 5 on behalf of the ECLIPSE Collaborative Group This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 02/06/02. The contractual start date was in November 2004. The draft report began editorial review in February 2015 and was accepted for publication in May 2015. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publicati...

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Levonorgestrel-releasing intrauterine system compared to low dose combined oral contraceptive pills for idiopathic menorrhagia: a randomized clinical trial

Cited by 100 publications

References 30 publications

Managing dub with progesterone - locally or orally which is a better option?

Managing dub with progesterone - locally or orally which is a better option?

Levonorgestrel-releasing intrauterine device for management of tamoxifen-induced menorrhagia in breast cancer patients

A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial

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