Document Detail


A levonorgestrel-releasing intrauterine system for the treatment of dysmenorrhea associated with endometriosis: a pilot study.
MedLine Citation:
PMID:  10519624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the efficacy and safety of an intrauterine system releasing 20 microg of levonorgestrel per 24 hours in the long-term treatment of recurrent dysmenorrhea in women already operated on conservatively for endometriosis. DESIGN: A prospective noncomparative pilot study. SETTING: A tertiary care and referral academic center for patients with endometriosis. PATIENT(S): Twenty parous women with recurrent moderate or severe dysmenorrhea after conservative surgery for endometriosis who did not want further children. INTERVENTION(S): A levonorgestrel-releasing intrauterine system was inserted in each woman within 7 days of the start of a menstrual cycle. MAIN OUTCOME MEASURE(S): Variations in severity of dysmenorrhea during treatment according to a 100-mm visual analogue scale and a 0-3-point verbal rating scale, modification of a pictorial blood-loss assessment chart devised to evaluate the amount of menstrual flow, and degree of satisfaction after 12 months of therapy. RESULT(S): One woman was lost to follow-up after achieving amenorrhea and expressing satisfaction, and 1 requested system removal because of weight gain and abdominal bloating. In another subject, the levonorgestrel intrauterine system was expelled 3 months after insertion. The menstrual patterns in the remaining 17 women were characterized by amenorrhea in 4 cases, hypomenorrhea or spotting in 8, and normal flow in 5. Baseline and 12-month follow-up mean +/- SD blood loss scores were 111+/-36 and 27+/-26, respectively. At the same time, mean +/- SD visual analogue and verbal rating scale scores dropped, respectively, from 76+/-12 to 34+/-23 points and from 2.5+/-0.5 to 1.2+/-0.5 points. Four women were very satisfied with treatment, 11 were satisfied, 2 were uncertain, and 3 were dissatisfied at 12-month follow-up. CONCLUSION(S): Because of the amenorrhea or hypomenorrhea induced in most women, a levonorgestrel intrauterine system greatly reduced menstrual pain associated with endometriosis and achieved a high degree of patient satisfaction.
Authors:
P Vercellini; G Aimi; S Panazza; O De Giorgi; A Pesole; P G Crosignani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  72     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-21     Completed Date:  1999-10-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  505-8     Citation Subset:  IM    
Affiliation:
Clinica Ostetrica e Ginecologica Luigi Mangiagalli, University of Milano, Italy. pgcros@imiucca.unimi.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Dysmenorrhea / drug therapy*,  etiology
Endometriosis / complications*
Female
Humans
Intrauterine Devices, Medicated
Levonorgestrel / administration & dosage*,  adverse effects,  therapeutic use
Menstrual Cycle
Patient Satisfaction
Pilot Projects
Prospective Studies
Uterus / drug effects
Chemical
Reg. No./Substance:
797-63-7/Levonorgestrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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