Hum Reprod. 2005 Mar;20(3):789-93.
The efficacy, side effects and continuation rates in women with symptomatic endometriosis undergoing treatment with an intra-uterine administered progestogen (levonorgestrel): a 3 year follow-up.
Lockhat FB, Emembolu JO, Konje JC.
Reproductive Sciences Section, Department of Cancer Studies and Molecular Medicine, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK.
Background:
side effects and choice of drugs influence compliance during treatment for endometriosis. Progestogen administered by a device with a 5-year lifespan, has been shown to be an effective medical alternative with several advantages. The aims of this study were to investigate its efficacy, continuation rates and side effects in women with endometriosis over a 3-year period.
Methods:
Thirty-four women with laparoscopically confirmed minimal to moderate symptomatic endometriosis offered insertion of an intrauterine device at diagnostic laparoscopy were followed up at 1, 3 and 6 months, and then every 6 months for 3 years. A symptom diary for side effects, documentation of symptoms on a visual analogue scale (VAS), a verbal rating scale (VRS) and quantified menstrual loss using the pictorial blood loss chart was used to assess response to treatment.
Results:
The continuation rates were respectively 85%, 68%, 62% and 56% at, 6, 12, 24 and 36 months. Discontinuation rates were highest at <12 months, and most of these were for irregular and intolerable bleeding and persistent pain. An improvement in symptoms was observed throughout the 36 months. The greatest changes in pain assessed by either the VAS or VRS were between the pretreatment scores and those after 12 months (7.7 +/- 1.3 versus 3.5 +/- 1.8 for VAS, P < 0.001; and 25 +/- 13.8 versus 14 +/- 9.4 for VRS, P < 0.002). The monthly quantified blood loss fell from 204 (196) pretreatment to 60 (50) at 12 months (P < 0.001) and then to 70 (30) after 36 months. The most common side effects were bleeding irregularities (14.7%), one-sided abdominal pain (11.8%) and weight gain (8.8%).
Conclusions:
Intrauterine progestogen is effective in symptom control throughout the 3 years on the device, and discontinuation is greatest between 3 and 6 months. For those patients with improvement in symptoms, it is an acceptable long-term alternative.
Please click on the required question.
- Pelvic Pain. Is this a common problem?
- What are the common causes of pelvic pain in women?
- What are the more common gynaecological causes of pelvic pain?
- What are the more common non-gynaecological causes of pelvic pain?
- What are primary and secondary dysmenorrhoea - painful periods?
- What is retrograde menstruation?
- How can dysmenorrhoea - painful periods be treated?
- What are ovarian cysts?
- How do ovarian cysts cause pain?
- How are ovarian cysts diagnosed?
- How are ovarian cysts treated?
- I think I may be pregnant and I have some pelvic pain. What should I do?
- What is pelvic inflammatory disease and how can it be treated?
- Mittelschmertz
- What are fibroids?
- I have fibroids. What difficulties might they cause for me?
- How are fibroids diagnosed?
- How could my fibroids be treated?
ENDOMETRIOSIS
- What is endometriosis?
- How prevalent is endometriosis?
- What causes endometriosis?
- How can my endometriosis be treated?
- How can my doctor determine the cause of my pelvic pain?
- What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
- What is laparoscopy?
- What are pelvic adhesions?
- I have chronic pelvic pain. Could this be related to adhesions?
- What is uterine retroversion (retroverted uterus)
- Does a retroverted uterus (backward tilted uterus) cause symptoms?
- How is a retroverted uterus - backward tilted uterus - treated?
- What is pelvic congestion?
- What causes pain associated with sexual intercourse (dyspareunia)
- How can painful sexual intercourse (dyspareunia) be treated?
- What is a pelvic mass?
IRRITABLE BOWEL SYNDROME - IBS
- What is irritable bowel syndrome?
- How can we find out if I have irritable bowel syndrome?
- Is irritable bowel syndrome (IBS) a common condition?
- What causes IBS?
- What is the pain associated with IBS like?
- Can IBS be mistaken for gynaecological problems?
- How can my IBS be treated?
- What other treatments are available for IBS?
- What can be done to reduce the amount of bowel gas(flatus)
- What is constipation?
- What causes constipation?
- How can constipation be treated?
- How could we summarise the treatments that are available for my pelvic pain?
- Where can I obtain more information?
- Pelvic Pain Support Groups.
- Endometriosis Support Groups.
- IBS Support Groups.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
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