A 5-year follow-up study on the use of a levonorgestrel intrauterine system in women receiving hormone replacement therapy

Varila, Eero; Wahlström, Torsten; Rauramo, Ilkka

doi:10.1016/s0015-0282(01)02846-1

Cited by 69 publications

(38 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, even endometrial protection against tamoxifen-stimulated endometrial changes by using LNG-IUS was demonstrated in several studies (Gardner et al 2000, Chan et al 2007, Kesim et al 2008). All in all, it can be concluded that LNG-IUS is a promising alternative to hysterectomy for the treatment of endometrial hyperplasia, although data are too sparse to recommend treatment of early endometrial cancer, and case reports are controversial (Parazzini et al 1994, Sturgeon et al 1997, Varila et al 2001, Giannopoulos et al 2004, Dhar et al 2005, Kresowik et al 2008.…”

Section: Risk Using Nonhormonal and Hormonal Intrauterine Devicesmentioning

confidence: 99%

Hormonal contraception and risk of endometrial cancer: a systematic review

Mueck¹,

Seeger²,

Rabe³

2010

Endocrine-Related Cancer

View full text Add to dashboard Cite

More than 15 case-control studies and at least four large cohort studies demonstrated a decrease in the risk of endometrial cancer of about 50% for ever use of combined oral contraceptives (COCs). In most of these studies, this protective effect persisted for more than 10-15-20 years after cessation of the COC. An increasing protective effect with longer duration of COC use has been found in most studies. The beneficial effect was independent of the composition of COC, i.e. dosage and type of progestogen, combined with ethinyl estradiol 30-50 mg/day. COCs with higher progestogen potency seem to be somewhat more effective. Nonhormonal uterine devices have also been found to be strongly protective; however, data on oral or injectable progestogen-only preparations (POPs) including the levonorgestrel-releasing intrauterine system (LNG-IUS) are still rare, but also suggest similar protective action. COCs, POPs, as well as LNG-IUS can effectively reduce endometrial hyperplasia but should only be used in exceptional cases in patients with or after endometrial cancer. In contrast to nonhormonal IUS, systemic side effects cannot be excluded with LNG-IUS, but they are certainly rare, as the main effect has decreased the endometrial estrogen response because of the high endometrial tissue levels of LNG.

show abstract

Section: Risk Using Nonhormonal and Hormonal Intrauterine Devicesmentioning

confidence: 99%

Hormonal contraception and risk of endometrial cancer: a systematic review

Mueck¹,

Seeger²,

Rabe³

2010

Endocrine-Related Cancer

View full text Add to dashboard Cite

show abstract

“…High rates of amenorrhea have been described after one year of combined LNG-IUS in addition to the conventional estrogen dose. [18][19][20] Raudaskoski et al 19 found a greater incidence of bleeding/spotting in the first trimester with estradiol/LNG-IUS (86% of patients, compared with 11.8% of patients receiving oral combined therapy). After 12 months, only three patients (from the LNG-IUS group) in that study presented any bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…After 12 months, only three patients (from the LNG-IUS group) in that study presented any bleeding. After a one-year follow-up, Varila et al 20 reported amenorrhea in 64% of patients using LNG-IUS associated with transdermal 50 µg 17β estradiol daily. Raudaskoski et al 18 in a one-year multicenter randomized trial, observed 90.9% of amenorrhea during the last 3 months in patients receiving LNG-IUS in addition to estradiol valerate (2 mg/day).…”

Section: Discussionmentioning

confidence: 99%

“…17 There are few prospective studies evaluating LNG-IUS use in HT, always associated with conventional estrogen doses. [18][19][20] Drospirenone (DRSP) is a synthetic, spironolactone-derived progestogen with a pharmacological profile that closely mimics that of endogenous progesterone. [21][22][23] Several studies have demonstrated graphic characteristics were found between the two groups (Table 1).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of hormone therapy on the endometrium in postmenopausal women: a one year randomized trial of low dose oral estradiol in association with a levonorgestrel-releasing intrauterine system or drospirenone

Schvartzman

Magalhães

Freitas

et al. 2013

Rev. Bras. Saude Mater. Infant.

View full text Add to dashboard Cite

Effects of hormone therapy on the endometrium in postmenopausal women: a one year randomized trial of low dose oral estradiol in association with a levonorgestrel-releasing intrauterine system or drospirenone Efeitos da terapia hormonal no endométrio de mulheres na pós-menopausa: estudo clínico randomizado por um ano com estradiol oral em baixa dosagem em associação com sistema intrauterino com levonorgestrel ou drospirona Resumo Objetivos: comparar os efeitos endometriais e no padrão de sangramento uterino de tratamento com (1) sistema intrauterine com levonorgestrel (SIU-LNG) e estradiol (1 mg/dia, v.o.) ou (2) associação oral de drospirenona (DRSP) (2 mg/dia) e estradiol (1 mg/dia).Métodos the safety and efficacy of continuous combined oral HT with 1 mg 17 β-estradiol (E2) plus 2 mg DRSP for the treatment of climacteric symptoms 21,[23][24][25] This association has anti-androgenic and anti-aldosterone properties. 22,23 The present study was designed to assess the endometrial effects (bleeding patterns, endometrial thickness, hysteroscopic pattern, and endometrial histology) in postmenopausal women using lowdose estradiol associated with either LNG-IUS or oral drospirenone.

show abstract

“…4,15 Literature and guidelines review. Recent studies have investigated the clinical, endometrial and metabolic response to the LNG-IUS 23,24 in women receiving HRT, and, in common with several texts, 1,8 conclude that the LNG-IUS can be used successfully and safely as part of HRT.…”

Section: The Lng-ius (Mirena) In the Perimenopausementioning

confidence: 95%