Low-dose LNG-IUS as Therapy for Endometrial Hyperplasia. A Prospective Cohort Pilot Study

Abstract

Background/aim: Progestin therapy has been accepted as therapy for low- and medium-risk endometrial hyperplasia. The aim of this study was to investigate the efficacy of the low-dose levonorgestrel-impregnated intrauterine system (LNG-IUS) 13.5 mg (Jaydess®, Bayer Pharmaceuticals, Berlin, Germany) as therapy for endometrial hyperplasia.

Patients and methods: A total of 21 women with histologically-verified endometrial hyperplasia were prospectively treated with LNG-IUS Jaydess. Therapy duration was 6 months (n=16) or 3-6 weeks (n=5) depending on individual risk (low- and medium-risk versus high-risk) for co-existent or future endometrial carcinoma. Paired endometrial biopsies were sampled prior to and after therapy and classified according to the WHO94 classification system and D-score.

Results: All women with low- and medium risk endometrial hyperplasia had-therapy response. In the group of women with high-risk endometrial hyperplasia only 40% (two out of five) obtained a therapy response.

Conclusion: Low-dose LNG-IUS Jaydess was proven to be an excellent therapy option for low- and medium-risk endometrial hyperplasia. For patients with high-risk endometrial hyperplasia hysterectomy or LNG-IUS therapy under close surveillance is advised.

Keywords: Endometrial hyperplasia; LNG-IUS; low-dose progestin therapy.