Objective: To evaluate the use of a levonorgestrel-releasing intrauterine system (LNG-IUS) for treating endometrial hyperplasia in patients with polycystic ovary syndrome (PCOS). Methods: LNG-IUSs were inserted in 60 PCOS patients with simple (40 cases), irregular (12 cases), or complex (8 cases) endometrial hyperplasia. Follow-ups were performed at 3, 6, 12, and 24 months after insertion. At each time point, changes in menstruation, hemoglobin level, and endometrial thickness and pathology were recorded. Menstrual changes were assessed with the Pictorial Blood Assessment Chart. Hemoglobin levels were measured by the Blood Routine Test. Endometrial thickness was determined by transvaginal ultrasound. Endometrial pathology was defined as simple, irregular, or complex endometrial hyperplasia by a pathologist after curettage. Outcomes at each time point were compared to baseline (pre-insertion) measurements by Student's t test or ANOVA (for multiple comparisons) with the post hoc Dunnett's test. Differences with a p < 0.05 were considered statistically significant. Results: At all time points after LNG-IUS insertion and in all patients, menstrual blood loss was decreased and hemoglobin level was increased significantly compared to pre-insertion levels. The endometrial thickness was significantly reduced in all groups after 12 months. Most patients showed transformation of the endometrial pathology, with complete disappearance of simple and irregular cases of endometrial hyperplasia and a decreased number of complex endometrial hyperplasia cases. Conclusions: LNG-IUS is an effective, safe, nonsurgical, and atraumatic approach with few side effects for the treatment of endometrial hyperplasia in patients with PCOS.

Badawy A, Elnashar A: Treatment options for polycystic ovary syndrome. Int J Womens Health 2011;3:25-35.
Macut D, Pfeifer M, Yildiz BO, Diamanti-Kandarakis E (eds): Polycystic ovary syndrome. Novel insights into causes and therapy. Front Horm Res. Basel, Karger, 2013, vol 40, pp 1-21.
Ewies AA, Alfhaily F: Use of levonorgestrel-releasing intrauterine system in the prevention and treatment of endometrial hyperplasia. Obstet Gynecol Surv 2012;67:726-733.
Azziz R: Diagnostic criteria for polycystic ovary syndrome: a reappraisal. Fertil Steril 2005;83:1343-1346.
Higham JM, O'Brien PM, Shaw RW: Assessment of menstrual blood loss using a pictorial chart. Br J Obstet Gynccol 1990;97:734-739.
Zakherah MS, Sayed GH, El-Nashar SA, Shaaban MM: Pictorial blood loss assessment chart in the evaluation of heavy menstrual bleeding. Gynecol Obstet Invest 2011;71:281-284.
Park JC, Lim SY, Jang TK, et al: Endometrial histology and predictable clinical factors for endometrial disease in women with polycystic ovary syndrome. Clin Exp Reprod Med 2011;38:42-46.
Dumesic DA, Lobo RA: Cancer risk and PCOS. Steroids 2013;78:782-785.
Chittenden BG, Fullerton G, Maheshwari A, Bhattacharya S: Polycystic ovary syndrome and the risk of gynaecological cancer: a systematic review. Reprod Biomed Online 2009;19:398-405.
Haoula Z, Salman M, Atiomo W: Evaluating the association between endometrial cancer and polycystic ovary syndrome. Hum Reprod 2012;27:1327-1331.
Hubbs JL, Saig RM, Abaid LN, Bae-Jump VL, Gehrig PA: Systemic and local hormone therapy for endometrial hyperplasia and early adenocarcinoma. Obstet Gynecol 2013;121:1172-1180.
Minig L, Franchi D, Valero de Bernabé J, Sideri M: Controversies of the hormonal conservative treatment of endometrial cancer. Gynecol Obstet Invest 2013;75:145-151.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.