The promise and reality of the intrauterine route for hormone delivery for prevention and therapy of gynecological disease.

Abstract:

CONTEXT:Progestins delivered by a variety of routes have been demonstrated, in addition to their high contraceptive effect, to have substantial benefits in the treatment of various gynecological disorders, and the intrauterine route has particular efficacy in treating endometrial and myometrial disorders. It should be possible to extend this to prevention of disease. THERAPY OF GYNECOLOGICAL DISEASE:Those conditions for which there is most evidence of therapeutic benefit from intrauterine release of progestins include heavy menstrual bleeding (due to most causes), endometrial hyperplasia, endometriosis and adenomyosis. PREVENTION OF GYNECOLOGICAL DISEASE:Reasonable evidence exists to support the findings that intrauterine levonorgestrel helps to prevent the development of uterine fibroids, endometriosis, endometrial hyperplasia, acute episodes of pelvic infection and a wide range of menstrual symptoms. There is also promise of prevention of endometrial carcinoma, endometrial polyps, infertility and perhaps adenomyosis. CONCLUSIONS:There is a need for specific studies to further explore the prevention of these gynecological conditions which can cause major health disturbances and community distress.

journal_name

Contraception

journal_title

Contraception

authors

Fraser IS

doi

10.1016/j.contraception.2006.12.013

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

S112-7

issue

6 Suppl

eissn

0010-7824

issn

1879-0518

pii

S0010-7824(07)00033-9

journal_volume

75

pub_type

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