What do systematic reviews say?

LNG‐IUS vs non‐intrauterine progestogen

LNG‐IUS may leads to lower hysterectomy; histologically and non‐histologically indicated compared with non‐intrauterine progestogen (low certainty).

• Levonorgestrel‐releasing intrauterine system for endometrial hyperplasia 2020 · Cochrane Headline outcomes only
  OR 0.26 [0.15, 0.46]
  4 studies · 452 participants
  Low

LNG‐IUS vs non‐intrauterine progestogen

It is very uncertain whether LNG‐IUS changes adverse effects associated with hormones:Bleeding/spotting Nausea… compared with non‐intrauterine progestogen (very low certainty).

• Levonorgestrel‐releasing intrauterine system for endometrial hyperplasia 2020 · Cochrane Headline outcomes only
  OR 2.13 [1.33, 3.43]
  3 studies · 428 participants
  Very low

LNG‐IUS vs non‐intrauterine progestogen

LNG‐IUS showed no clear difference in withdrawal secondary to adverse effects compared with non‐intrauterine progestogen (low certainty).

• Levonorgestrel‐releasing intrauterine system for endometrial hyperplasia 2020 · Cochrane Headline outcomes only
  OR 0.41 [0.12, 1.35]
  4 studies · 360 participants
  Low

LNG‐IUS vs non‐intrauterine progestogen

It is very uncertain whether LNG‐IUS changes satisfaction with treatment compared with non‐intrauterine progestogen (very low certainty).

• Levonorgestrel‐releasing intrauterine system for endometrial hyperplasia 2020 · Cochrane Headline outcomes only
  OR 5.28 [2.51, 11.1]
  2 studies · 202 participants
  Very low

LNG vs no treatment

The review found no eligible studies for this question.

• Levonorgestrel‐releasing intrauterine system for endometrial hyperplasia 2020 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

The LNG‐IUS with endometrial surveillance probably leads to lower endometrial polyps compared with endometrial surveillance alone (moderate certainty).

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  OR 0.22 [0.13, 0.39]
  4 studies · 417 participants
  Moderate

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

The LNG‐IUS with endometrial surveillance probably leads to lower endometrial hyperplasia compared with endometrial surveillance alone (moderate certainty).

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  OR 0.13 [0.03, 0.67]
  4 studies · 417 participants
  Moderate

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 154 participants
  Moderate

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

The LNG‐IUS with endometrial surveillance showed no clear difference in fibroids compared with endometrial surveillance alone (moderate certainty).

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  OR 0.48 [0.16, 1.46]
  3 studies · 314 participants
  Moderate

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

The LNG‐IUS with endometrial surveillance probably leads to higher abnormal vaginal bleeding or spotting compared with endometrial surveillance alone (moderate certainty).

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  OR 7.26 [3.37, 15.66]
  3 studies · 376 participants
  Moderate

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

The LNG‐IUS with endometrial surveillance showed no clear difference in breast cancer recurrence compared with endometrial surveillance alone (moderate certainty).

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  OR 1.74 [0.64, 4.74]
  2 studies · 154 participants
  Moderate

The LNG‐IUS with endometrial surveillance vs endometrial surveillance alone

The LNG‐IUS with endometrial surveillance showed no clear difference in breast cancer‐related death compared with endometrial surveillance alone (moderate certainty).

• Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen 2020 · Cochrane Headline outcomes only
  OR 1.02 [0.36, 2.84]
  3 studies · 277 participants
  Moderate

LNG‐IUS vs medroxyprogesterone (MPA) 10 mg

It is very uncertain whether levonorgestrel‐releasing intrauterine system (LNG‐IUS) changes regression rate at 6 months compared with medroxyprogesterone (MPA) 10 mg (very low certainty).

• Oral and intrauterine progestogens for atypical endometrial hyperplasia 2018 · Cochrane Headline outcomes only
  OR 2.76 [0.26, 29.73]
  1 study · 19 participants
  Very low

LNG‐IUS vs medroxyprogesterone (MPA) 10 mg

It is very uncertain whether levonorgestrel‐releasing intrauterine system (LNG‐IUS) changes nausea over 6‐month compared with medroxyprogesterone (MPA) 10 mg (very low certainty).

• Oral and intrauterine progestogens for atypical endometrial hyperplasia 2018 · Cochrane Headline outcomes only
  OR 0.58 [0.28, 1.18]
  1 study · 153 participants
  Very low

LNG‐IUS vs medroxyprogesterone (MPA) 10 mg

Levonorgestrel‐releasing intrauterine system (LNG‐IUS) may leads to higher vaginal bleeding over 6‐month compared with medroxyprogesterone (MPA) 10 mg (low certainty).

• Oral and intrauterine progestogens for atypical endometrial hyperplasia 2018 · Cochrane Headline outcomes only
  OR 2.89 [1.11, 7.52]
  1 study · 153 participants
  Low