Cochrane · systematic review · CD008994

Progestogens or progestogen‐releasing intrauterine systems for uterine fibroids (other than preoperative medical therapy)

Sangkomkamhang, US, Lumbiganon, P, Pattanittum, P · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library

Gynaecology and Fertility2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
11
No studies
3
Included studies
NR
No studies 3 · 21.4%Ungraded 0 · 0%Very low 11 · 78.6%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Levonorgestrel‐releasing intrauterine device compared to low dose combined oral contraceptive for uterine fibroids

Population: women with uterine fibroids
5 questions
OutcomeEffectEvidenceStatus / GRADE
Uterine fibroid‐related symptoms (change in abnormal uterine bleeding, measured at 12 months, with the alkaline hematin test)
Levonorgestrel‐releasing intrauterine device vs low dose combined oral contraceptive
no estimate extracted1 study · 44 participantsVery low
Downgraded: risk of bias, imprecision
Uterine fibroid‐related symptoms (change in abnormal uterine bleeding, measured at 12 months, with the pictorial blood assessment chart (PBAC))
Levonorgestrel‐releasing intrauterine device vs low dose combined oral contraceptive
no estimate extracted1 study · 44 participantsVery low
Downgraded: risk of bias, imprecision
Uterine fibroid‐related symptoms (haemoglobin level, at 12 months; higher = better)
Levonorgestrel‐releasing intrauterine device vs low dose combined oral contraceptive
no estimate extracted1 study · 44 participantsVery low
Downgraded: risk of bias, imprecision
Fibroid size (percentage of change, at 12 months; higher = better)
Levonorgestrel‐releasing intrauterine device vs low dose combined oral contraceptive
no estimate extracted1 study · 44 participantsVery low
Downgraded: risk of bias, imprecision
Adverse events
Levonorgestrel‐releasing intrauterine device vs low dose combined oral contraceptive
no estimate extractedNRNo studies

Levonorgestrel‐releasing intrauterine device compared to oral progestogen (norethisterone acetate) for uterine fibroids

Population: women with uterine fibroids
5 questions
OutcomeEffectEvidenceStatus / GRADE
Uterine fibroid‐related symptoms (change in abnormal uterine bleeding, measured from baseline to 6 months, with a visual bleeding score (VBS); lower = better)
Levonorgestrel‐releasing intrauterine device vs oral progestogen (norethisterone acetate)
no estimate extracted1 study · 48 participantsVery low
Downgraded: risk of bias, imprecision
Uterine fibroid‐related symptoms (change in haemoglobin level, from baseline to 3 months; higher = better)
Levonorgestrel‐releasing intrauterine device vs oral progestogen (norethisterone acetate)
no estimate extracted1 study · 48 participantsVery low
Downgraded: risk of bias, imprecision
Uterine fibroid‐related symptoms (change in haemoglobin level, from baseline to 6 months; higher = better)
Levonorgestrel‐releasing intrauterine device vs oral progestogen (norethisterone acetate)
no estimate extracted1 study · 45 participantsVery low
Downgraded: risk of bias, imprecision
Fibroid size
Levonorgestrel‐releasing intrauterine device vs oral progestogen (norethisterone acetate)
no estimate extractedNRNo studies
Adverse events (spotting at 3 and 6 months)
Levonorgestrel‐releasing intrauterine device vs oral progestogen (norethisterone acetate)
no estimate extracted1 study · 45 participantsVery low
Downgraded: risk of bias, imprecision

Oral progestogen (dienogest, desogestrel) compared to goserelin acetate for uterine fibroids

Population: women with uterine fibroids
4 questions
OutcomeEffectEvidenceStatus / GRADE
Uterine fibroid‐related symptoms (duration of uterine bleeding, measured at 12 weeks; lower = better)
Oral progestogen (dienogest, desogestrel) vs goserelin acetate
no estimate extracted1 study · 14 participantsVery low
Downgraded: risk of bias, imprecision
Uterine fibroid‐related symptoms (abnormal uterine bleeding, measured at 12 weeks, with the pictorial blood assessment chart (PBAC); lower = better)
Oral progestogen (dienogest, desogestrel) vs goserelin acetate
no estimate extracted1 study · 14 participantsVery low
Downgraded: risk of bias, imprecision
Fibroid size
Oral progestogen (dienogest, desogestrel) vs goserelin acetate
no estimate extractedNRNo studies
Adverse events (vasomotor symptoms (e.g. hot flashes)
Oral progestogen (dienogest, desogestrel) vs goserelin acetate
no estimate extracted1 study · 14 participantsVery low
Downgraded: risk of bias, imprecision