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Objective: The purpose of this study was to evaluate the effects of levonorgestrel-releasing intrauterine system (Mirena®) combination to GnRH (gonadotropin releasing hormone) agonist treatment on chronic pelvic pain of endometriosis, hypoestrogenic symptoms. Methods: One hundred twenty eight patien...

Objective: The purpose of this study was to evaluate the effects of levonorgestrel-releasing intrauterine system (Mirena®) combination to GnRH (gonadotropin releasing hormone) agonist treatment on chronic pelvic pain of endometriosis, hypoestrogenic symptoms. Methods: One hundred twenty eight patients who were diagnosed as endometriosis, were divided into endometriosis without adenomyosis group (n=88) and endometriosis with adenomyosis group (n=40). In 57 of 88 patients who had only endometriosis without adenomyosis, only GnRH agonist for 6 months was injected monthly (Group A). In the other 31 of 88 patients, Mirena® was inserted and GnRH agonist for 6 months was injected monthly (Group B). In 12 of 40 patients who had endometriosis and adenomyosis, only GnRH agonist for 6 months was injected monthly (Group C). In the other 28 of 40 patients, Mirena® was inserted and GnRH agonist for 6 months was injected monthly (Group D). The degree of pelvic pain, dysmenorrhe, and hypoestrogenic symptoms of each groups were observed and compared. Results: The decreased pain rates of Group B and D were significantly higher than Group A and C (p<0.01), and decreased pain rates of Group D were significantly higher than Group B (p<0.05). The incidence of hot flush, depression and insomnia of 4 groups were not significantly different. Conclusions: Although Mirena® combination to GnRH agonist treatment cannot prevent the hypoestrogeic symptoms, Mirena® combination increases the treatment effect for pain of endometriosis. Especially, this effect is the more if adenomyosis is combined to endometriosis.

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