25001020
OBJECTIVE	To compare the efficacy and safety of the levonorgestrel-releasing intrauterine device ( LNG-IUD ) with dydrogesterone applied for the same duration in patients having endometrial hyperplasia ( EH ) without atypia .
METHODS	One hundred thirty eight women aged between 30 and 50 years with abnormal uterine bleeding and diagnosed as EH by transvaginal ultrasound were randomized to receive either LNG-IUD or dydrogesterone for 6 months .
METHODS	Primary outcome measures were regression of hyperplasia after 6 months of therapy .
METHODS	Secondary outcome measures were occurrence of side effects during treatment or recurrence of hyperplasia during follow-up period .
RESULTS	After 6 months of treatment , regression of EH occurs in 96 % of women in the levonorgestrel-releasing intrauterine system ( LNG-IUS ) group versus 80 % of women in the oral group ( P < .001 ) .
RESULTS	Adverse effects were relatively common with minimal differences between the 2 groups .
RESULTS	Intermenstrual vaginal spotting and amenorrhea were more common in the LNG-IUD group ( P value .01 and .0001 ) .
RESULTS	Patient satisfaction was significantly higher in the LNG-IUS group ( P value .0001 ) .
RESULTS	Hysterectomy rates were lower in the LNG-IUS group than in the oral group ( P = .001 ) .
RESULTS	Recurrence rate was 0 % in the LNG-IUD group compared to 12.5 % in the oral group .
CONCLUSIONS	In management of EH without atypia , LNG-IUS achieves a higher regression and a lower hysterectomy rate than oral progesterone and could be used as a first-line therapy .

