Adenomyosis Clinical Trial
Official title:
Levonorgestrel-releasing Intrauterine System Versus a Low-dose Combined Oral Contraceptive for Management of Adenomyosis Uteri
This study aims to compare the efficacy of LNG - IUD (Levonorgestrel releasing intrauterine device) Versus Low dose COCs (combined oral contraceptive pills) on management of heavy menstrual bleeding and Dysmenorrhea caused by Adenomyosis.
Levonorgestrel releasing intrauterine device will be MetraPlant-E, which is used in this
study in group A, is a modified Levonorgestrel -releasing intrauterine system from the old
IUD - Intrauterine Device "Metraplant", MetraPlant-E design has a T-shaped frame containing
Levonorgestrel and Ethylene Vinyl Acetate as well as Barium Sulphate to make it
radio-opaque, All the "T" frame, the bulb of 20 mm length and sleeves contain: Ethylene
Vinyl Acetate, Levonorgestrel and Barium Sulphate, which ensures more exposure of the
endometrial surface to the system and hence expected more endometrial suppression.
It consists of Levonorgestrel Hormone (60 mg), Ethylene Vinyl Acetate (120 mg) & Barium
Sulphate (20 mg) Metraplant-E is designed without any coat membrane, which will help in more
rise in Levonorgestrel level (higher initial release). The high initial release of
Levonorgestrel (reached more than 28µg/24hrs in Metraplant-E in this study of in-vitro
release) may help in early stoppage of bleeding in patients who suffer from irregular
bleeding.
Women in group A will receive IUD - Intrauterine Device- during menstruation .It will be
inserted into uterus in similar procedure to non-hormonal IUD .Pelvic exam will be done, the
vagina will hold open with speculum, grasping the cervix, measuring uterine length and
proper insertion of IUD - Intrauterine Device by non-touch technic. Women will receive
proper antibiotics after insertion.
Group B will receive combined oral contraceptive pills (Yasmin) which will be Monophasic
pills have a constant dose of both estrogen and progestin in each of the hormonal active
pills throughout the entire cycle . Yasmin (ethinyl estradiol 0.03 mg/ drospirenone 3 mg)
tablets, it provides an oral contraceptive regimen, it will be used continuously for 6
months with stoppage after 3 months for withdrawal bleeding.
Both treatment arms (Metraplant E and Yasmin) will be followed up after 3 months and 6 month
of patients' recruitment. Assessment of pain related symptoms will be done using visual
analogue scale pain score, while assessment of menstrual improvement will be done using
menstrual diary.
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