What is the most effective treatment for endometrial intraepithelial neoplasia?

A new study comparing the effectiveness of oral progestogens versus a levonorgestrel-releasing intrauterine system to treat women with endometrial intraepithelial neoplasia (EIN) presents data on patient outcomes compiled over 8 years, as reported in Journal of Women's Health.

Mary Marnach, MD and coauthors from Mayo Clinic, Rochester, MN, and Mayo Clinic Hospital, Phoenix, AZ, conducted a retrospective analysis to determine which treatment approach was more effective in women with EIN who either wanted to preserve their fertility and not undergo a hysterectomy or were not optimal surgical candidates. Overall, the treatments led to disease resolution in more than 80% of patients with subcategory 1 EIN and more than 60% of patients with subcategory 2 EIN. Intrauterine hormone delivery offers greater convenience and minimal adverse effects, is rapidly reversible, and provides long-term protection of the endometrial lining.

The researchers report their results in the article "Oral Progestogens Versus Levonorgestrel-Releasing Intrauterine System for Treatment of Endometrial Intraepithelial Neoplasia."

"Available guidelines for the treatment of EIN have been limited due to the absence of data from comparative studies involving substantial numbers of patients," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health. "This study by Marnach et al. demonstrates the effectiveness of two nonsurgical treatment approaches in different subcategories of EIN, and the authors suggest timelines for routine endometrial surveillance."