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Abstract To compare the efficacy of etonogesterone implant and levonorgestrel-releasing intrauterine system (LNG-IUS) for treating patients with adenomyosis. Methods: 214 patients with adenomyosis from January 2017 to April 2019 were selected and were divided into group A (106 cases given etonogesterone implant) and group B (108 cases given LNG-IUS) according to the principle of random number. The patients in the two groups were followed up for 12 months after treatment. The efficacy and the adverse reactions of the patients at different time were compared between the two groups. Results: The dysmenorrhea score, the uterine volume, and the serum CA125 level of the patients in the two groups before treatment, and in the 3rd, 6th, and 12th month after treatment had increased gradually, but their hemoglobin level had decreased gradually (all P<0.05). The serum CA125 level of the patients in group A in the 12th month after treatment was significantly lower than that of the patients in group B (P<0.05), but there were no significant differences in the dysmenorrhea score, the uterine volume, and the hemoglobin level of the patients between the two groups (P>0.05). There were no significant differences in the levels of TC and TG of the patients before treatment in the 3rd month after treatment between the two groups (P>0.05), but the levels of TC and TG of the patients in the two groups in the 6th and 12th month had decreased gradually, the levels of TC and TG of the patients in group A in the 12th month were significantly lower than that of the patients in group B (all P<0.05). There were no significant differences in the levels of high-density lipoprotein and low density lipoprotein of the patients in the 3rd, 6th and 12th month after treatment between the two groups (P>0.05). The composition ratio of menstrual pattern of the patients in both groups in the 3rd, 6th and 12th month after treatment had changed significantly (P<0.05) , but which had no significant different of the patients in the two groups between 3 months after treatment and before treatment (P>0.05). There were no significant differences in the total incidence of adverse reactions, the weight gain value, the acne rate, the rates of discharge or displacement of etonogesterone implant or LNG-IUS, the breast swelling and pain rates of the patients between the two groups (P>0.05). Conclusion: Etonogesterone implants for treating the patients with adenomyosis is superior to LNG-IUS in decreasing serum CA125 level, but the incidences of frequent menstruation and prolonged bleeding after treatment by etonogesterone implants is relatively higher than those by LNG-IUS, so etonogesterone implants can be used in the patients who are not suitable to LNG-IUS inserted.
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