{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T06:00:15Z","timestamp":1774072815616,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persistent pelvic pain (PPP) affects 5%\u201327% of women of reproductive age. The calls for earlier and improved access to surgery to diagnose endometriosis do not address the requirement for symptom management and exclude the 50% of women who undergo a laparoscopy for identical pain symptoms but do not have endometriosis identified. Moreover, current evidence for the management of pelvic pain almost exclusively focuses on patients diagnosed with endometriosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the pain scores and overall satisfaction with symptom control in participants with PPP who utilised the levonorgestrel\u2010intrauterine device 52\u2009mg (LNG\u2010IUD), to explore the association between time since last menstrual period (LMP) and other potential factors, including the impact of surgery and surgical findings, on pain outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This prospective cohort study recruited participants between February 2015 and December 2017 following outpatient clinic referral for pelvic pain symptoms (dysmenorrhea, non\u2010cyclic pelvic pain, dysuria, dyspareunia or dyschezia). Over 18\u2009months, 72 participants had an LNG\u2010IUD (52\u2009mg) inserted, with 51 completing a follow\u2010up questionnaire 6\u201318\u2009months after insertion to assess pain outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Dysmenorrhoea (coefficient\u2009=\u2009\u22120.142,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and overall satisfaction with symptom control (coefficient\u2009=\u20090.079,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020) scores improved linearly with increased months since LMP in LNG\u2010IUD users. In multivariate analysis, the age of onset of symptoms, laparoscopies prior to study entry or during the study period, and a histological diagnosis of endometriosis did not have a significant relationship with pain outcome or overall satisfaction with symptom control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that menstrual suppression with the LNG\u2010IUD, regardless of a diagnosis of endometriosis, significantly improves a woman's overall satisfaction with PPP management. The LNG\u2010IUD is an effective first\u2010line medical management option for patients presenting with PPP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70042","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T09:01:49Z","timestamp":1746176509000},"page":"848-853","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Levonorgestrel\u2010Releasing Intrauterine Device: An Effective Treatment for Symptoms of Persistent Pelvic Pain"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4426-8633","authenticated-orcid":false,"given":"Renee M.","family":"Cocks","sequence":"first","affiliation":[{"name":"Department of Gynaecology Mercy Hospital for Women  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-9148","authenticated-orcid":false,"given":"Samantha S.","family":"Mooney","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Mercy Hospital for Women  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia R.","family":"Grover","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Mercy Hospital for Women  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Parkville Victoria Australia"},{"name":"Royal Children's Hospital, and Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2014\/17\/E141"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223316"},{"key":"e_1_2_7_4_1","unstructured":"\u201cEndoActive: The Cost of Endometriosis in Australia.\u201dA Report for EndoActive 2019."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/0167482X.2015.1074173"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2018.7615"},{"key":"e_1_2_7_7_1","unstructured":"RCOG \u201cThe Initial Management of Chronic Pelvic Pain. 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