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Pontis A, D'Alterio MN, Pirarba S, et al. Adenomyosis: a systematic review of medical treatment. Gynecol Endocrinol. 2016;32(9):696-700doi: 10.1080/09513590.2016.1197200.
Pontis, A., D'Alterio, M. N., Pirarba, S., de Angelis, C., Tinelli, R., & Angioni, S. (2016). Adenomyosis: a systematic review of medical treatment. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 32(9), 696-700. https://doi.org/10.1080/09513590.2016.1197200
Pontis, A, et al. "Adenomyosis: a systematic review of medical treatment." Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology vol. 32,9 (2016): 696-700. doi: https://doi.org/10.1080/09513590.2016.1197200
Pontis A, D'Alterio MN, Pirarba S, de Angelis C, Tinelli R, Angioni S. Adenomyosis: a systematic review of medical treatment. Gynecol Endocrinol. 2016 Sep;32(9):696-700. doi: 10.1080/09513590.2016.1197200. Epub 2016 Jul 05. PMID: 27379972.
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Gynecol Endocrinol. 2016 Sep;32(9):696-700. doi: 10.1080/09513590.2016.1197200. Epub 2016 Jul 05.

Adenomyosis: a systematic review of medical treatment.

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology

A Pontis, M N D'Alterio, S Pirarba, C de Angelis, R Tinelli, S Angioni

Affiliations

  1. a U.O.C. Gynecology and Obstetrics, Ospedale San Francesco , Nuoro , Italy.
  2. b Department of Surgical Sciences , Section of Obstetrics & Gynecology, University of Cagliari , Monserrato , Italy.
  3. c Casa di Cura Accreditata Fabia Mater , Roma , Italy , and.
  4. d Department of Obstetrics and Gynecology , Perrino Hospital , Brindisi , Italy.

PMID: 27379972 DOI: 10.1080/09513590.2016.1197200

Abstract

Adenomyosis is a heterogeneous gynaecologic condition with a range of clinical presentations, the most common being heavy menstrual bleeding and dysmenorrhoea; however, patients can also be asymptomatic. Several studies support the theory that adenomyosis results from invasion of the endometrium into the myometrium, causing alterations in the junctional zone. These changes are commonly seen on imaging studies, such as transvaginal ultrasound and magnetic resonance imaging. The aim of this review is to discuss the medical approach to the management of adenomyosis symptoms, including pain and abnormal uterine bleeding. The standard treatment of adenomyosis is hysterectomy, but there is no medical therapy to treat the symptoms of adenomyosis while still allowing patients to conceive. Medical therapies using suppressive hormonal treatments, such as continuous use of oral contraceptive pills, high-dose progestins, selective oestrogen receptor modulators, selective progesterone receptor modulators, the levonorgestrel-releasing intrauterine device, aromatase inhibitors, danazol, and gonadotrophin receptor hormone agonists can temporarily induce regression of adenomyosis and improve the symptoms.

Keywords: Adenomyosis; GnRH agonist; aromatase inhibitors; danazol; endometriosis; levonorgestrel-releasing intrauterine device; oral contraceptive; progestins

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