title: Concomitant treatment of severe uterine adenomyosis in a premenopausal woman with an aromatase inhibitor and a gonadotropin-releasing hormone agonist.
abstract: OBJECTIVE
  To assess the effect of aromatase inhibitors with GnRH agonist for a severe symptomatic adenomyosis that is refractory to GnRH agonist and danazol with GnRH agonist.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Clinical practice in university hospital.
  
  
  METHODS
  A 34-year-old woman with a complaint of severe dysmenorrheal, symptomatic anemia, and a desire to retain fertility.
  
  
  METHODS
  Aromatase inhibitor anastrozole given orally (1.0 mg or 2.0 mg daily) for 16 weeks and GnRH agonist given monthly (injected SC, 1.8 mg) for 4 months.
  
  
  METHODS
  Measurements of uterine volume and levels of serum E(2), estrone, A, dehydroepiandrosterone sulfate, LH, FSH, and CA125.
  
  
  RESULTS
  Uterine volume was reduced. The reduction rate of uterine volume estimated by magnetic resonance imaging and ultrasonography was 60% after 8 weeks of treatment.
  
  
  CONCLUSIONS
  Aromatase inhibitor with GnRH agonist therapy was useful for the management of a severely adenomyotic woman whose desire was for conservative treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Kimura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Takebayashi
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kita
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Noda
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Harada
mesh_terms: D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D002064:Buserelin / Q000627:therapeutic use*; D004715:Endometriosis / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008279:Magnetic Resonance Imaging; D017697:Premenopause; D014591:Uterine Diseases / Q000188:drug therapy* / Q000473:pathology
chemical_list: D047072:Aromatase Inhibitors; D007987:Gonadotropin-Releasing Hormone; D002064:Buserelin