Concomitant treatment of severe uterine adenomyosis in a premenopausal woman with an aromatase inhibitor and a gonadotropin-releasing hormone agonist.
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.
Kimura
Fuminori
F
Department of Obstetrics and Gynecology, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Japan.
Takahashi
Kentaro
K
Takebayashi
Koichi
K
Fujiwara
Mutsuko
M
Kita
Nobuyuki
N
Noda
Yoichi
Y
Harada
Nobuhiro
N
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
D047072:Aromatase Inhibitors; D007987:Gonadotropin-Releasing Hormone; D002064:Buserelin