Aromatase inhibitors or gonadotropin-releasing hormone agonists for the management of uterine adenomyosis: a randomized controlled trial.
OBJECTIVE
To compare the efficacy of aromatase inhibitor vs. gonadotrophin-releasing hormone agonists in treating premenopausal women with uterine adenomyosis.


METHODS
A prospective randomized controlled study.


METHODS
A university hospital and a private practice setting.


METHODS
Thirty-two patients with uterine adenomyosis.


METHODS
Patients were randomly allocated to receive oral letrozole (2.5 mg/day) or a subcutaneous gonadotropin-releasing hormone agonist (goserelin, 3.6 mg) for 12 weeks. Uterine and adenomyoma volumes were determined at baseline and during treatment at four, eight and 12 weeks.


METHODS
Measurements were performed at baseline and during treatment at four, eight 8 and 12 weeks, and mean values were calculated. Symptoms at the start and after 12 weeks were evaluated.


RESULTS
No significant differences in the total uterine size between the post treatment uterine volumes in the two groups (20.1, 15.4 and 13.0 cm(3) vs. 21.7, 15.1 and 11.7 cm(3) , at four, eight and 12 weeks, respectively). Total adenomyoma volume decreased by 8.6, 29.7 and 40.9% vs. 5.7, 34.6 and 49.1% after four, eight and 12 weeks of treatment, in group A and B, respectively. Two patients became pregnant in group A during treatment.


CONCLUSIONS
Aromatase inhibitors are as effective as gonadotropin-releasing hormone agonists in reducing adenomyoma volume and improving symptoms.
Department of Obstetrics & Gynecology, Mansoura University, Egypt. ambadawy@yahoo.com
Ahmed M
AM
Badawy
Aboubakr M
AM
Elnashar
Alaa A
AA
Mosbah
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004715:Endometriosis / Q000188:drug therapy*; D005260:Female; D059247:Fertility Preservation; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D007279:Injections, Subcutaneous; D000077289:Letrozole; D009570:Nitriles / Q000627:therapeutic use*; D017697:Premenopause; D016037:Single-Blind Method; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D014591:Uterine Diseases / Q000188:drug therapy*; D055815:Young Adult
D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D017273:Goserelin; D007987:Gonadotropin-Releasing Hormone; D000077289:Letrozole