title: Adenomyosis: a systematic review of medical treatment.
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.
authors.affiliation: a U.O.C. Gynecology and Obstetrics, Ospedale San Francesco , Nuoro , Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pontis
authors.affiliation: b Department of Surgical Sciences , Section of Obstetrics & Gynecology, University of Cagliari , Monserrato , Italy.
authors.forename: M N
authors.initials: MN
authors.lastname: D'Alterio
authors.affiliation: b Department of Surgical Sciences , Section of Obstetrics & Gynecology, University of Cagliari , Monserrato , Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pirarba
authors.affiliation: c Casa di Cura Accreditata Fabia Mater , Roma , Italy , and.
authors.forename: C
authors.initials: C
authors.lastname: de Angelis
authors.affiliation: d Department of Obstetrics and Gynecology , Perrino Hospital , Brindisi , Italy.
authors.forename: R
authors.initials: R
authors.lastname: Tinelli
authors.affiliation: b Department of Surgical Sciences , Section of Obstetrics & Gynecology, University of Cagliari , Monserrato , Italy.
authors.forename: S
authors.initials: S
authors.lastname: Angioni
mesh_terms: D062788:Adenomyosis / Q000188:drug therapy*; D005260:Female; D006801:Humans
keywords: Adenomyosis; GnRH agonist; aromatase inhibitors; danazol; endometriosis; levonorgestrel-releasing intrauterine device; oral contraceptive; progestins