Aromatase inhibitors or gonadotropin‐releasing hormone agonists for the management of uterine adenomyosis: a randomized controlled trial

Badawy, Ahmed; Elnashar, Aboubakr; Mosbah, Alaa

doi:10.1111/j.1600-0412.2012.01350.x

Cited by 72 publications

(51 citation statements)

References 21 publications

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“…Similar to endometriosis and uterine fibroids, uterine adenomyosis is an estrogen‐dependent disease. Currently, GnRH agonists, danazol, aromatase inhibitor and levonorgestrel‐releasing intrauterine devices have been used as treatments for uterine adenomyosis. Symptoms could recur when medication administration is discontinued; hence, medicines that could be safely used for a long period, that is, until menopause, are highly desirable.…”

Section: Introductionmentioning

confidence: 99%

Long‐term dienogest administration in patients with symptomatic adenomyosis

Neriishi

Hirata

Fukuda

et al. 2018

J of Obstet and Gynaecol

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Section: Introductionmentioning

confidence: 99%

Long‐term dienogest administration in patients with symptomatic adenomyosis

Neriishi

Hirata

Fukuda

et al. 2018

J of Obstet and Gynaecol

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“…21 One study evaluated side effects, having reported hot flushes in 81.3% of women treated with GnRH analog. 22…”

Section: Treatment With Gonadotropin-releasing Hormone Agonist (Gnrh mentioning

confidence: 99%

Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review

Benetti‐Pinto

Mira

Yela

et al. 2019

Rev Bras Ginecol Obstet

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Objective To assess the efficacy of non-surgical treatment for adenomyosis. Data Sources A search was performed by two authors in the Pubmed, Scopus, and Scielo databases and in the grey literature from inception to March 2018, with no language restriction. Selection of Studies We have included prospective randomized studies for treating symptomatic women with adenomyosis (abnormal uterine bleeding and/or pelvic pain) diagnosed by ultrasound or magnetic resonance imaging. Data Collection Studies were primarily selected by title and abstract. The articles that were eligible for inclusion were evaluated in their entirety, and their data was extracted for further processing and analysis. Data Synthesis From 567 retrieved records only 5 remained for analysis. The intervention groups were: levonorgestrel intrauterine system (LNG-IUS)(n = 2), dienogest (n = 2), and letrozole (n = 1). Levonorgestrel intrauterine system was effective to control bleeding when compared to hysterectomy or combined oral contraceptives (COCs). One study assessed chronic pelvic pain and reported that LNG-IUS was superior to COC to reduce symptoms. Regarding dienogest, it was efficient to reduce pelvic pain when compared to placebo or goserelin, but less effective to control bleeding than gonadotropin-releasing hormone (GnRH) analog. Letrozole was as efficient as GnRH analog to relieve dysmenorrhea and dyspareunia, but not for chronic pelvic pain. Reduction of uterine volume was seen with aromatase inhibitors, GnRH analog, and LGN-IUD. Conclusion Levonorgestrel intrauterine system and dienogest have significantly improved the control of bleeding and pelvic pain, respectively, in women with adenomyosis. However, there is insufficient data from the retrieved studies to endorse each medication for this disease. Further randomized control tests (RCTs) are needed to address pharmacological treatment of adenomyosis.

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“…Medical treatment for adenomyosis is similar to that of endometriosis. LNG‐IUD, GnRH agonists, danazol, oral progestins and aromatase inhibitors have all been effective in treating adenomyosis related symptoms . Surgical treatment includes fertility‐sparing surgeries such as excision or cytoreductive procedures, and non‐fertility sparing procedures such as endometrial ablation, uterine artery embolization or hysterectomy …”

Section: Diagnosis and Managementmentioning

confidence: 99%

Gynecological associated disorders and management

et al. 2019

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Background Chronic pelvic pain syndrome is complex and involves multiple organ systems. The gynecological aspects of chronic pelvic pain syndrome can be divided into four different areas: intra‐abdominal, vaginal, pelvic floor muscles and sexual pain. This article provides an overview of gynecological evaluation in patients with chronic pelvic pain and reviews the most common gynecological diagnoses and their management. Methods An extensive review of the literature including guidelines from the International Continence Society, the European Association of Urology, and the International Association for the Study of Pain was performed. Results Gynecological evaluation of patients with chronic pelvic pain begins with a thorough history and physical examination. Laboratory tests, imaging studies and diagnostic procedures can be used as adjuncts to make a diagnosis. Treatment modalities include physical therapy, medications, trigger points injections, and surgery. Conclusion Common gynecological diagnoses of chronic pelvic pain include endometriosis, adenomyosis, vulvodynia, high tone pelvic floor dysfunction, and genitopelvic pain/penetration disorder. Gynecology is one of the many systems that can be associated with chronic pelvic pain. Managing patients with chronic pelvic pain requires a multimodal and multidisciplinary approach.

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Aromatase inhibitors or gonadotropin‐releasing hormone agonists for the management of uterine adenomyosis: a randomized controlled trial

Abstract: Aromatase inhibitors are as effective as gonadotropin-releasing hormone agonists in reducing adenomyoma volume and improving symptoms.

Cited by 72 publications

References 21 publications

Long‐term dienogest administration in patients with symptomatic adenomyosis

Long‐term dienogest administration in patients with symptomatic adenomyosis

Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review

Gynecological associated disorders and management

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