Materiały źródłowe

• #1 Adenomyosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adenomyosis/diagnosis-treatment/drc-20369143?_escaped_fragment_=&p=1

  Adenomyosis often goes away after menopause, so treatment might depend on how close you are to that stage of life. […] Treatment options for adenomyosis include: […] Anti-inflammatory drugs. Your doctor might recommend anti-inflammatory medications, such as ibuprofen (Advil, Motrin IB, others), to control the pain. By starting an anti-inflammatory medicine one to two days before your period begins and taking it during your period, you can reduce menstrual blood flow and help relieve pain. […] Hormone medications. Combined estrogen-progestin birth control pills or hormone-containing patches or vaginal rings might lessen heavy bleeding and pain associated with adenomyosis. Progestin-only contraception, such as an intrauterine device, or continuous-use birth control pills often cause amenorrhea the absence of your menstrual periods which might provide some relief. […] Hysterectomy. If your pain is severe and no other treatments have worked, your doctor might suggest surgery to remove your uterus. Removing your ovaries isn’t necessary to control adenomyosis.

• #1 Adenomyosis: symptoms, diagnosis, treatment – IFEM Endo

  https://www.institutendometriose.com/en/lendometriose/quest-ce-que-ladenomyose/

  Medical treatment of adenomyosis is aimed at controlling symptoms, not the disease in the anatomical sense. As in the case of endometriosis, the principle of treatment is to block ovulation and suppress menstruation, allowing atrophy of the endometrium and reduction or disappearance of microhemorrhages. However, the results of medical treatment are highly variable, with bleeding and pain persisting despite well-managed therapy. […] Surgical treatment is either conservative (conservation of the uterus) or radical (removal of the uterus or hysterectomy). Conservative techniques aim to destroy areas of adenomyosis in the most targeted way possible, in order to reduce symptoms. […] The most effective surgery for adenomyosis is hysterectomy, with disappearance of haemorrhage and improvement of pain. Hysterectomy is, of course, reserved for patients who no longer wish to become pregnant, and after failure of medical treatments.

• #1 Adenomyosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/14167-adenomyosis

  Adenomyosis is typically treated with medication or surgery. […] These treatments can ease pain, and help with heavy bleeding and other symptoms: Pain medications, Nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), ease cramping. […] Certain hormonal medications can help with menstruation and abnormal bleeding. Options include birth control pills, Depo-Provera injection and hormonal intrauterine devices (IUD), such as Mirena. […] Medications like tranexamic acid can reduce the amount of vaginal bleeding. […] Adenomyomectomy: This surgery removes adenomyosis from your uterine muscle. […] Hysterectomy: This surgery removes your uterus. After a hysterectomy, you won’t have a menstrual cycle or be able to get pregnant. […] Left untreated, adenomyosis can lead to infertility or miscarriage.

• #1 Adenomyosis: An Update Concerning Diagnosis, Treatment, and Fertility

  https://www.mdpi.com/2077-0383/13/17/5224

  For patients with adenomyosis experiencing dysmenorrhea, non-steroidal anti-inflammatory drugs (NSAIDs) have proven effective in managing pain by reducing prostaglandin production. […] LNG-IUS is highly effective in reducing uterine volume, pain, and abnormal uterine bleeding (AUB), making it the first-line medical treatment for adenomyosis. […] A randomized clinical trial (RCT) with 57 patients diagnosed with adenomyosis showed that a six-month treatment with either combined oral contraceptive pill (COC) or LNG-IUS reduced pain and bleeding, with larger reductions observed in the LNG-IUS group. […] A recent RCT confirmed that dienogest significantly decreases patient pain scores, improves QoL, and is well-tolerated as a long-term treatment option. […] Uterine artery embolization (UAE) is an angiographic procedure that utilizes embolic agents injected into the uterine arteries to induce ischemic necrosis in adenomyotic lesions. […] A meta-analysis involving 1049 patients across 30 studies reported significant symptom improvement in 83.1% of patients treated with UAE. […] Radiofrequency ablation (RFA) is an emerging uterine-preserving treatment for adenomyosis, particularly focal adenomyosis. […] High-intensity focused ultrasound (HIFU) is a non-surgical treatment option that uses ultrasound waves to thermally ablate adenomyotic lesions, causing coagulative necrosis and cell death. […] Uterus-sparing surgical approaches have been developed for the treatment of adenomyosis by removing diseased tissue, reducing uterine size and alleviating clinical symptoms.

• #1 Adenomyosis Diagnosis & Treatment | Dr. Len Kliman

  https://drlenkliman.com.au/services/gynaecology/adenomyosis/

  Management for adenomyosis include hormonal therapy or surgery. These treatments are mainly targeted at reducing symptoms such as pain and heavy bleeding. Non-steroidal anti-inflammatory drugs (NSAIDS) are useful for pain. Tranxenamic acid can be used to reduce heavy menstrual bleeding. Oral progesterone can be used to control menstrual bleeding. Low dose continuous combined oral contraceptives with withdrawal bleeds every four to six months may also be used for symptom control. Progesterone releasing IUDs are very effective in managing adenomyosis. […] Adenomyosis is an infiltrative lesion that is not easily removed surgically from the normal uterine wall. An endometrial ablation is a treatment used for various superficial types of adenomyosis. This works by destroying the lining of the uterus. This procedure significantly reduces the amount of blood loss from heavy menses but may not cure the pain component.

• #1 Current and Prospective Treatment of Adenomyosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8348135/

  (1) Background: Adenomyosis is a poorly understood entity which makes it difficult to standardize treatment. In this paper we review and compare the currently approved medical and surgical treatments of adenomyosis and present the evidence behind them. […] (3) Results: Several treatment options have been studied and were found to be effective in the treatment of adenomyosis. […] (4) Conclusions: Further randomized controlled trials are needed to compare treatment modalities and establish a uniform treatment algorithm for adenomyosis. […] The National Institute for Health and Care Excellence recommends using a hormonal intrauterine device as first line treatment for adenomyosis. […] In this paper, we review the current treatment options for adenomyosis, and compare their efficacies in controlling the condition.

• #1 Current and Prospective Treatment of Adenomyosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8348135/

  Dienogest is a selective synthetic oral progestin that has been shown to improve primary and secondary dysmenorrhea. […] Aromatase inhibitors work by halting the production of estrogen, which explains their use in adenomyosis to suppress the hormonal medium which favors the progression of the disease. […] Uterine artery embolization has been used in the treatment of leiomyomas and was shown to be as effective as myomectomy in improving quality of life and controlling symptoms. […] Radiofrequency ablation of adenomyotic lesions is another promising uterine-preserving option for focal adenomyosis. […] High-intensity focused ultrasound is a non-surgical option that utilizes ultrasound waves to cause coagulative necrosis and cell death to pathologic tissue. […] Treatment of adenomyosis varies widely from simple medication to a total hysterectomy and several options in between. […] Levonorgestrel IUD is effective, non-invasive, and fertility-preserving and seems to be the superior choice of treatment for this population.

• #1 Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8584979/

  The major disadvantage of progestin use is that approximately one-third of patients do not respond to these drugs, most likely due to progesterone resistance. […] Ulipristal acetate (UPA) is a selective progesterone receptor modulator currently registered for specific clinical indications: emergency contraception and long-term management of symptomatic uterine fibroids or prior to myoma surgery. […] GnRH agonist competitively binds to the natural GnRH receptors, but has a longer life span than the endogenous peptide. […] Its use in the context of adenomyosis relies on its anti-proliferative effects in the myometrium, following the suppression of gonadotropin secretion and the subsequent drastic decline in estradiol. […] While not yet registered for clinical use against symptomatic adenomyosis, oral GnRH antagonists constitute an attractive option, increasingly gaining the interest of the medical community and yielding promising results in preliminary studies.

• #1 Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8584979/

  While currently available options for conservative management of adenomyosis do have some capacity for alleviating symptoms and enhancing patient fertility perspectives, more effective new options are needed, with gonadotropin-releasing hormone antagonists showing encouraging results in preliminary studies. […] The choice of suitable therapy depends on individual patient age, severity of symptoms, and reproductive status, and can vary from full-scale hysterectomy to medical management of clinical symptoms and infertility. […] Currently available medical therapies for adenomyosis aim to alleviate local hyperestrogenism and tackle the most severe symptoms of adenomyosis, namely heavy menstrual bleeding, dysmenorrhea, and non-menstrual pelvic pain. […] The LNG-IUD, an intrauterine version of progestin, has also been proposed to manage symptomatic adenomyosis, yielding satisfactory outcomes, but with some debate around appropriate treatment durations.

• #1 Current and Prospective Treatment of Adenomyosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8348135/

  Medical treatments that aim to regress the adenomyotic lesions by controlling the hormonal medium. […] Surgical approaches, other than total hysterectomies, include physically removing tissue where pathology is present, or disrupting the blood flow to the affected area. […] Surgical techniques that preserve fertility have been developed to avoid hysterectomies in younger women. […] The LNG-IUD can help in the management of adenomyosis by both decidualization and atrophy of the endometrium and by downregulating estrogen receptors due to high progestin release. […] In a recent systematic review by Abbass et al., LNG-IUD was found to be a highly effective option for the management of adenomyosis. […] Danazol is an androgenic hormone used in the treatment of endometriosis to shrink the ectopic endometrial tissue.

• #1 Medical Therapy for Adenomyosis – Sydney Fibroid Clinic

  https://www.sydneyfibroidclinic.com.au/adenomyosis-treatments/medical-therapy/

  Hormonal manipulation to turn off oestrogen production might cause regression of adenomyosis. […] These drugs can therefore shrink the adenomyotic tissue and the overall size of the uterus. […] Once the treatment is stopped, a womans adenomyosis might bounce back. Symptoms can recur, and the uterus may increase to pre-treatment size. […] Is telling women to wait for menopause good advice? Probably not. […] In the past, hysterectomy was the only solution. Nowadays, we have progesterone-releasing IUDs (Mirena and Kyleena), and UAE, which can be used alone or in conjunction with each other, especially when medical therapies are not effective or are undesirable.

• #1 Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8584979/

  Uterine adenomyosis is a commonly encountered estrogen-dependent disease in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. […] It is clear that hysterectomy, the standard approach to definitively manage the disease, is not an option for patients wishing to preserve their fertility, so there is an urgent need to develop novel conservative strategies. […] We searched the current literature for available methods for conservative management of adenomyosis, including both pharmacological and surgical approaches. […] There is no existing drug that can cure adenomyosis at present, but some off-label treatment options may be used to tackle disease symptoms and improve fertility outcomes. […] Adenomyosis in patients wishing to conceive can be treated by conservative surgery, though these procedures require highly experienced surgeons and pose a considerable risk of uterine rupture during subsequent pregnancies.

• #1 Adenomyosis Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/2500101-treatment

  Hysterectomy is currently considered the only definitive management for adenomyosis and is still the recommended method if desired future fertility is not a factor. In many instances, adenomyosis is incidentally noted on histologic examination. […] Uterine artery embolization (UAE) has long been used as conservative treatment for women with symptomatic uterine fibroids. More recently, it has been considered as a treatment for symptomatic adenomyosis for women who are not candidates for surgical management. After UAE, patients with adenomyosis have reported significant improvement in dysmenorrhea, pelvic heaviness and urinary frequency. […] Adenomyomectomy is a surgical option for adenomyomas and is performed in the same manner as a myomectomy. After the location of the adenomyoma has been identified as well as possible using imaging techniques, the adenomyoma can be removed via laparotomy or laparoscopy. […] Long-term monitoring is not typically indicated. Conservative management can be continued without scheduled surveillance, and future management can be dictated by the patient’s symptoms.

• #1 Adenomyosis Non-Surgical Treatment – Los Angeles California

  https://cvifibroidcenter.com/services/adenomyosis-treatment-specialist/

  UAE presents a useful option for those who wish to avoid hysterectomy and prefer a minimally invasive technique without a hospital stay. […] 83.1% of patients who underwent UAE for adenomyosis demonstrated overall symptom improvement and 82% in a 7 year follow-up study were able to avoid a hysterectomy. […] The doctor has the freedom to spend as much time as needed for patient consultations and medical procedures.

• #1 Management of Adenomyosis – Endovascular Today

  https://evtoday.com/articles/2018-jan/management-of-adenomyosis

  Adenomyosis is defined as ectopic endometrial tissue within the musculature of the uterus. The interventionalists role is to offer uterine artery embolization (UAE), which provides some benefits over traditional medical and surgical therapies for adenomyosis. Management of symptomatic adenomyosis can include medication, hysterectomy, conservative surgery, or UAE. Conventional treatment with hysterectomy allows for definitive diagnosis and treatment; however, medications, conservative surgery, and UAE are less invasive techniques that permit preservation of the uterus and possible fertility. Medical therapies using suppressive hormonal treatments, such as continuous use of oral contraceptive pills, high-dose progestins, selective estrogen/progesterone receptor modulators, the levonorgestrel intrauterine device, aromatase inhibitors, danazol, and gonadotropin-releasing hormone receptor agonists, can improve symptoms by temporarily inducing regression of adenomyosis. For reproductive-age women and those with focal adenomyoma, conservative surgical approaches may be a better option. Although hysterectomy is the gold standard for diagnosis and treatment of adenomyosis, it is reserved for women who have completed childbearing. With the limitations of the aforementioned techniques, several studies have investigated the use of UAE for adenomyosis and have shown promise. When considering UAE for the treatment of adenomyosis, all patients at our institution have a preprocedural consultation, which allows for review of the symptomatology, a physical examination, and imaging. UAE presents a useful option for those who wish to avoid hysterectomy and prefer a minimally invasive technique with a short hospital stay. UAE offers favorable short-term outcomes for patients with adenomyosis, but further randomized controlled trials are needed to determine if symptom resolution is sustainable and explore the impact on fertility.

• #1 Adenomyosis | Endometriosis Treatment Center of America

  https://www.centerofendometriosis.com/endometriosis-services/adenomyosis/

  Adenomyosis Treatment Options […] Hormonal therapy involves taking medications that reduce estrogen levels or prevent ovulation, such as birth control pills, progestin injections, or hormonal IUDs. This can help reduce the bleeding and pain caused by adenomyosis. […] For mild cases of adenomyosis, pain relievers or anti-inflammatory drugs may reduce discomfort. These include over-the-counter or prescription painkillers, such as ibuprofen or naproxen. They can help relieve the inflammation and cramps associated with adenomyosis. […] Uterine artery embolization is a minimally invasive procedure that involves blocking the blood supply to the adenomyotic tissue with tiny particles injected through a catheter. This can shrink the tissue and reduce bleeding and pain. […] Endometrial ablation is a surgical procedure that destroys the lining of the uterus with heat, cold, or electricity. This can reduce or stop the menstrual bleeding caused by adenomyosis. However, this procedure is not recommended for women who want to have children in the future.

• #1 Adenomyosis – Is a new treatment solution available?

  https://www.imrpress.com/journal/CEOG/48/1/10.31083/j.ceog.2021.01.2144/htm

  Therefore these findings suggest that HIFU treatment of adenomyosis can reduce the uterine volume and adenomyotic lesions in the short term (at 12 months follow up) and also effectively relieve the dysmenorrhea and heavy menstrual flow. […] Nevertheless with increasing experience of HIFU treatment, the efficacy of HIFU ablation for adenomyosis has significantly improved and has also been widely recognized in China. […] The combined therapy of GnRH-a or/and Mirena with HIFU treatment can further consolidate the curative effect and reduce the recurrence of adenomyosis. […] Now the recurrence rate was significantly reduced, therefore HIFU may now become a new treatment solution for adenomyosis. […] Although HIFU ablation for adenomyosis has been shown to relieve period pain, heavy periods and reduce the uterine size, it may not be possible to provide a cure for adenomyosis.

• #1

  https://link.springer.com/article/10.1007/s13669-024-00379-w

  LNG-IUS improves the symptoms associated with adenomyosis by inducing decasualization and atrophy of the endometrium and downregulating estrogen receptors through increased progesterone release. It is highly effective in reducing pain and AUB and is regarded to be more efficacious than COCs. […] Non-surgical interventions for adenomyosis can be categorized into UAE and image-guided thermal ablation techniques. UAE, an angiographic technique, utilizes embolic agents delivered into uterine arteries to create ischemic necrosis within adenomyotic lesions. […] HIFU employs focused ultrasonic energy externally to thermally ablate adenomyotic lesions beneath the skin without surface disruption. […] RFA involves inserting electrodes, directly into the target lesion under ultrasound guidance.

• #1 Best Adenomyosis Treatment – Seckin Endometriosis Center

  https://drseckin.com/best-adenomyosis-treatment/

  There are no standard drugs that can treat adenomyosis. Most endometriosis medications can also be helpful for adenomyosis. […] If adenomyosis is the only disease present, the symptoms often go away after menopause. […] Suppose you are nearing menopause and the symptoms are not severe. In that case, adenomyosis can be managed with over-the-counter pain medications and hormonal birth control such as progestin-only mini pills or intrauterine hormonal devices. […] It is important to note that these medications do not treat the lesions themselves but only help in managing the symptoms of the disease. […] When adenomyosis is diffuse, there are few good surgical options. […] When there is a focal area of adenomyosis or an adenomyoma, we can carefully excise these. Excision of these areas can lead to improved pain, bleeding, and possibly fertility. However, exceptional skill is necessary to reconstruct the uterus layer by layer so as to facilitate a safe future pregnancy.

• #1 Adenomyosis | Endometriosis Treatment Center of America

  https://www.centerofendometriosis.com/endometriosis-services/adenomyosis/

  For patients who do not want to have children in the future, this major surgery may be an option. This is the only definitive treatment for adenomyosis that eliminates all symptoms. The treatment of adenomyosis depends on the severity of the symptoms and the patients preferences. At the Endometriosis Treatment Center of America, we listen to your concerns and we partner with you to develop a custom treatment plan. With locations in Lake Orion, MI and Birmingham, MI, relief is within reach. Schedule your appointment with us now to learn more about adenomyosis treatments.

• #1 Adenomyosis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/2500101-overview

  The only definitive treatment for symptoms associated with adenomyosis is hysterectomy; however, this is not an option for patients who desire future fertility and may not be an option for patients who are poor surgical candidates. […] The medications most commonly used to treat symptoms of adenomyosis are anti-inflammatory drugs and hormonal therapies. […] Some studies suggest that adenomyosis has a negative impact on fertility outcomes; however, limited data exist. […] A meta-analysis by Cozzolino et al showed that infertile women with adenomyosis who underwent in vitro fertilization (IVF) had a lower live birth rate, clinical pregnancy rate, and ongoing pregnancy rate than did women without adenomyosis. […] Additionally, the rate of miscarriage was higher in women who had adenomyosis.

• #1 The Impact of Conservative Surgical Treatment of Adenomyosis on Fertility and Perinatal Outcomes

  https://www.mdpi.com/2077-0383/13/9/2531

  Despite the clear benefits shown by available data regarding uterus-sparing surgeries, all studies lack crucial information regarding the mention of adenomyosis subtypes, instead grouping the pathology into two major categories (focal/diffuse). […] Available data suggests that uterine-preserving surgeries, with or without medical treatment, may positively impact fertility and pregnancy outcomes. However, due to the lack of high-quality evidence, further well-designed studies with standardized classification systems, surgical techniques, and additional medical therapies are needed to better understand the optimal approach for patient care while mitigating associated risks, such as uterine rupture and placenta accreta spectrum in subsequent pregnancies.

• #1 Adenomyosis – Epworth HealthCare

  https://www.epworth.org.au/our-services/endometriosis-centre/related/adenomyosis

  Non-pharmacological (not involving medication) pain management includes heat including baths and heat packs offer relief from pain secondary to adenomyosis. […] Endometrial ablation involves burning the lining of the uterus. It is performed under general anaesthetic. It can assist with heavy bleeding secondary to adenomyosis (and other conditions), but rarely improves pain and has the potential to worsen pain depending on the severity of the adenomyosis. […] Uterine artery embolisation is a procedure where the blood supply to the uterus is intentionally interrupted to cause the uterus to shrink. It rarely has a role in the management of adenomyosis. […] Occasionally, adenomyosis can be contained in one area or lump, known as an adenomyoma. There are some circumstances where removing just that part of the uterus is the best course of action. […] Complementary therapies, including acupuncture and CBD oil have been useful for some patients, however evidence is lacking at this point in time.

• #1 Adenomyosis | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/ovaries-uterus/adenomyosis

  Treatment for adenomyosis will depend on your symptoms, stage of life and whether you plan to have children. You can also try things like gentle physical activity, meditation, yoga and acupuncture in addition to standard treatments to help manage your symptoms. […] Research shows the Mirena IUD has the best outcomes for managing symptoms of adenomyosis. The IUD is inserted into your uterus. It releases progesterone, which reduces bleeding and pain and thins the endometrial cells. You can have the IUD removed if you are planning a pregnancy. […] The combined oral contraceptive pill may reduce bleeding and pain, but research suggests it is not as effective as the Mirena IUD. You can stop taking either treatment if you are planning a pregnancy. […] Your doctor or specialist may not recommend surgery if you are planning a pregnancy. Surgery can result in scar tissue in the uterus, which might affect your fertility.

• #1 How to Relieve Pain From Adenomyosis

  https://blog.nbir.com.au/how-to-relieve-pain-for-adenomyosis

  A transcutaneous electrical nerve stimulation machine, better known as a TENS machine, is one such device that can provide pain relief. […] Studies have shown that a TENS machine can help provide pain relief for women suffering painful periods, a common symptom of adenomyosis, which makes it a solution worth trying if you have been diagnosed with adenomyosis. […] Often viewed as the only true solution to uterine conditions, a hysterectomy can remove 100% of your adenomyosis and is used to treat severe cases of adenomyosis. […] However, its not the only surgical option available, and minimally-invasive treatments such as uterine artery embolisation are viable alternatives to a hysterectomy for many women. […] Endometrial ablation is a minimally invasive procedure that reduces menstrual flow by destroying (ablating) the uterine lining.

• #1 Available Treatment for Adenomyosis | Endometriosis.netShare to Facebookprint pageBookmark for latercommentcaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon

  https://endometriosis.net/clinical/adenomyosis-treatment

  Conventional treatment of adenomyosis include a hysterectomy, hormonal suppression with the continuous use oral contraceptives, or a hormonal IUD (intrauterine device) such as a Mirena. Unfortunately, the only completely effective therapy for adenomyosis is a hysterectomy. […] Natural treatments for adenomyosis can help symptoms but cannot cure the condition. Given the condition is similar to endometriosis in that it is inflammatory, consists of underlying immune dysfunction, and fueled by estrogen, eating an anti-inflammatory diet and consuming plenty of fiber is important to escort excess estrogen out of the body. […] Supplements and herbal medicine for adenomyosis: Curcumin (a constituent of turmeric) lightens periods and helps lower pain and inflammation. Zinc helps reduce pain and inflammation. Magnesium can help lower inflammation, helps with muscle relaxation and mood.

• #1 Adenomyosis: Enlarged Uterus Causes (+ Natural Relief) – Dr. Axe

  https://draxe.com/health/adenomyosis/

  Ask about TENS […] In general, however, there is virtually no data on safety. If you choose to use herbal remedies or supplements for menstrual pain or heavy bleeding, do so with caution. Consult a health care professional before you start any new herbs or supplements, since they can interact with other medications. […] Conventional management of adenomyosis typically includes over-the-counter pain relievers and anti-inflammatory drugs. In severe cases, women may receive surgery to destroy the endometrial tissue or to remove the uterus entirely. […] Natural tips for managing adenomyosis symptoms at home include: […] Use heating pads. […] Get massage therapy or acupressure. […] Try herbs and supplements. […] Alter your diet. […] Exercise. […] Ask about TENS.

• #1 Adenomyosis – stages, symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/adenomyosis

  Talk to your doctor about what would be a suitable option for you. This is important as these treatments can affect your fertility. […] There are some surgical procedures that can be considered for the treatment of adenomyosis. […] A hysterectomy may be an option if you have severe adenomyosis symptoms and have not responded to other treatments.

• #1 Adenomyosis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/3000384

  Adenomyosis is a noncancerous gynecologic condition characterized by the existence of endometrial-like tissue within the uterine myometrium. […] Treatment is dependent on the type and severity of symptoms, patient preference, and the desire to preserve fertility. The levonorgestrel intrauterine device (IUD) is the preferred first-line medical treatment, although alternative hormonal therapies can also be used. A nonsteroidal anti-inflammatory drug (NSAID) or tranexamic acid may be used alone for mild symptoms or in combination with hormonal treatment if symptoms persist or recur. […] Hysterectomy is a definitive treatment option for women with severe symptoms who do not desire future fertility. Endometrial ablation or uterine artery embolization are alternative approaches for patients who wish to preserve their uterus or are unsuitable for hysterectomy. Uterine-sparing focal excision procedures may be considered in women with severe adenomyotic disease who desire preservation of fertility, but this is a challenging surgical technique with uncertain fertility outcomes.

• #1 Adenomyosis Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/2500101-treatment

  The most important factor when considering treatment of a patient with adenomyosis is her desire for future fertility. The only definitive treatment for symptoms associated with adenomyosis is hysterectomy; however, this is not an option for patients who desire future fertility and may not be an option for patients who are poor surgical candidates. Additionally, because adenomyosis is still rarely definitively diagnosed before hysterectomy, treatment relies on a presumptive diagnosis. Surveillance for improvement is based on clinical presentation, with little ability for surveillance through imaging studies. […] The medications most commonly used to treat symptoms of adenomyosis are anti-inflammatory medications and hormonal therapies. The most common class of anti-inflammatory medications used to treat menorrhagia are nonsteroidal anti-inflammatory drugs. These inhibit formation of prostaglandins, which are considered the primary mechanism of action in uterine pain. Hormonal therapies cause ovarian suppression, mainly through negative feedback on the hypothalamic-pituitary-ovarian axis. By suppressing ovarian function, hormonal stimulation of adenomyotic tissue is suppressed.

• #1

  https://link.springer.com/article/10.1007/s13669-024-00379-w

  Uterine-sparing excisional surgical techniques for adenomyosis are complex, carry significant risks, and after all have substantial recurrence rates. Consequently, there has been a trend towards adopting non-surgical treatments. This narrative review outlines the latest in non-surgical treatments for adenomyosis, highlighting their significance in managing this condition and stresses the importance of further research, especially concerning long-term outcomes and fertility implications. […] Emerging evidence suggests that non-surgical techniques for the treatment of adenomyosis offer promising alternatives to traditional uterus-conserving surgery. […] LNG-IUS is recommended as the primary management strategy for adenomyosis. In our clinical evaluation, a pretreatment with GnRH-analogs, HIFU, or UAE prior to LNG-IUS insertion in enlarged uteri may mitigate treatment failure risks, notably device expulsion. Concurrently, post-intervention LNG-IUS application post non-surgical modalities can diminish recurrence probability.

• #1 Adenomyosis: An Update Concerning Diagnosis, Treatment, and Fertility

  https://www.mdpi.com/2077-0383/13/17/5224

  Adenomyosis: An Update Concerning Diagnosis, Treatment, and Fertility […] This review article aims to summarize current tools used in the diagnosis of adenomyosis with relative pharmacological and surgical treatment and to clarify the relative association between adenomyosis and infertility, considering the importance of an accurate diagnosis of this heterogeneous disease. […] Adenomyosis has been increasingly identified in young women with pain, AUB, infertility, or no symptoms by using imaging techniques such as transvaginal ultrasound and magnetic resonance. […] A standard, universally accepted classification system needs to be implemented to improve our understanding and inform precise diagnosis of the type of adenomyosis. This could be the key to designing RCT studies and evaluating the impact of adenomyosis on quality of life in terms of menstrual symptoms, fertility, and pregnancy outcome, given the high risk of miscarriage and obstetric complications.

• #1 Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8584979/

  Future randomized clinical trials should evaluate if UAE should be offered to women in whom conservative management for adenomyosis has failed as a less invasive alternative to hysterectomy. […] Uterine adenomyosis remains an enigmatic disease and there are currently no widely accepted guidelines on its conservative management. […] Medical treatment is the option of choice to improve clinical symptoms and partially reverse infertility, especially in milder cases.

• #2 Adenomyosis – stages, symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/adenomyosis

  Adenomyosis is a condition that affects your uterus (womb). […] Treatment will depend on your symptoms and stage of life, including whether you want to become pregnant in the future. […] Your doctor will talk with you about the different treatments available. […] The choice of treatment will depend on your symptoms and life stage. This includes thinking about whether you are planning a pregnancy or want to have a baby in your future. […] If you have pain associated with adenomyosis, your doctor may recommend a trial of anti-inflammatory medicines. They may suggest that you take these medicines with paracetamol. […] Hormonal treatments can help relieve your pain and reduce heavy periods. […] Your doctor may recommend a hormonal intrauterine device (IUD), the pill (combined oral contraceptive pill), a progestogen-only pill, or a hormone-releasing contraceptive implant.

• #2 Adenomyosis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0100/p33.html

  Adenomyosis is a clinical condition where endometrial glands are found in the myometrium of the uterus. […] Treatment of adenomyosis typically starts with hormonal menstrual suppression. Levonorgestrel-releasing intrauterine systems have shown some effectiveness. Patients with adenomyosis may ultimately have a hysterectomy if symptoms are not controlled with medical therapy. […] Treatment of adenomyosis focuses on symptom control. There are no medical treatments approved by the U.S. Food and Drug Administration for adenomyosis; however, many medical therapies that are successful in treating endometriosis are also used off label for adenomyosis. Definitive therapy for adenomyosis is hysterectomy if other therapies are not effective. […] Uterine artery embolization is a potential minimally invasive option to treat focal adenomyosis.

• #2 Adenomyosis Diagnosis & Treatment | Dr. Len Kliman

  https://drlenkliman.com.au/services/gynaecology/adenomyosis/

  Management for adenomyosis include hormonal therapy or surgery. These treatments are mainly targeted at reducing symptoms such as pain and heavy bleeding. Non-steroidal anti-inflammatory drugs (NSAIDS) are useful for pain. Tranxenamic acid can be used to reduce heavy menstrual bleeding. Oral progesterone can be used to control menstrual bleeding. Low dose continuous combined oral contraceptives with withdrawal bleeds every four to six months may also be used for symptom control. Progesterone releasing IUDs are very effective in managing adenomyosis. […] Adenomyosis is an infiltrative lesion that is not easily removed surgically from the normal uterine wall. An endometrial ablation is a treatment used for various superficial types of adenomyosis. This works by destroying the lining of the uterus. This procedure significantly reduces the amount of blood loss from heavy menses but may not cure the pain component.

• #2 Adenomyosis: Symptoms, Causes, and Treatments

  https://www.webmd.com/women/adenomyosis-symptoms-causes-treatments

  If a hysterectomy doesn’t make sense for you, other treatments can ease symptoms until you reach menopause. […] These include: […] Painkillers. You might use over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to relieve pain and cramps. Your doctor might suggest you start taking them 1-2 days before your period begins and through the first few days of bleeding. […] Hormone therapy. Certain hormonal medications, including hormone-releasing intrauterine devices (IUDs), birth control pills, patches, and injections, can help with bleeding and pain. Some will stop periods, offering extra symptom relief. […] Nonhormonal medication. Medications such as tranexamic acid can reduce menstrual bleeding. […] Adenomyomectomy. This is surgery to remove tissue from your uterine muscle. It’s similar to a myomectomy, which removes uterine fibroids.

• #2 Adenomyosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/14167-adenomyosis

  Adenomyosis is typically treated with medication or surgery. […] These treatments can ease pain, and help with heavy bleeding and other symptoms: Pain medications, Nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), ease cramping. […] Certain hormonal medications can help with menstruation and abnormal bleeding. Options include birth control pills, Depo-Provera injection and hormonal intrauterine devices (IUD), such as Mirena. […] Medications like tranexamic acid can reduce the amount of vaginal bleeding. […] Adenomyomectomy: This surgery removes adenomyosis from your uterine muscle. […] Hysterectomy: This surgery removes your uterus. After a hysterectomy, you won’t have a menstrual cycle or be able to get pregnant. […] Left untreated, adenomyosis can lead to infertility or miscarriage.

• #2 Adenomyosis – Fibroid Treatment Collaborative

  https://www.fibroid.com/about-fibroids/what-is-adenomyosis/

  Adenomyosis isn’t the same as endometriosis – a condition in which the uterine lining becomes implanted outside the uterus – although women with adenomyosis often also have endometriosis. […] For women who experience severe discomfort from adenomyosis, there are treatments that can help, but hysterectomy is the only cure. […] The Fibroid Treatment Collaborative is dedicated to the comprehensive multi-disciplinary approach to the management of pelvic pain, abnormal bleeding and adenomyosis. […] Treatment options for adenomyosis include: Anti-inflammatory drugs. If you’re nearing menopause, your doctor may have you try anti-inflammatory medications, such as ibuprofen (Advil, Motrin, others), to control the pain. […] Hormone therapy. Controlling your menstrual cycle through combined estrogen-progestin oral contraceptives, hormone-containing patches or vaginal rings may lessen the heavy bleeding and pain associated with adenomyosis.

• #2 Adenomyosis: An Update Concerning Diagnosis, Treatment, and Fertility

  https://www.mdpi.com/2077-0383/13/17/5224

  For patients with adenomyosis experiencing dysmenorrhea, non-steroidal anti-inflammatory drugs (NSAIDs) have proven effective in managing pain by reducing prostaglandin production. […] LNG-IUS is highly effective in reducing uterine volume, pain, and abnormal uterine bleeding (AUB), making it the first-line medical treatment for adenomyosis. […] A randomized clinical trial (RCT) with 57 patients diagnosed with adenomyosis showed that a six-month treatment with either combined oral contraceptive pill (COC) or LNG-IUS reduced pain and bleeding, with larger reductions observed in the LNG-IUS group. […] A recent RCT confirmed that dienogest significantly decreases patient pain scores, improves QoL, and is well-tolerated as a long-term treatment option. […] Uterine artery embolization (UAE) is an angiographic procedure that utilizes embolic agents injected into the uterine arteries to induce ischemic necrosis in adenomyotic lesions. […] A meta-analysis involving 1049 patients across 30 studies reported significant symptom improvement in 83.1% of patients treated with UAE. […] Radiofrequency ablation (RFA) is an emerging uterine-preserving treatment for adenomyosis, particularly focal adenomyosis. […] High-intensity focused ultrasound (HIFU) is a non-surgical treatment option that uses ultrasound waves to thermally ablate adenomyotic lesions, causing coagulative necrosis and cell death. […] Uterus-sparing surgical approaches have been developed for the treatment of adenomyosis by removing diseased tissue, reducing uterine size and alleviating clinical symptoms.

• #2 Uterine Adenomyosis > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/uterine-adenomyosis

  Treatment includes medication and surgery […] Treatments, including medication and surgical procedures, may ease uncomfortable symptoms. Hysterectomy, a permanent solution, may eliminate pain and heavy menstrual bleeding, but this is not appropriate for everyone, especially those who wish to retain the option of childbearing. […] Adenomyosis can be treated medically or surgically, including but not limited to oral progesterone and levonorgestrel-releasing intrauterine devices [IUDs] such as Mirena, says Yale Medicine gynecologic surgeon Farinaz Seifi, MD. Surgical approaches include focal resection of adenomyosis to hysterectomy. […] Doctors may offer women one or more of the following medications to reduce symptoms of uterine adenomyosis: Non-steroidal anti-inflammatory drugs (NSAIDs), which may soothe menstrual cramps. Birth control pills, may lighten menstrual flow and can also help reduce discomfort. Hormone-containing intrauterine device (IUD), which contains the hormone levonorgestrel, can ease cramps and lighten menstrual blood flow. Insertion of a hormone-containing IUD may also help shrink the uterus to shrink to a more normal size. Danazol, a medication that suppresses the pituitary glands creation of certain hormones, such as FSH. This may reduce pain and lighten menstrual flow. Gonadotropin-releasing hormone agonists, a class of medication that triggers the ovaries to stop producing hormones, can help reduce menstrual flow and pain.

• #2 Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8584979/

  The major disadvantage of progestin use is that approximately one-third of patients do not respond to these drugs, most likely due to progesterone resistance. […] Ulipristal acetate (UPA) is a selective progesterone receptor modulator currently registered for specific clinical indications: emergency contraception and long-term management of symptomatic uterine fibroids or prior to myoma surgery. […] GnRH agonist competitively binds to the natural GnRH receptors, but has a longer life span than the endogenous peptide. […] Its use in the context of adenomyosis relies on its anti-proliferative effects in the myometrium, following the suppression of gonadotropin secretion and the subsequent drastic decline in estradiol. […] While not yet registered for clinical use against symptomatic adenomyosis, oral GnRH antagonists constitute an attractive option, increasingly gaining the interest of the medical community and yielding promising results in preliminary studies.

• #2

  https://link.springer.com/article/10.1007/s40265-023-01957-7

  The efficacy and safety of DNG have also been compared with other progestins such as LNG-IUS or danazol, as well as with other hormonal treatments like GnRH-as. […] The use of danazol in the treatment of adenomyosis is limited due to serious side effects, especially when administered orally, and the need for restricted treatment duration and patient adherence. […] COCs can be offered to young patients who do not desire to place LNG-IUS, and who do not tolerate the (often common) side effects occurring under oral progestin therapy, or who also requires contraception. […] GnRH-as have demonstrated effectiveness in managing symptoms related to adenomyosis, although at the moment they should be considered as second-line therapy for patients with adenomyosis. […] The important point being made is that relying solely on GnRH-as or -ants to suppress ovarian estrogen production may not be sufficient to completely quiesce adenomyosis because of this local estrogen production by aromatase in the adenomyotic tissue itself.

• #2 Adenomyosis Diagnosis & Treatment | Dr. Len Kliman

  https://drlenkliman.com.au/services/gynaecology/adenomyosis/

  Another option to treat adenomyosis is a uterine artery embolization (UAE). A UAE is an interventional radiology procedure that can be performed under local anaesthetic and light sedation. A tiny tube is inserted into the femoral artery in the groin and guided by X-ray into the left and right uterine arteries. Tiny particles are injected to restrict blood flow. Normal uterine muscle has the immense capacity to recruit dormant blood vessels to survive. Adenomyotic tissue does not have the capacity to recruit new vessels and therefore it will shrink and die. […] In the past when conservative treatments failed, hysterectomy was the only definitive treatment for adenomyosis. In cases where conservative treatments have failed, hysterectomy may still be a valuable treatment option in women who have completed their childbearing.

• #2 Adenomyosis – Epworth HealthCare

  https://www.epworth.org.au/our-services/endometriosis-centre/related/adenomyosis

  Non-pharmacological (not involving medication) pain management includes heat including baths and heat packs offer relief from pain secondary to adenomyosis. […] Endometrial ablation involves burning the lining of the uterus. It is performed under general anaesthetic. It can assist with heavy bleeding secondary to adenomyosis (and other conditions), but rarely improves pain and has the potential to worsen pain depending on the severity of the adenomyosis. […] Uterine artery embolisation is a procedure where the blood supply to the uterus is intentionally interrupted to cause the uterus to shrink. It rarely has a role in the management of adenomyosis. […] Occasionally, adenomyosis can be contained in one area or lump, known as an adenomyoma. There are some circumstances where removing just that part of the uterus is the best course of action. […] Complementary therapies, including acupuncture and CBD oil have been useful for some patients, however evidence is lacking at this point in time.

• #2 Adenomyosis Treatment in Delhi, India | Symptoms, Causes & Diagnosis | Max Hospital

  https://www.maxhealthcare.in/our-specialities/obstetrics-and-gynaecology/conditions-treatments/adenomyosis

  In this minimally invasive procedure, small particles are injected into the arteries that supply blood to the uterus, blocking blood flow to the adenomyosis lesions. UAE can help reduce symptoms such as heavy menstrual bleeding and pelvic pain. […] Endometrial Ablation: This procedure involves destroying the lining of the uterus to reduce menstrual bleeding. It may provide relief for some women with adenomyosis, but it is not suitable for those who desire future fertility. […] Hysterectomy: Removal of the uterus is the definitive treatment for adenomyosis, and it can effectively alleviate symptoms. Hysterectomy is recommended for women who have completed childbearing and have severe symptoms that do not respond to other treatments. […] Eating a healthy diet, exercising regularly, and managing stress can help improve overall health and may alleviate symptoms of adenomyosis. […] It’s essential for individuals with adenomyosis to discuss treatment options with their healthcare provider to determine the most appropriate approach based on their individual circumstances and preferences.

• #2 Adenomyosis – Fibroid Treatment Collaborative

  https://www.fibroid.com/about-fibroids/what-is-adenomyosis/

  Presacral Neurectomy. A surgical procedure to interrupt the pain nerve supply, or presacral nerve plexus, to the uterus. […] Hysterectomy. If your pain is severe and menopause is years away, your doctor may suggest surgery to remove your uterus (hysterectomy). Removing your ovaries isn’t necessary to control adenomyosis.

• #2 Adenomyosis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/2500101-overview

  Furthermore, a meta-analysis by Wang et al found that symptomatic and diffuse adenomyosis, but not asymptomatic adenomyosis, was associated with worse IVF outcomes, including live birth and clinical pregnancy rates. […] The symptoms of adenomyosis are very common among other gynecologic diseases. […] If adenomyosis is suspected or the diagnosis of adenomyosis is made, discussing the pathophysiology and natural history of the disease should be considered to allow the patient to understand her prognosis and the mechanism of possible treatment.

• #2 Adenomyosis: What it is and how it affects fertility | IVF-Life

  https://www.ivf-spain.com/en/blog/adenomyosis-a-possible-cause-of-infertility-in-women

  Adenomyosis treatment […] The treatment of this condition largely depends on its symptoms. Among the existing treatment options for adenomyosis are pharmacological methods, with anti-inflammatory medications that reduce its symptoms or hormonal medication prescribed by the specialist. In cases where medication has not been effective, surgery may be considered. […] What are the recommended assisted reproduction methods for women with adenomyosis? The assisted reproduction treatment protocols at IVF-Life are tailored to the needs of each patient. The first consultation with our specialists will focus on achieving an accurate diagnosis. Only then can we determine from the outset whether the patient’s infertility is due to this condition. […] In the case of a woman with adenomyosis, the patient must start with proper preparation of the uterine cavity. Therefore, it is proposed to initially perform ovarian stimulation. This allows for the retrieval of oocytes and the performance of in vitro fertilization, placing the embryos with the highest implantation potential into the woman’s uterus. Another option would be to consider egg vitrification to plan the appropriate treatment at another time.

• #2 Adenomyosis: Enlarged Uterus Causes (+ Natural Relief) – Dr. Axe

  https://draxe.com/health/adenomyosis/

  Tissue destruction. Procedures such as endometrial ablation and MRI-guided focused ultrasound surgery try to destroy the endometrial tissue that is causing adenomyosis. These procedures may not work for everyone and more research is needed. […] Hysterectomy. This is surgical removal of the uterus. It permanently cures adenomyosis but is a major surgery. Adenomyosis hysterectomy is only done for women who have severe symptoms and who do not wish to have any more children. […] Natural treatments for adenomyosis generally involve managing the menstrual pain and bleeding caused by the condition. […] Natural tips for managing adenomyosis symptoms include: […] Use heating pads […] Get massage therapy or acupressure […] Try herbs and supplements […] Alter your diet […] Exercise

• #2 How to Relieve Pain From Adenomyosis

  https://blog.nbir.com.au/how-to-relieve-pain-for-adenomyosis

  Like many conditions, treatment options vary based on the severity of symptoms, and adenomyosis is no different. […] At one end of the scale you have lifestyle changes and home remedies, right through to surgical intervention at the other end. […] If youve suffered from painful periods or pelvic pain for some time you may have discovered a home remedy you can turn to to help relieve the pain. […] Common examples include a warm bath, a hot water bottle placed on your stomach, or over-the-counter pain medication, which we will discuss next. […] Yoga has also been shown to provide pain relief, with certain poses activating areas commonly associated with uterine or pelvic pain. […] If yoga isnt your thing, simply increasing the amount of light-to-moderate exercise you do can help improve your symptoms.

• #2 Adenomyosis: Enlarged Uterus Causes (+ Natural Relief) – Dr. Axe

  https://draxe.com/health/adenomyosis/

  Ask about TENS […] In general, however, there is virtually no data on safety. If you choose to use herbal remedies or supplements for menstrual pain or heavy bleeding, do so with caution. Consult a health care professional before you start any new herbs or supplements, since they can interact with other medications. […] Conventional management of adenomyosis typically includes over-the-counter pain relievers and anti-inflammatory drugs. In severe cases, women may receive surgery to destroy the endometrial tissue or to remove the uterus entirely. […] Natural tips for managing adenomyosis symptoms at home include: […] Use heating pads. […] Get massage therapy or acupressure. […] Try herbs and supplements. […] Alter your diet. […] Exercise. […] Ask about TENS.

• #2 Adenomyosis – stages, symptoms and treatment | healthdirect

  https://www.healthdirect.gov.au/adenomyosis

  Talk to your doctor about what would be a suitable option for you. This is important as these treatments can affect your fertility. […] There are some surgical procedures that can be considered for the treatment of adenomyosis. […] A hysterectomy may be an option if you have severe adenomyosis symptoms and have not responded to other treatments.

• #2 Adenomyosis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/3000384

  Adenomyosis is a noncancerous gynecologic condition characterized by the existence of endometrial-like tissue within the uterine myometrium. […] Treatment is dependent on the type and severity of symptoms, patient preference, and the desire to preserve fertility. The levonorgestrel intrauterine device (IUD) is the preferred first-line medical treatment, although alternative hormonal therapies can also be used. A nonsteroidal anti-inflammatory drug (NSAID) or tranexamic acid may be used alone for mild symptoms or in combination with hormonal treatment if symptoms persist or recur. […] Hysterectomy is a definitive treatment option for women with severe symptoms who do not desire future fertility. Endometrial ablation or uterine artery embolization are alternative approaches for patients who wish to preserve their uterus or are unsuitable for hysterectomy. Uterine-sparing focal excision procedures may be considered in women with severe adenomyotic disease who desire preservation of fertility, but this is a challenging surgical technique with uncertain fertility outcomes.

• #2

  https://link.springer.com/article/10.1007/s13669-024-00379-w

  Given these complexities and risks, the past decades have seen a shift towards the development and adoption of less invasive treatment modalities for adenomyosis. Techniques such as Uterine Artery Embolization (UAE), High-Intensity Focused Ultrasound (HIFU), Percutaneous Microwave Ablation (PMWA), and Radiofrequency Ablation (RFA) have emerged as promising alternatives as reports increase on their efficiency and safety for the treatment of adenomyosis. […] This narrative review concentrates on the existing evidence for non-surgical treatments and their significance in the management of adenomyosis. […] Medical treatment is primarily indicated for patients with adenomyosis who wish to preserve their fertility or for those nearing menopause. It is also recommended for patients who are unsuitable for surgical intervention because of other medical comorbidities. The range of hormonal treatments available for adenomyosis includes combined oral contraceptive (COC) pills, progestins, the levonorgestrel-releasing intrauterine system (LNG-IUS), and gonadotropin-releasing hormone (GnRH) agonists and antagonists and danazol.

• #2 Adenomyosis: An Update Concerning Diagnosis, Treatment, and Fertility

  https://www.mdpi.com/2077-0383/13/17/5224

  Adenomyosis: An Update Concerning Diagnosis, Treatment, and Fertility […] This review article aims to summarize current tools used in the diagnosis of adenomyosis with relative pharmacological and surgical treatment and to clarify the relative association between adenomyosis and infertility, considering the importance of an accurate diagnosis of this heterogeneous disease. […] Adenomyosis has been increasingly identified in young women with pain, AUB, infertility, or no symptoms by using imaging techniques such as transvaginal ultrasound and magnetic resonance. […] A standard, universally accepted classification system needs to be implemented to improve our understanding and inform precise diagnosis of the type of adenomyosis. This could be the key to designing RCT studies and evaluating the impact of adenomyosis on quality of life in terms of menstrual symptoms, fertility, and pregnancy outcome, given the high risk of miscarriage and obstetric complications.

• #2

  https://link.springer.com/article/10.1007/s40265-023-01957-7

  To address this issue, the use of AIs has been investigated, showing efficacy for the improvement of AUB and pelvic pain associated with adenomyosis. […] In conclusion, adenomyosis remains a challenging condition to manage due to the lack of approved medical therapies and limited high-quality evidence supporting treatment decisions.

• #3

  https://link.springer.com/article/10.1007/s40265-023-01957-7

  Further research is needed to establish evidence-based guidelines for the medical management of adenomyosis. Additionally, the investigation of new treatment targets, including GnRH antagonists and aromatase inhibitors, holds promise but requires more exploration for their potential in adenomyosis treatment. […] The use of LNG-IUS in the treatment of pelvic pain and AUB related to adenomyosis could be justified not only by the direct effect of LNG on adenomyotic foci but also by its modulatory action on altered endometrial factors. […] Although there is limited specific literature on the treatment of adenomyosis with LNG-IUS, a few randomized trials have been conducted in this setting. Currently, LNG-IUS is one of the most extensively investigated treatments and has shown to be effective in managing symptoms related to adenomyosis.

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