Current Medical Therapy for Adenomyosis: From Bench to Bedside

Area of Science:

• Gynecology
• Reproductive Medicine
• Medical Research

Background:

• Adenomyosis involves endometrial tissue growth in the uterine wall, causing significant treatment challenges.
• Current management often focuses on abnormal uterine bleeding (AUB) and dysmenorrhea, with limited efficacy of NSAIDs and tranexamic acid.
• Adenomyosis frequently coexists with endometriosis and uterine leiomyomas, complicating diagnosis and treatment decisions.

Purpose of the Study:

• To review current medical management strategies for adenomyosis.
• To highlight the limitations of existing therapies and identify areas for future research.
• To emphasize the need for evidence-based guidelines to improve patient outcomes.

Main Methods:

• Literature review of current therapeutic options for adenomyosis.
• Analysis of the efficacy and limitations of hormonal and non-hormonal treatments.
• Discussion of diagnostic complexities and impact on quality of life and fertility.

Main Results:

• Levonorgestrel-releasing intrauterine systems (LNG-IUS) and dienogest (DNG) show promise but lack standardized guidelines.
• Danazol has side effects, while combined oral contraceptives (COCs) may be less effective.
• Gonadotropin-releasing hormone (GnRH) agonists manage symptoms but cause menopausal side effects; GnRH antagonists and aromatase inhibitors (AIs) require further investigation.

Conclusions:

• Effective medical management of adenomyosis remains challenging due to limited evidence and treatment options.
• Further research is crucial for developing standardized guidelines, understanding fertility outcomes, and exploring novel therapeutic targets.
• Optimizing treatment strategies and establishing evidence-based guidelines are essential for improving adenomyosis patient care and quality of life.