Current treatment for adenomyosis

Abstract

Prior to the identification of diagnostic criteria for adenomyosis using modern imaging, the condition could only be diagnosed in hysterectomy specimens. The use of Magnetic Resonance Imaging and modern Ultrasound created the conditions for less radical treatment. This may include symptomatic treatment for heavy bleeding or dysmenorrhea, gonadotropin-releasing hormone agonists, levonorgestrel-releasing intrauterine device, continuous administration of the oral contraceptive pill, progestogens, danazol or aromatase inhibitors but the evidence base for these options is limited and the disease recurs following discontinuation. Uterine sparing adenomyomectomy, hysteroscopic endomyometrial ablation or uterine artery embolisation may have a role. But these options remain limited because of the often diffuse nature of adenomyosis and because of uncertainty about the effect on future pregnancy.