انتباذ عضل الرحم: ماذا تفعل حين لا يُجدي العلاج الطبي الأولي نفعاً

References

DOI: 10.1016/j.jogc.2023.04.008

1. Gonadotropin-releasing hormone (GnRH) agonists can be considered as a second-line agent for management of pain and heavy menstrual bleeding from adenomyosis; add-back hormones should be initiated if GnRH agonists are used longer than 6 months (strong, low).
2. A large multicentre prospective study of 465 patients with symptomatic adenomyosis treated with triptorelin every 28 days for 3 to 6 months showed a significant improvement in heavy bleeding, dysmenorrhea, and pelvic pain, with only 14% experiencing hot flushes.
3. A retrospective cohort study of 52 patients with MRI-confirmed adenomyosis treated with GnRH agonist (leuprorelin or goserelin), low-dose COC, or dienogest found that only GnRH agonists led to a significant reduction in uterine volume at 16 weeks post-treatment.