Efficacy of Hormonal Therapies for Decreasing Uterine Volume in Patients with Adenomyosis.

STUDY OBJECTIVE

The aim of this study is to evaluate the efficacy of hormonal therapies for inhibiting an increase in uterine volume in patients with adenomyosis.

DESIGN

This was retrospective cohort study.

SETTING

This study was conducted at Nippon Medical School Musashikosugi Hospital.

PATIENTS

A total of 28 women diagnosed with adenomyosis using magnetic resonance imaging.

METHODS

After providing informed consent, patients were treated with gonadotropin-releasing hormone agonist (GnRHa group), a low-dose estrogen and progestin combination (LEP group), or dienogest (DNG group) for ≥16 weeks. Uterine volume was assessed using the formula for an ovoid; uterine volumes before and after 16 weeks of treatment were compared. A <5% increase in uterine volume at 16 weeks was considered to reflect inhibition of uterine volume increase and efficacy of the medication. We compared the efficacy rate among the groups.

RESULTS

In the GnRHa group, a significant reduction in uterine volume was noted, from 307.4 ± 230.1 to 177.9 ± 142.1 cm ( < 0.001). In the LEP and the DNG groups, there was no significant change (LEP: 226.7 ± 116.6 cm pre-treatment and 230.5 ± 128.6 cm post-treatment, = 0.85; DNG: 232.6 ± 117.8 cm pre-treatment and 262.1 ± 136.8 cm post-treatment, = 0.37). The number of responders (efficacy rate) in the GnRHa group, LEP group, and DNG group was 25/26 (96.2%), 7/15 (46.7%), and 6/11 (54.5%), respectively. The efficacy rate of GnRHa therapy was significantly higher than that of LEP or DNG therapy ( < 0.001 and = 0.005, respectively).

CONCLUSION

We conclude that the efficacy of GnRHa in reducing uterine volume should be considered when prescribing hormone therapy for adenomyosis.