Effect of GNRH agonist and LNG-IUS for treatment of adenomyosis

Abstract

Background: Uterine adenomyosis is a chronic condition that is dependent on estrogen and affects approximately 20% of gynaecology patients. Dysmenorrhea, menorrhagia, and an enlarged uterus are commonly observed adenomyosis clinical symptoms. Objective: This study aimed to assess levonorgestrel-releasing intrauterine system (LNG-IUS) and gonadotropin-releasing hormone agonist (GnRH-a) effectiveness for adenomyosis symptoms improvement.
Methods: This case-control study was carried out on 60 women with adenomyosis who had regular follow-up examinations. The patients were categorized into 2 equal groups: Case group (group 1 receiving GnRH-a as well as LNG-IUS) and control group (group 2 receiving GnRH-a only). The indices observed included: Serum CA125 level during, before and after the treatment, hemoglobin value before and 3 months after treatment, verbal rating scale (VRS), visual analogue scale (VAS), and uterine volume.
Results: After treatment, the Hb level was significantly elevated in the case group compared to the control group (P=0.035), whereas CA125 was significantly lower in the case group compared to the control group (P=0.009). Regarding the clinical assessment, after treatment, the dysmenorrhea VRS score, and the dysmenorrhea VAS score were significantly reduced in the case group compared to the control group (P<0.05).
Conclusions: Both LNG-IUS and GnRH-a combination treatment is efficient and safe in adenomyosis and caused a significant reduction in serum CA125 and dysmenorrhea.