Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach
Uterine adenomyosis is a commonly encountered estrogen-dependent disease in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. Although adenomyosis was previously considered a disease of multiparous women, it is becoming increasingly evident that it also...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/21/4878 |
| _version_ | 1797512325783093248 |
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| author | Christina Anna Stratopoulou Jacques Donnez Marie-Madeleine Dolmans |
| author_facet | Christina Anna Stratopoulou Jacques Donnez Marie-Madeleine Dolmans |
| author_sort | Christina Anna Stratopoulou |
| collection | DOAJ |
| description | Uterine adenomyosis is a commonly encountered estrogen-dependent disease in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. Although adenomyosis was previously considered a disease of multiparous women, it is becoming increasingly evident that it also affects younger nulliparous women and may compromise their fertility potential. It is clear that hysterectomy, the standard approach to definitively manage the disease, is not an option for patients wishing to preserve their fertility, so there is an urgent need to develop novel conservative strategies. We searched the current literature for available methods for conservative management of adenomyosis, including both pharmacological and surgical approaches. There is no existing drug that can cure adenomyosis at present, but some off-label treatment options may be used to tackle disease symptoms and improve fertility outcomes. Adenomyosis in patients wishing to conceive can be ‘treated’ by conservative surgery, though these procedures require highly experienced surgeons and pose a considerable risk of uterine rupture during subsequent pregnancies. While currently available options for conservative management of adenomyosis do have some capacity for alleviating symptoms and enhancing patient fertility perspectives, more effective new options are needed, with gonadotropin-releasing hormone antagonists showing encouraging results in preliminary studies. |
| first_indexed | 2024-03-10T06:00:14Z |
| format | Article |
| id | doaj.art-f545a1840c97434abf8b55726d134065 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T06:00:14Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f545a1840c97434abf8b55726d1340652023-11-22T21:04:00ZengMDPI AGJournal of Clinical Medicine2077-03832021-10-011021487810.3390/jcm10214878Conservative Management of Uterine Adenomyosis: Medical vs. Surgical ApproachChristina Anna Stratopoulou0Jacques Donnez1Marie-Madeleine Dolmans2Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, BelgiumSociété de Recherche pour l’Infertilité, 1150 Brussels, BelgiumPôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, BelgiumUterine adenomyosis is a commonly encountered estrogen-dependent disease in reproductive-age women, causing heavy menstrual bleeding, intense pelvic pain, and infertility. Although adenomyosis was previously considered a disease of multiparous women, it is becoming increasingly evident that it also affects younger nulliparous women and may compromise their fertility potential. It is clear that hysterectomy, the standard approach to definitively manage the disease, is not an option for patients wishing to preserve their fertility, so there is an urgent need to develop novel conservative strategies. We searched the current literature for available methods for conservative management of adenomyosis, including both pharmacological and surgical approaches. There is no existing drug that can cure adenomyosis at present, but some off-label treatment options may be used to tackle disease symptoms and improve fertility outcomes. Adenomyosis in patients wishing to conceive can be ‘treated’ by conservative surgery, though these procedures require highly experienced surgeons and pose a considerable risk of uterine rupture during subsequent pregnancies. While currently available options for conservative management of adenomyosis do have some capacity for alleviating symptoms and enhancing patient fertility perspectives, more effective new options are needed, with gonadotropin-releasing hormone antagonists showing encouraging results in preliminary studies.https://www.mdpi.com/2077-0383/10/21/4878uterine adenomyosisinfertilityheavy menstrual bleedingdysmenorrheamedical treatmentGnRH antagonist |
| spellingShingle | Christina Anna Stratopoulou Jacques Donnez Marie-Madeleine Dolmans Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach Journal of Clinical Medicine uterine adenomyosis infertility heavy menstrual bleeding dysmenorrhea medical treatment GnRH antagonist |
| title | Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach |
| title_full | Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach |
| title_fullStr | Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach |
| title_full_unstemmed | Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach |
| title_short | Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach |
| title_sort | conservative management of uterine adenomyosis medical vs surgical approach |
| topic | uterine adenomyosis infertility heavy menstrual bleeding dysmenorrhea medical treatment GnRH antagonist |
| url | https://www.mdpi.com/2077-0383/10/21/4878 |
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