BACKGROUND: Hysterectomy and hysteroscopic endometrial ablation remain common treatment of symptomatic adenomyosis for women who have completed childbearing. However, for patients who wish to avoid surgery and in whom adenomyosis is suspected of causing infertility, repeated abortion or physical symptoms, medical treatment with gonadotropin-releasing hormone analogue (GnRH-a) should be considered. CASES: Two cases of documented adenomyosis were suspected of causing infertility; both were treated with a three-month course of GnRH-a via a nasal spray. Both patients experienced relief of symptoms and conceived within six months of the cessation of treatment. CONCLUSION: The efficacy and safety of a short course of GnRH-a treatment of adenomyosis may be considered in patients who take less time than others to achieve a significant reduction of uterine size and relief of symptoms and in those who develop side effects.
BACKGROUND: Hysterectomy and hysteroscopic endometrial ablation remain common treatment of symptomatic adenomyosis for women who have completed childbearing. However, for patients who wish to avoid surgery and in whom adenomyosis is suspected of causing infertility, repeated abortion or physical symptoms, medical treatment with gonadotropin-releasing hormone analogue (GnRH-a) should be considered. CASES: Two cases of documented adenomyosis were suspected of causing infertility; both were treated with a three-month course of GnRH-a via a nasal spray. Both patients experienced relief of symptoms and conceived within six months of the cessation of treatment. CONCLUSION: The efficacy and safety of a short course of GnRH-a treatment of adenomyosis may be considered in patients who take less time than others to achieve a significant reduction of uterine size and relief of symptoms and in those who develop side effects.