Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (7): 20-25.doi: 10.6040/j.issn.1671-7554.0.2022.0407

Previous Articles     Next Articles

Progress on the medical treatment of adenomyosis

PENG Chao, ZHOU Yingfang   

  1. Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China
  • Published:2022-07-27

Abstract: Pain relief, bleeding reduction and fertility promotion are the main therapeutic goals of adenomyosis. The medical drugs for the treatment of adenomyosis are similar to those of endometriosis, including non-steroidal anti-inflammatory drugs, gonadotropin releasing hormone analogues(GnRH-a), compound oral contraceptives, progesterone drugs and traditional Chinese medicine. Adenomyosis is a chronic disease that requires long-term management.

Key words: Adenomyosis, Medical treatment, Long-term management

CLC Number: 

  • R711.74
[1] 中国医师协会妇产科医师分会子宫内膜异位症专业委员会. 子宫腺肌病诊治中国专家共识[J]. 中华妇产科杂志, 2020, 55(6): 376-383.
[2] 中国医师协会妇产科医师分会, 中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症诊治指南(第三版)[J]. 中华妇产科杂志, 2021, 56(12): 812-824.
[3] 郎景和. 子宫腺肌症的迷惑与解惑[J]. 中华妇产科杂志, 2020, 55(11): 737-739.
[4] 彭超, 周应芳. 子宫内膜异位症的药物治疗[J]. 山东大学学报(医学版), 2019, 57(6): 46-50. PENG Chao, ZHOU Yingfang. Medical treatment of endometriosis: an update [J]. Journal of Shandong University(Health Sciences), 2019, 57(6): 46-50.
[5] Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novelinnovations [J]. Lancet, 2021, 397(10276): 839-852.
[6] 中华医学会妇产科学分会子宫内膜异位症协作组. 子宫内膜异位症长期管理中国专家共识[J]. 中华妇产科杂志, 2018, 53(12): 836-841.
[7] Vannuccini S, Luisi S, Tosti C, et al. Role of medical therapy in the management of uterine adenomyosis [J]. Fertil Steril, 2018, 109(3): 398-405.
[8] 彭超, 周应芳. 子宫腺肌病药物治疗选择及长期管理[J]. 中国实用妇科与产科杂志, 2019, 35(5): 516-519. PENG Chao, ZHOU Yingfang. Drug choice in medical therapy and long-term management for patients with adenomuosis of the uterus [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2019, 35(5): 516-519.
[9] No authors listed. ACOG Committee Opinion No. 760 Summary: dysmenorrhea and endometriosis in the adolescent [J]. Obstet Gynecol, 2018, 132(6): 1517-1518.
[10] 彭超, 周应芳. 药物治疗在子宫内膜异位症长期管理中的应用和选择[J]. 中国实用妇科与产科杂志, 2021, 37(3): 303-308. PENG Chao, ZHOU Yingfang. Application and selection of medical treatment in the long-term management of endometriosis [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2021, 37(3): 303-308.
[11] Brown J, Crawford TJ, Allen C, et al. Nonsteroidal anti-inflammatory drugs for pain in women with endometriosis [J]. Cochrane Database Syst Rev, 2017, 1(1): CD004753.
[12] Oladosu FA, Tu FF, Hellman KM. Nonsteroidal anti-inflammatory drug resistance in dysmenorrhea: epidemiology, causes, and treatment [J]. Am J Obstet Gynecol,2018, 218(4): 390-400.
[13] ETIC Endometriosis Treatment Italian Club. When more is not better: 10'don'ts' in endometriosis management. An ETIC* position statement [J]. Hum Reprod Open, 2019, 2019(3): hoz009.
[14] 石一复, 张信美, 黄秀峰, 等. 子宫腺肌症[M]. 北京: 人民卫生出版社, 2018: 129-142.
[15] Chapron C, Marcellin L, Borghese B, et al. Rethinking mechanisms, diagnosis and management of endometriosis [J]. Nat Rev Endocrinol, 2019, 15(11): 666-682.
[16] 彭超, 周应芳. 子宫腺肌病的药物治疗新探索[J]. 中国计划生育和妇产科, 2019, 11(4): 18-20.
[17] Matsushima T, Akira S, Fukami T, et al. Efficacy of hormonal therapies for decreasing uterine volume in patients with adenomyosis [J]. Gynecol Minim Invasive Ther, 2018, 7(3): 119-123.
[18] 周应芳. 子宫腺肌病药物治疗原则及注意事项[J]. 中国实用妇科与产科杂志, 2017, 34(2): 157-160. ZHOU Yingfang. Principles and precautions of medical treatment for adenomyosis of the uterus [J]. Chinese Journal of Practical Gynecology and Obstetrics, 2017, 34(2): 157-160.
[19] Taylor HS, Giudice LC, Lessey BA, et al. Treatment of endometriosis-associated pain with Elagolix, an oral GnRH antagonist [J]. N Engl J Med, 2017, 377(1): 28-40.
[20] Surrey E, Taylor HS, Giudice L, et al. Long-term outcomes of Elagolix in women with endometriosis: results from two extension studies [J]. Obstet Gynecol, 2018, 132(1): 147-160.
[21] Barra F, Grandi G, Tantari M, et al. A comprehensive review of hormonal and biological therapies for endometriosis: latest developments [J]. Expert Opin Biol Ther, 2019, 19(4): 343-360.
[22] Perricos A, Wenzl R. Efficacy of elagolix in the treatment of endometriosis [J]. Expert Opin Pharmacother, 2017, 18(13): 1391-1397.
[23] Vercellini P, Viganò P, Barbara G, et al. Elagolix for endometriosis: all that glitters is not gold [J]. Hum Reprod, 2019, 34(2): 193-199.
[24] Barra F, Vitale SG, Seca M, et al. The potential role of elagolix for treating uterine bleeding associated to uterine myomas [J]. Expert Opinion on Pharmacotherapy, 2020, 21(12): 1419-1430.
[25] Al-Hendy A, Bradley L, Owens CD, et al. Predictors of response for elagolix with add-back therapy in women with heavy menstrual bleeding associated with uterine fibroids [J]. Am J Obstet Gynecol, 2021, 224(1): 72.
[26] Muneyyirci-Delale O, Archer DF, Owens CD, et al. Efficacy and safety of elagolix with add-back therapy in women with uterine fibroids and coexisting adenomyosis [J]. F S Rep, 2021, 2(3): 338-346.
[27] Donnez J, Stratopoulou CA, Dolmans MM. Uterine adenomyosis: from disease pathogenesis to a new medical approach using GnRH antagonists [J]. Int J Environ Res Public Health, 2021, 18(19): 9941.
[28] Donnez O, Donnez J. Gonadotropin-releasing hormone antagonist(linzagolix): a new therapy for uterine adenomyosis [J]. Fertil Steril, 2020, 114(3): 640-645.
[29] Donnez J, Donnez O, Tourniaire J, et al. Uterine adenomyosis treated by Linzagolix, an oral gonadotropin-releasing hormone receptor antagonist: a pilot study with a New ‘Hit Hard First and then Maintain’ regimen of administration [J]. J Clin Med, 2021, 10(24): 5794.
[30] 复方口服避孕药临床应用中国专家共识专家组. 复方口服避孕药临床应用中国专家共识[J]. 中华妇产科杂志, 2015, 50(2): 81-91.
[31] 周应芳, 彭超, 冷金花. 要重视子宫内膜异位症的一级和二级预防[J]. 中华妇产科杂志, 2020, 55(9): 624-626.
[32] Shaaban OM, Ali MK, Sabra AM, et al. Levonorgestrel-releasing intrauterine system versus a low-dose combined oral contraceptive for treatment of adenomyotic uteri: a randomized clinical trial [J]. Contraception, 2015, 92(4): 301-307.
[33] Wu J, Huang Y, Chen L, et al. Treatment of adenomyosis with subcutaneous etonogestrel implants: a clinical observational study in 17 patients [J]. Med Sci Monit, 2018, 24: 6085-6092. doi: 10.12659/MSM.908979.
[34] Murji A, Biberoglu K, Leng J, et al. Use of dienogest in endometriosis: a narrative literature review and expert commentary [J]. Curr Med Res Opin, 2020, 36(5): 895-907.
[35] Caruso S, Iraci M, Cianci S, et al. Effects of long-term treatment with Dienogest on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain [J]. J Pain Res, 2019, 12: 2371-2378. doi:10.2147/JPR.S207599.
[36] Lang J, Yu Q, Zhang S, et al. Dienogest for treatment of endometriosis in Chinese women: a placebo-controlled, randomized, double-blind phase 3 study [J]. J Womens Health(Larchmt), 2018, 27(2): 148-155.
[37] Osuga Y, Fujimoto-Okabe H, Hagino A. Evaluation of the efficacy and safety of dienogest in the treatment of painful symptoms in patients with adenomyosis: a randomized, double-blind, multicenter, placebo-controlled study [J]. Fertil Steril, 2017, 108(4): 673-678.
[38] 徐冰, 陈文勤. 子宫内膜异位症治疗药物地诺孕素的研究进展[J]. 中华妇产科杂志, 2016, 51(3): 222-224.
[39] 徐冰, 李华军, 贾婉璐, 等. 地诺孕素用于难治性子宫内膜异位症疼痛的临床研究[J]. 中华妇产科杂志, 2021, 56(3): 178-184.
[40] Takeuchi A, Koga K, Miyashita M, et al. Dienogest reduces proliferation, NGF expression and nerve fiber density in human adenomyosis [J]. Eur J Obstet Gynecol Reprod Biol, 2016, 207: 157-161. doi: 10.1016/j.ejogrb.2016.10.053.
[41] Prathoomthong S, Tingthanatikul Y, Lertvikool S, et al. The effects of dienogest on macrophage and natural killer cells in adenomyosis: a randomized controlled study [J]. Int J Fertil Steril, 2018, 11(4): 279-286.
[42] Ji M, Yuan M, Jiao X, et al. A cohort study of the efficacy of the dienogest and the gonadotropin-releasinghormone agonist in women with adenomyosis and dysmenorrhea [J]. Gynecol Endocrinol, 2022, 38(2): 164-169.
[43] Matsushima T, Akira S, Yoneyama K, et al. Recurrence of uterine adenomyosis after administration of gonadotropin-releasing hormone agonist and the efficacy of dienogest [J]. Gynecol Endocrinol, 2020, 36(6): 521-524.
[44] Neriishi K, Hirata T, Fukuda S, et al. Long-term dienogest administration in patients with symptomatic adenomyosis [J]. J Obstet Gynaecol Res, 2018, 44(8): 1439-1444.
[45] Nirgianakis K, Vaineau C, Agliati L, et al. Risk factors for non-response and discontinuation of dienogest in endometriosispatients: a cohort study [J]. Acta Obstet Gynecol Scand, 2021, 100(1): 30-40.
[46] Matsubara S, Kawaguchi R, Akinishi M, et al. Subtype I(intrinsic)adenomyosis is an independent risk factor fordienogest-related serious unpredictable bleeding in patients with symptomatic adenomyosis [J]. Sci Rep, 2019, 9(1): 17654.
[47] Osuga Y, Watanabe M, Hagino A. Long-term use of dienogest in the treatment of painful symptoms in adenomyosis [J]. J Obstet GynaecolRes, 2017, 43(9): 1441-1448.
[48] 黄艳, 彭超, 周应芳. 地诺孕素治疗子宫腺肌病的研究进展[J]. 中华妇产科杂志, 2021, 56(12): 876-880.
[49] Bahamondes L, Valeria Bahamondes M, Hulman LP. Non-contraceptive benefits of hormonal and intrauterine reversible contraceptive methods [J]. Hum Reprod Update, 2015, 21(5): 640-651.
[50] 程利南, 狄文, 丁岩, 等. 女性避孕方法临床应用的中国专家共识[J]. 中华妇产科杂志, 2018, 53(7): 1-15.
[51] 郎景和, 冷金花, 邓姗, 等. 左炔诺孕酮宫内缓释系统临床应用的中国专家共识[J]. 中华妇产科杂志, 2019, 54(12): 815-825.
[52] Benetti-Pinto CL, de Mira TAA, Yela DA, et al. Pharmacological treatment for symptomatic adenomyosis: a systematic review [J]. Rev Bras Ginecol Obstet, 2019, 41(9): 564-574.
[53] 李雷, 冷金花, 戴毅, 等. LNG-IUS治疗子宫腺肌病相关重度痛经的前瞻性研究[J]. 中华妇产科杂志, 2016, 51(5): 345-351.
[54] 邓婷, 周应芳. 左炔诺孕酮宫内缓释系统下移和脱落的危险因素及防治措施[J]. 中华妇产科杂志, 2019, 54(12): 780-783.
[55] 邓婷, 彭超, 黄艳, 等. 影响宫腔镜下放置左炔诺孕酮宫内节育系统脱落的多因素分析[J]. 中国微创外科杂志, 2020, 20(8): 673-677. DENG Ting, PENG Chao, HUANG Yan, et al. Multivariate analysis of influence factors of expulsion of levonorgestrel-releasing intrauterine system inserted by hysteroscopy [J]. Chinese Journal of Minimally Invasive Surgery, 2020, 20(8): 673-677.
[56] Che X, Wang J, He J, et al. New application of mifepristone in the treatment of adenomyosis dysmenorrhea [J]. Int J Med Sci, 2020, 17(2): 224-233.
[57] 周应芳.子宫肌瘤药物治疗之评价[J]. 实用妇产科杂志, 2016, 32(3): 180-182.
[58] Cope AG, Ainsworth AJ, Stewart EA. Current and future medical therapies for adenomyosis [J]. Semin Reprod Med, 2020, 38(2-03): 151-156.
[59] Baboo Kalianee Devi, 陈正云, 张信美. 子宫腺肌病患者药物治疗进展[J]. 浙江大学学报(医学版), 2019, 48(2): 142-147. Baboo Kalianee Devi, CHEN Zhengyun, ZHANG Xinmei. Progress on medical treatment in the management of adenomyosis [J]. Journal of Zhejiang University(Medical Sciences), 2019, 48(2): 142-147.
[60] 王国云, 王凯, 袁明, 等. 子宫内膜异位症立体化管理体系(山东方案)[J]. 山东大学学报(医学版), 2021, 59(10): 1-16. WANG Guoyun, WANG Kai, YUAN Ming, et al. Multidimensional management system for endometriosis(The Program for Shandong Provence)[J]. Journal of Shandong University(Health Sciences), 2021, 59(10): 1-16.
[1] Guoyun WANG,Zangyu PAN. Research progress of animal models of adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 48-55.
[2] Lei YAN,Zijiang CHEN. Treatment of adenomyosis complicated with infertility [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 43-47.
[3] Guowei TAO,Fang WANG,Xiangyi DONG,Yaxuan XU,Linli ZHAO,Beibei HU. Diagnosis of adenomyosis using ultrasound and magnetic resonance imaging [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 56-65.
[4] AILI Aixingzi,Zhengyu GUO,Xiaofei ZHANG. Latest research advances of high intensity focused ultrasound treatment for adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 36-42.
[5] Xiaofang YI,Jihua HUANG. Patient education and proper management of adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 32-35.
[6] Xinmei ZHANG,Ping XU. Surgical treatment strategies of adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 26-31.
[7] LENG Jinhua, SHI Jinghua. Clinical manifestations of adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 1-5.
[8] GUO Sunwei, LIU Xishi. Cracking the enigma of pathogenesis and pathophysiology of adenomyosis [J]. Journal of Shandong University (Health Sciences), 2022, 60(7): 6-19.
[9] XU Ge, LI Qing, ZHANG Cancan, TIAN Yongjie. Expressions and clinical significance of PARP-1 and HIF-1α in adenomyosis tissues and primary cells [J]. Journal of Shandong University (Health Sciences), 2022, 60(4): 55-61.
[10] GENG Chen, YANG Yang, ZHAO Yue, LIU Haoran, CHAO Lan. Identification of differentially expressed genes and Wilms tumor-1 expression in adenomyosis [J]. Journal of Shandong University (Health Sciences), 2021, 59(4): 79-86.
[11] WANG Bingyu, YANG Yang, CHAO Lan. Expression and role of toll-like receptor 4 in adenomyosis [J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 47-52.
[12] LI Yang, WANG Zhongsu, LIU Luqi, LIU Tianqi, WANG Dong, LIU Xue, WANG Minghua, HOU Yinglong. Clinical features and comparison of medical and surgical efficacies of infective endocarditis in 80 patients in a tertiary hospital [J]. Journal of Shandong University (Health Sciences), 2020, 58(6): 22-27.
[13] PENG Chao, ZHOU Yingfang. Medical treatment of endometriosis: an update [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 46-50.
[14] LENG Jinhua, SHI Jinghua. Long-term management strategy of endometriosis [J]. Journal of Shandong University (Health Sciences), 2019, 57(6): 1-5.
[15] HUANG Yufei, YANG Yang, SHAO Qianqian, DENG Xiaohui, CHAO Lan. Expression and role of adenosine monophosphate dependent protein kinase in adenomyosis [J]. Journal of Shandong University (Health Sciences), 2019, 57(2): 93-98.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] SUO Dongyang, SHEN Fei, GUO Hao, LIU Lichang, YANG Huimin, YANG Xiangdong. Expression and mechanism of Tim-3 in animal model of drug-induced acute kidney injury[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 1 -6 .
[2] MA Qingyuan, PU Peidong, HAN Fei, WANG Chao, ZHU Zhoujun, WANG Weishan, SHI Chenhui. Effect of miR-27b-3p regulating SMAD1 on osteosarcoma cell proliferation, migration and invasion[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 32 -37 .
[3] XU Yuxiang, LIU Yudong, ZHANG Peng, DUAN Ruisheng. A retrospective analysis of risk factors of cerebral microbleeds in 101 patients with cerebral small vessel disease[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 67 -71 .
[4] DING Xiangyun, YU Qingmei, ZHANG Wenfang, ZHUANG Yuan, HAO Jing. Correlation of the expression of insulin-like growth factor II in granulosa cells and ovulation induction outcomes of 84 patients with polycystic ovary syndrome[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 60 -66 .
[5] GUO Zhihua, ZHAO Daqing, XING Yuan, WANG Wei, LIANG Leping, YANG Jing, ZHAO Qianqian. Single-stage end-to-end anastomosis in the management of severe cervical tracheal stenosis[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 72 -76 .
[6] LYU Longfei, LI Lin, LI Shuhai, QI Lei, LU Ming, CHENG Chuanle, TIAN Hui. Application of laparoscopic fine needle catheter jejunostomy in minimally invasive McKeown resection of esophageal cancer[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 77 -81 .
[7] ZHANG Juan, ZHANG Lujia, XIAO Wei, LI Shunping. Influencing factors of perceived stress and job retention in national standardized training for resident doctors[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 108 -114 .
[8] LUO Xin, HE Bing, NIE Qingsheng, HOU Zhenbo, DONG Jun, LI Yuhua, ZENG Xiangqin, LIU Wei, KONG Demin, CAO Jinfeng. Comparison of the value of mono-exponential mode and diffusion kurtosis imaging mode in grading clear cell renal cell carcinoma using magnetic resonance diffusion-weighted imaging[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 89 -95 .
[9] LONG Tingting, XIE Ming, ZHOU Lu, ZHU Junde. Effect of Noggin protein on learning and memory abilities and the dentate gyrus structure after cerebral ischemia reperfusion injury in mice[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 15 -23 .
[10] LI Ning, LI Juan, XIE Yan, LI Peilong, WANG Yunshan, DU Lutao, WANG Chuanxin. Expression of LncRNA AL109955.1 in 80 cases of colorectal cancer and its effect on cell proliferation, migration and invasion[J]. Journal of Shandong University (Health Sciences), 2020, 1(7): 38 -46 .