| ORIGINAL ARTICLE |
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| Year : 2018 | Volume
: 7
| Issue : 3 | Page : 119-123 |
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Efficacy of hormonal therapies for decreasing uterine volume in patients with adenomyosis
Takashi Matsushima1, Shigeo Akira2, Takehiko Fukami1, Koichi Yoneyama1, Toshiyuki Takeshita2
1 Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan
2 Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
Correspondence Address:
Dr. Takashi Matsushima
Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital 1-396 Kosugi-Cho, Nakahara-Ku, Kawasaki, Kanagawa 211-8533
Japan
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/GMIT.GMIT_35_18
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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 cm3 (P < 0.001). In the LEP and the DNG groups, there was no significant change (LEP: 226.7 ± 116.6 cm3 pre-treatment and 230.5 ± 128.6 cm3 post-treatment, P = 0.85; DNG: 232.6 ± 117.8 cm3 pre-treatment and 262.1 ± 136.8 cm3 post-treatment, P = 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 (P < 0.001 and P = 0.005, respectively).
Conclusion: We conclude that the efficacy of GnRHa in reducing uterine volume should be considered when prescribing hormone therapy for adenomyosis.
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