**5. Conclusion**

High recurrence rate rapidly after finishing GnRHa leads us to examine the efficacy of sequential management with GnRHa and dienogest in perimenopausal women with endometrisosis-associated uterine myoma. Consideration of GnRHa advantages on myoma shrinkage and low incidence of dienogest-induced adverse events may lead to long-term management of perimenopausal women with myoma and adenomyosis.
