**6.4 Histological examination**

The gold standard for the diagnosis of adenomyosis is histological examination. The diagnosis is usually based on histologic findings in surgical specimens after hysterectomy.

**77**

*Adenomyosis*

**7. Treatment**

*7.1.1 GnRHa*

desire for fertility.

*7.1.2 Oral dienogest*

and CA 19-9 levels [20].

7 days of menstruation.

*7.1.3 LNG-IUS*

*7.1.4 Other drugs*

menorrhagia.

**7.2 Surgical treatment**

*7.2.1 Hysterectomy*

**7.1 Medical treatment**

*DOI: http://dx.doi.org/10.5772/intechopen.90942*

pain and reduce the adenomyotic lesions' size [17].

flashes, vaginal dryness, and bone mineral loss.

symptoms in women with endometriosis [18].

The treatment of adenomyosis depends on the patient's age, symptoms, and

Gonadotropin-releasing hormone (GnRH) agonists have been shown to release

GnRHa agonists cause hypoestrogenism, resulting in adverse effects such as hot

Dienogest, a novel 19-nortestosterone derivative, is a synthetic oral progestin that is highly selective for progesterone receptors. Dienogest reduces the painful

A recent study of the oral dienogest for premenopausal menorrhagia and pelvic pains in women with uterine adenomyosis indicated that oral dienogest might be a valuable alternative for treatment of premenopausal pelvic pains in women with uterine adenomyosis [19]. Another pilot study presented the results on the efficacy and safety of dienogest in the treatment of symptomatic adenomyosis. Dienogest significantly reduced adenomyosis-associated pelvic pain as well as serum CA-125

Menorrhagia associated with adenomyosis can be treated with levonorgestrelreleasing IUS that releases levonorgestrel, 20 μg/day. It is placed in uterus within

Danazol has been the medical therapy for treatment of adenomyosis for several

Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve mild pain associated with adenomyosis. NSAIDs are the analgesia and anti-inflammatory agents

Combination oral contraceptives can be used to induce endometrial atrophy and decrease endometrial prostaglandin production to improve dysmenorrhea and

This is the definitive treatment of adenomyosis; however, most of the patients do not accept the surgery of total hysterectomy, with or without ovarian conservation. Patients who have a desire for pregnancy can be treated by focal adenomyosis

years. Danazol has a direct antiestrogen effect on endometriotic lesions

through the pathway of inhibition of PGE2 and COX-2.

resection using either laparotomy or laparoscopic surgery.

**Figure 3.** *MRI of adenomyosis.*
