Adenomyosis Clinical Trial
Official title:
Can the Effect of Levonorgestrel Intrauterine System for Treatment of Adenomyosis be Predicted at Baseline Visit?
Adenomyosis is defined when the endometrial tissue (gland and stroma) is present within the
myometrium . The depth of endometrial penetration which uses in diagnosis of adenomyosis not
yet agreed; opinions range from one high power field to 25% of the myometrial thickness. It
is a common condition in women aged 40-50 years and is considered an important cause of
dysmenorrhea and menorrhagia in around 65 % of cases.
Until past few years; hysterectomy was the suggested definitive treatment, however; this may
not be acceptable to women not willing to loss their fertility. Many treatment lines were
studied and proved their beneficial effect on adenomyosis such as GnRH agonists, danazol,
combined oral contraceptive pills, dienogest and finally endometrial ablation. However,
these line of treatment are not commonly used because high incidence of side effects and
relatively high cost of some of them.
The levonorgestrel-releasing intrauterine system (LNG-IUS) was emerged as an effective line
for treatment of adenomyosis associated pain and bleeding. It can successfully, within 6 to
12 months, down-regulate the estrogen receptors in adenomyotic tissues which lead to
decidualization and atrophy of the adenomyosis .
In fact, some adenomyotic women respond well to LNG-IUDs and show high acceptability and
satisfaction, on the other hand; a group of women may not respond to LNG-IUDs and opt to
remove it and start a new medical or surgical option for treatment.
However, factors related to LNG-IUS effectiveness in patients with adenomyosis were not well
available. Only one report states that a large uterine volume could be a factor associated
with LNG-IUS treatment discontinuation in adenomyotic patient.
For this reason; the prediction of the responsiveness to LNG-IUS is interesting issue which
should be addressed. The present study examines the hypothesis that patient's data reported
at baseline visit before using LNG-IUSfor controlling pain/bleeding with adenomyosis can
help the prediction of the responsiveness for this important line of treatment at 6 months
follow up visit. Up to our knowledge; no clinical trial had been registered or conducted to
predict the responsiveness for LNG-IUS in controlling the pain/ bleeding with adenomyosis.
n/a
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