{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:52:09Z","timestamp":1792813929167,"version":"4.5.0"},"reference-count":28,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"09","license":[{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>\n            Objective\u2003To assess the efficacy of non-surgical treatment for adenomyosis.<\/jats:p><jats:p>\n            Data Sources\u2003A search was performed by two authors in the Pubmed, Scopus, and Scielo databases and in the grey literature from inception to March 2018, with no language restriction.<\/jats:p><jats:p>\n            Selection of Studies\u2003We have included prospective randomized studies for treating symptomatic women with adenomyosis (abnormal uterine bleeding and\/or pelvic pain) diagnosed by ultrasound or magnetic resonance imaging.<\/jats:p><jats:p>\n            Data Collection\u2003Studies were primarily selected by title and abstract. The articles that were eligible for inclusion were evaluated in their entirety, and their data was extracted for further processing and analysis.<\/jats:p><jats:p>\n            Data Synthesis\u2003From 567 retrieved records only 5 remained for analysis. The intervention groups were: levonorgestrel intrauterine system (LNG-IUS)(n\u2009=\u20092), dienogest (n\u2009=\u20092), and letrozole (n\u2009=\u20091). Levonorgestrel intrauterine system was effective to control bleeding when compared to hysterectomy or combined oral contraceptives (COCs). One study assessed chronic pelvic pain and reported that LNG-IUS was superior to COC to reduce symptoms. Regarding dienogest, it was efficient to reduce pelvic pain when compared to placebo or goserelin, but less effective to control bleeding than gonadotropin-releasing hormone (GnRH) analog. Letrozole was as efficient as GnRH analog to relieve dysmenorrhea and dyspareunia, but not for chronic pelvic pain. Reduction of uterine volume was seen with aromatase inhibitors, GnRH analog, and LGN-IUD.<\/jats:p><jats:p>\n            Conclusion\u2003Levonorgestrel intrauterine system and dienogest have significantly improved the control of bleeding and pelvic pain, respectively, in women with adenomyosis. However, there is insufficient data from the retrieved studies to endorse each medication for this disease. Further randomized control tests (RCTs) are needed to address pharmacological treatment of adenomyosis.<\/jats:p>","DOI":"10.1055\/s-0039-1695737","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T22:31:23Z","timestamp":1569277883000},"page":"564-574","source":"Crossref","is-referenced-by-count":31,"title":["Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review"],"prefix":"10.61622","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6198-5593","authenticated-orcid":false,"given":"Cristina Laguna","family":"Benetti-Pinto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ticiana Aparecida Alves de","family":"Mira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Angerame","family":"Yela","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassia Raquel","family":"Teatin-Juliato","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Gustavo Oliveira","family":"Brito","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"47794","published-online":{"date-parts":[[2019,9,23]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.diii.2012.10.012","article-title":"An update on adenomyosis","volume":"94","author":"G Levy","year":"2013","journal-title":"Diagn Interv Imaging"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.fertnstert.2018.01.024","article-title":"Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis","volume":"109","author":"M Bazot","year":"2018","journal-title":"Fertil Steril"},{"issue":"01","key":"ref3","first-page":"221","article-title":"Adenomyosis: current perspectives","volume":"16","author":"R Azziz","year":"1989","journal-title":"Obstet Gynecol Clin North Am"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/humupd\/4.5.496","article-title":"Myometrial zonal differentiation and uterine junctional zone hyperplasia in the non-pregnant uterus","volume":"4","author":"J J Brosens","year":"1998","journal-title":"Hum Reprod Update"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1093\/humrep\/17.10.2725","article-title":"Endometriosis results from the dislocation of basal endometrium","volume":"17","author":"G Leyendecker","year":"2002","journal-title":"Hum Reprod"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.bpobgyn.2006.01.006","article-title":"The symptomatology of adenomyosis","volume":"20","author":"H Peric","year":"2006","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.bpobgyn.2014.04.010","article-title":"Imaging for the evaluation of endometriosis and adenomyosis","volume":"28","author":"C Exacoustos","year":"2014","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1097\/GCO.0b013e3282f1bf00","article-title":"Transvaginal ultrasound or MRI for diagnosis of adenomyosis","volume":"19","author":"M Dueholm","year":"2007","journal-title":"Curr Opin Obstet Gynecol"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.bpobgyn.2006.01.016","article-title":"Pathology and physiopathology of adenomyosis","volume":"20","author":"C Bergeron","year":"2006","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1007\/s11547-011-0714-5","article-title":"Adenomyosis: from the sign to the diagnosis. 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