{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:38:37Z","timestamp":1791488317506,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T00:00:00Z","timestamp":1560470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000871","name":"Mayo Clinic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Adenomyosis is a benign uterine disease where endometrial glands and stroma are found within the myometrium surrounded by an area of hypertrophic myometrium. Symptomatology includes heavy menstrual bleeding and pelvic pain. The pathogenesis of adenomyosis is not known; however, animal models have shown increased uterine concentration of prolactin as a risk factor. Prolactin acts as a smooth muscle cell mitogen. If prolactin is central to adenomyosis pathogenesis, reducing uterine prolactin could be a possible medical treatment option. In this pilot study, we aim to evaluate the effect of bromocriptine, a prolactin inhibitor, on menstrual bleeding and pain in women with adenomyosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>23 women with diffuse adenomyosis were enrolled from a university hospital in Sweden and a tertiary care center in the USA. Nineteen patients completed 6\u00a0months of treatment with vaginal bromocriptine at a dose of 5\u00a0mg daily. Participants completed validated measures at baseline, 3 and 6\u00a0months of treatment, and at 9\u00a0months (3 months after cessation of bromocriptine). Validated measures utilized included Pictorial Blood Loss Assessment Chart (<jats:styled-content style=\"fixed-case\">PBLAC<\/jats:styled-content>), Aberdeen Menorrhagia Clinical Outcomes Questionnaire (<jats:styled-content style=\"fixed-case\">AMCOQ<\/jats:styled-content>), Visual Analog Scale for pain (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>), McGill Pain Questionnaire (<jats:styled-content style=\"fixed-case\">MPQ<\/jats:styled-content>), Endometriosis Health Profile (<jats:styled-content style=\"fixed-case\">EHP<\/jats:styled-content>\u201030), Female Sexual Function Index (<jats:styled-content style=\"fixed-case\">FSFI<\/jats:styled-content>) and the Fibroid Symptom Quality of Life (<jats:styled-content style=\"fixed-case\">UFS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">QOL<\/jats:styled-content>) symptom severity and health\u2010related quality of life (<jats:styled-content style=\"fixed-case\">HRQL<\/jats:styled-content>) subscores. Scores were compared between baseline and 9\u00a0months using the Wilcoxon signed rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age of participants was 44.8\u00a0years. About 77.8% reported <jats:styled-content style=\"fixed-case\">PBLAC<\/jats:styled-content> scores\u00a0&gt;250 and 68.4% reported moderate to severe pain at baseline. Compared with baseline, women had lower 9\u2010month scores (median [interquartile range] for all) on <jats:styled-content style=\"fixed-case\">PBLAC<\/jats:styled-content> (baseline 349 [292\u2010645] vs 9\u2010month 233 [149\u2010515], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003), <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> (5.0 [4\u20108.3] vs 2.5 [0\u20104.5], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), <jats:styled-content style=\"fixed-case\">EHP<\/jats:styled-content> Core Pain (15.9 [9.1\u201050.0] vs 3.4 [2.3\u201034.1], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.029), <jats:styled-content style=\"fixed-case\">EHP<\/jats:styled-content> Core Self\u2010image (41.7 [16.7\u201058.3] vs 25 [0\u20105], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.048) and Symptom Severity Score (60 [44\u201072] vs 44 [25\u201056], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and higher <jats:styled-content style=\"fixed-case\">HRQL<\/jats:styled-content> scores (57 [37\u201063] vs 72 [51\u201085], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) following bromocriptine treatment. Other <jats:styled-content style=\"fixed-case\">EHP<\/jats:styled-content> core parameters and <jats:styled-content style=\"fixed-case\">FSFI<\/jats:styled-content> were not significantly different.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Significant improvement in menstrual bleeding, pain and quality of life after vaginal bromocriptine treatment suggests a novel therapeutic agent for adenomyosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13632","type":"journal-article","created":{"date-parts":[[2019,4,26]],"date-time":"2019-04-26T08:37:09Z","timestamp":1556267829000},"page":"1341-1350","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Vaginal bromocriptine improves pain, menstrual bleeding and quality of life in women with adenomyosis: A pilot 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E.","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Department of Health Sciences Research Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-1444","authenticated-orcid":false,"given":"Kristina","family":"Gemzell\u2010Danielsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Division of Obstetrics and Gynecology Karolinska Institutet Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility Department of Obstetrics &amp; Gynecology Mayo Clinic Rochester MN 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