{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:02:20Z","timestamp":1794013340075,"version":"4.8.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To date, there are no clear guidelines available on the treatment of adenomyosis-associated pelvic pain (AAPP); however, numerous hormonal treatments (HTs) are currently being used off-label. We conducted a systematic review and network metanalysis with the aim of assessing the efficacy and safety of HTs to reduce AAPP and ranking the available options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, LILACS, EMBASE, Scielo.br, PROSPERO, Cochrane Library, conference proceedings, and international registries were searched with no time, region, or language restrictions. Randomized controlled trials that analyzed AAPP in women undergoing HTs were deemed suitable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six studies (563 women affected by adenomyosis) were included. At 3 months, women who received a placebo or a levonorgestrel-based intrauterine system (LNG-IUS) experienced more AAPP than those who received dienogest [mean difference of visual analog scale (VAS) pain scores (MD) 4.10 (95% CI 0.49 to 7.71); high evidence; MD 3.05 (95% CI 0.45 to 5.65); high evidence]. At 6 months, women who received dienogest experienced significantly less AAPP compared to those who received combined oral contraceptives [MD -2.85 (95% CI -5.30 to -0.39); moderate evidence], while the prevalence of AAPP was higher among those who received a LNG-IUS than those who received dienogest [MD 1.79 (95% CI 0.06 to 3.53); low evidence].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Dienogest seems to be the most effective HT for AAPP. However, although rare, it is also related to more adverse effects compared to other HTs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:uri>, identifier CRD42024535472.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1571727","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T05:26:03Z","timestamp":1742189163000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Efficacy and safety of hormone therapies for treating adenomyosis-associated pelvic pain: a systematic review and network meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"16","author":[{"given":"Andrea","family":"Etrusco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Agrifoglio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"D\u2019Amato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Chiantera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio 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