Drug treatment of uterine adenomyosis typically prescribed for mild forms of adenomyosis, and women who plan to have future children.
One of the most common types of medical treatment of uterine adenomyosis is the use levonorgestrel-containing intrauterine devices, such as Mirena. One study examined the effects of long-term clinical use of intrauterine devices. The researchers evaluated the condition of patients in several indicators (degree of tissue damage, the severity of symptoms such as dysmenorrhea and menorrhagia) before installing the IUD, and 36 months after it was installed. Patients noted that more than 6 months after the installation of a spiral of pain during menstruation became much weaker. Three years later, almost all of the symptoms of adenomyosis
Adenomyosis: Symptoms - what to expect from the body?
either disappeared or have become considerably less pronounced.
In another study, doctors in three years watching the 94 women who for the treatment of uterine adenomyosis established levonorgestrel-releasing intrauterine devices. Before treatment all patients experienced moderate or severe dysmenorrhea. In the course held in six and twelve months of examination the doctor noted a significant improvement in the subjects.
Danazol-content intrauterine devices
Recently in Japan developed danazol-containing intra-uterine devices, which are, in fact, IUDs, coated with silicone rubber containing 300-400 mg of danazol. Externally, the device is very similar to conventional intrauterine device, but it is much thicker rod. Because of this feature, danazol-containing intrauterine devices for proper installation may need cervical dilatation.
During clinical trials of these devices danazol levels in the blood of the subjects remained below the detection threshold, so it is believed that their use does not cause side effects associated with oral administration of danazol.
After clinical trials have been completed, the danazol-containing intra-uterine devices were tested on 14 women who called adenomyosis, dysmenorrhea, menorrhagia
Menorrhagia (menorrhagia) - excessive blood loss
and infertility. After a few months in 12 patients completely disappeared menorrhagia and significant relief of dysmenorrhea occurred in 9 patients. Only two women's use of danazol-containing intrauterine devices to no avail.
In another study, involving 21 women with adenomyosis, for 6 months 81% of patients completely got rid of menstrual pain. Menstrual bleeding normalized in 76% of subjects. There was no single case of occurrence of the known side effects of danazol.
The only disadvantage of danazol-containing intrauterine devices, which have been noted in the course of investigations, was short-lived smearing bleeding.
Available treatments adenomyosis are far from ideal, so experts are constantly looking for new ways in which it would be possible to treat this violation more safely and effectively.
Adenomyosis as endometriosis, is considered to be estrogen dependent diseases. One of the most important steps to a better understanding of the disease was the discovery that women with adenomyosis as the eutopic and ectopic endometrium express the enzyme that converts androgens into estrogens - P450 aromatase. Presumably, this phenomenon is observed only in women with reproductive system diseases such as endometriosis, uterine fibroids and adenomyosis.
If adenomyosis develops under the influence of estrogen, the only effective treatment for its operation is the complete removal of the affected tissue adenomyosis - otherwise the disease will continue to progress. In practice, it cuts out all the diseased tissue is extremely difficult.
An alternative method of treatment, scientists believe the use of substances that can inhibit the biosynthesis of estrogen locally
Estrogen - the key to bone health
(aromatase inhibitors), along with GnRH agonists. This will help to significantly reduce the risk of re-development of adenomyosis after conservative surgery.
This assumption was confirmed by the results of the study, in which patients with endometriosis after surgery assigned to receive an aromatase inhibitor - anastrozole and GnRH agonist - goserelin. For the subjects were followed for 24 months after surgery. It turned out that those who took the drugs, the probability of relapse is significantly lower than in patients who took a placebo
Placebo - an effective tool for self-hypnosis
. Scientists believe that this method of treatment is as effective for women with adenomyosis. It is expected that in the near future it will be widely used for the treatment of severe endometriosis and adenomyosis in women of reproductive age.
The researchers found that the walls of the uterine tissue in the adenomyosis and endometriosis process of angiogenesis (formation of new blood vessels in tissues) begins to change. This discovery prompted the idea of the possibility of using for the treatment of adenomyosis angiogenesis inhibitors. In the course of experiments on animals it has been found that cabergoline leads to slower tumor growth in adenomyosis and endometriosis, and also blocks the formation of new blood vessels in diseased tissue. There will be more research to understand how this medication may affect humans.