Aromatase inhibitors or gonadotropin- releasing hormone agonists for the management of uterine adenomyosis: A randomized controlled study Aboubakr Elnashar Benha university Hospital Ahmed Badawy Mansura university Hospital Alaa Mosbah Mansura university Hospital Egypt Aboubakr Elnashar
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Aromatase inhibitors or gonadotropin-releasing hormone agonists for the management of uterine adenomyosis: A randomized controlled study
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Aromatase inhibitors or gonadotropin-
releasing hormone agonists for the
management of uterine adenomyosis:
A randomized controlled study
Aboubakr Elnashar Benha university Hospital
Ahmed Badawy Mansura university Hospital
Alaa Mosbah Mansura university Hospital
Egypt
Aboubakr Elnashar
Adenomyosis of the uterus:
Common amongst women in their reproductive
years (Farquhar et al, 2006).
1% of women
With improved imaging: diagnosis is more frequent.
Aboubakr Elnashar
Although adenomyosis & endometriosis are
different diseases, both of them grow& regress in an
oestrogen-dependent fashion (Kitawaki et al,2006).
Adenomyotic tissue contains:
1. Steroid receptors
2. Aromatase& sulphatase enzymes.
Circulating &locally produced oestrogens stimulate
the growth of tissue mediated by the oestrogen
receptors.
Aboubakr Elnashar
To date, there is no agreement on the most
appropriate therapeutic methods for managing
women with uterine adenomyosis who want to
preserve their fertility (Wang et al, 2009).
Hormonal treatment that aims to reduce the
proliferation of endometrial cells is promising, but
there is a paucity of well-designed studies to guide
treatment.
There is a strong need to develop pharmacological
agents that provide an efficient outcome (Farquhar et al,
2006).
Aboubakr Elnashar
GnRHa: in adenomyosis (Wood et al, 2001).
Constant hypoestrogenic state Amenorrhoea
Control of pain
Uterine shrinkage.
But, pure antiestrogen may offer some advantage in
the treatment of adenomyosis& trials are required to
assess its usefulness.
Aboubakr Elnashar
AI: in Leiomyoma (Parsanezhad et al,2010).
Reduction of leiomyoma& uterine volumes GnRHa &AI concomitantly: in adenomyiosis (Kimura
et al, 2007).
Assuming aromatase production activity in the
adenomyosis lesion This stimulated us to undergo this study
Aboubakr Elnashar
Objective: To examine& compare the efficacy of AI vs. GnRHa
in premenopausal women with uterine adenomyosis.
Design: Prospective RCT
Aboubakr Elnashar
Setting: •Teaching hospitals affiliated with Mansoura