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首页> 外文期刊>Journal of endometriosis and pelvic pain disorders. >Current and future medical treatment of adenomyosis
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Current and future medical treatment of adenomyosis

机译：当前和未来的医疗子宫腺肌症

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摘要

Adenomyosis is a benign gynecological disorder associated with abnormal uterine bleeding, dysmenorrhea, dys-pareunia and infertility, requiring a life-long management plan through medical or surgical treatment. The choice depends on woman's age, reproductive status and clinical symptoms. However, until now no drug labelled for adenomyosis is available; thus, the present review will focus on medical treatments currently used for adenomyosis and those in development.Adenomyosis may be considered a sex steroid hormone-related disorder associated with an intense inflammatory process. The use of gonadotropin-releasing hormone agonists (GnRH-a) for treating adenomyosis is described blocking the hypothalamic-pituitary-gonadal axis; however, it has long been associated with frequent and intolerable hypoestrogenic side effects. An antiproliferative effect of progestins suggests their use for treating adenomyosis, reducing bleeding and pain. Continuous oral norethisterone acetate or medroxyprogesterone acetate may help to inducing regression of adenomyosis, relief pain and reduce bleeding. The use of vaginal danazol has therapeutic effect on adenomyosis combining progestogenic and anti-inflammatory activity. The intrauterine device releasing levonorgestrel (Lng-IUD) is widely assessed in menorrhagia, and has been shown to be extremely effective in resolving pain and bleeding symptoms associated with adenomyosis. Recent data show a therapeutic effect of dienogest on adenomyosis symptoms.New drugs are under development for the treatment of adenomyosis, such as aromatase inhibitors (Als) and selective estrogen receptor modulators (SERMs), that produce a hypoestrogenic environment reducing pain, but are correlated with some adverse effects and a recurrence of symptoms after discontinuation of treatment. Selective progesterone receptor modulators (SPRMs) may reduce adenomyosis-associated pelvic pain, by inhibiting endometrial proliferation and suppressing adenomyotic lesion growth, as shown in animal models; however, the long-term effect with SPRMs needs further determination.
机译：子宫腺肌症是一种良性妇科疾病相关的异常子宫出血,痛经,dys-pareunia不孕,需要一个终身管理计划医疗或手术治疗。女人的年龄,生殖状态和临床症状。子宫腺肌症是可用的;检查重点是目前医学治疗用于子宫腺肌症和发展。类固醇与荷尔蒙相关的障碍有关一个强烈的炎症过程。促性腺激素释放激素受体激动剂(GnRH-a)治疗子宫腺肌症描述阻塞hypothalamic-pituitary-gonadal轴;它一直伴随着频繁的和无法忍受hypoestrogenic副作用。抗增殖效果黄体酮使用子宫腺肌症的治疗,减少出血和疼痛。醋酸和醋酸甲羟孕酮可能会有所帮助子宫腺肌症诱导回归,解脱疼痛和减少出血。达那唑对子宫腺肌症有治疗效果结合progestogenic和抗炎活动。levonorgestrel (Lng-IUD)是广泛的评估月经过多,已被证明是非常有效地解决疼痛和出血的症状与子宫腺肌症有关。dienogest子宫腺肌症的治疗效果症状。子宫腺肌症的治疗,如芳香化酶抑制剂(Als)和选择性雌激素受体调节器(SERMs),产生一个hypoestrogenic环境减少疼痛,但相关的一些副作用和复发停药后症状的治疗。选择性孕激素受体调节剂(SPRMs)可能降低adenomyosis-associated骨盆疼痛,通过抑制子宫内膜增殖和抑制adenomyotic损伤增长,如图所示在动物模型;与SPRMs需要进一步确定。

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