Clinical review for general practice

ISSN (Print) 2713-2552
ISSN (Online) 2782-5671
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FULLSCREEN > Archive > 2025 > Vol 6, №2 (2025) > Adenomyosis: clinicist’s tactics through the prism of domestic and international guidelines

Adenomyosis: clinicist’s tactics through the prism of domestic and international guidelines

Mekan R. Orazov

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Abstract

Today, both adenomyosis and endometriosis are at the forefront of scientific debate. The kinship of adenomyosis and endometriosis at first glance still raise no doubts, since there is reliable scientific evidence of the fact that the pathogenesis of these disease entities has much in common. However, despite the continuing similarity, adenomyosis is currently considered as a separate disorder; in the updated International Classification of Diseases 11th Revision adenomyosis is not included in the endometriosis section (GA10 Endometriosis), but allocated to a separate category (GA11 Adenomyosis). The development of the guidelines on the diagnosis and treatment of adenomyosis by two organizations at once, the Asian Society of Endometriosis and Adenomyosis and the Society of Obstetricians and Gynaecologists of Canada, in 2023 is an indirect evidence of that. Using dienogest 2 mg as monotherapy or dienogest-based combined oral contraceptives (for patients in need of reliable contraception) is one of the most suitable options for the long-term effective adenomyosis symptom management.
Keywords: adenomyosis, pathogenesis, drug therapy, dienogest, combined oral contraceptives.

About the Author

Mekan R. Orazov 1

1 Patrice Lumumba Peoples' Friendship University of Russia, Moscow, Russia omekan@mail.ru

References

1. Оразов М.Р., Радзинский В.Е., Локшин В.Н. и др. Роль рецепторов к окситоцину и вазопрессину в патогенезе тазовой боли, обусловленной аденомиозом. Патологическая физиология и экспериментальная терапия. 2019;63(2):99-107.
Orazov M.R., Radzinsky V.E., Lokshin V.N. et al. The role of oxytocin and vasopressin receptors in the pathogenesis of pelvic pain caused by adenomyosis. Pathological physiology and experimental therapy. 2019;63(2):99-107 (in Russian).
2. Оразов М.Р., Токтар Л.Р., Семенов П.А. Тазовая боль и аденомиоз – опасный тандем. Вопросы гинекологии, акушерства и перинатологии. 2020;19(3):110-6. DOI: 10.20953/1726-1678-2020-3-110-116 Orazov M.R., Toktar L.R., Semenov P.A. Pelvic pain and adenomyosis - a dangerous tandem. Issues of gynecology, obstetrics and perinatology. 2020;19(3):110-6. DOI: 10.20953/1726-1678-2020-3-110-116 (in Russian).
3. Оразов М.Р., Михалева Л.М., Хамошина М.Б. и др. Бесплодие, ассоциированное с аденомиозом. Обзор литературы. Клинический разбор в общей медицине. 2023;4(3):34-40. DOI: 10.47407/kr2023. 4.3.00219 Orazov MR, Mikhaleva LM, Khamoshina MB, et al. Infertility associated with adenomyosis. Literature review. Clinical review for general practice. 2023;4(3):34-40. DOI: 10.47407/kr2023.4.3.00219 (in Russian).
4. Habiba M, Benagiano G. Classifying Adenomyosis: Progress and Challenges. Int J Environ Res Public Health 2021;18(23):12386.
5. Клинические рекомендации «Эндометриоз». Российское общество акушеров-гинекологов. М., 2024. Режим доступа: https://cr.minzdrav.gov.ru/schema/259_1210 Clinical guidelines "Endometriosis". Russian Society of Obstetricians and Gynecologists. Moscow, 2024. Available at: https://cr.minzdrav. gov.ru/schema/259_1210 (in Russian).
6. Nelsen LM, Lenderking WR, Pokrzywinski R et al. Experience of Symptoms and Disease Impact in Patients with Adenomyosis. Patient 2018;11(3):319-28.
7. García-Solares J, Donnez J, Donnez O, Dolmans MM. Pathogenesis of uterine adenomyosis: invagination or metaplasia? Fertil Steril 2018;109(3):371-9.
8. Chapron C, Tosti C, Marcellin L et al. Relationship between the magnetic resonance imaging appearance of adenomyosis and endometriosis phenotypes. Hum Reprod 2017;32(7):1393-401.
9. Khan KN, Kitajima M, Hiraki K et al. Changes in tissue inflammation, angiogenesis and apoptosis in endometriosis, adenomyosis and uterine myoma after GnRH agonist therapy. Hum Reprod 2010;25(3):642-53.
10. Guo SW. The Pathogenesis of Adenomyosis vis-à-vis Endometriosis. J Clin Med 2020;9(2):485.
11. Kishi Y, Suginami H, Kuramori R et al. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol 2012;207(2):114.e1-7.
12. Sinha S, Agarwal M, Bhadani PP et al. Development and validation of sonological classification and scoring system for uterine adenomyosis: A pilot study. F1000Res 2023;(11):1138.
13. Dason ES, Maxim M, Sanders A et al. Guideline No. 437: Diagnosis and Management of Adenomyosis. J Obstet Gynaecol Can 2023;45(6):417-429.e1.
14. Harada T, Taniguchi F, Guo SW et al. The Asian Society of Endometriosis and Adenomyosis guidelines for managing adenomyosis. Reprod Med Biol 2023;22(1):e12535.
15. Lin SC, Wang XY, Fu XL et al. Systematic review and Meta-analysis of efficacy and safety of dienogest in treatment of endometriosis. World J Meta-Anal 2021;9(4):377-88. DOI: 10.13105/wjma.v9.i4.377
16. Maiorana A, Maranto M, Restivo V et al. Evaluation of long-term efficacy and safety of dienogest in patients with chronic cyclic pelvic pain associated with endometriosis. Arch Gynecol Obstet 2024;309(2):589-97.
17. Ali MK, Hussein RS, Abdallah KS, Mohamed AA. The use of dienogest in treatment of symptomatic adenomyosis: A systematic review and meta-analysis. J Gynecol Obstet Hum Reprod 2024;53(7):102795. DOI: 10.1016/j.jogoh.2024.102795. Epub 2024 May 8. PMID: 38729430.
18. Bee R et al. Current Trends and Future Strategies on Diagnosis and Management of Adenomyosis: An Updated Review. Current Womens Health Reviews 2025;21(3):e110324227857.
19. Mueck AO, Sitruk-Ware R. Nomegestrol acetate, a novel progestogen for oral contraception. Steroids 2011;76(6):531-9.
20. Bono Y, Kyo S, Kiyono T et al. Concurrent estrogen action was essential for maximal progestin effect in oral contraceptives. Fertil Steril 2014;(101):5.

For citation:Orazov M.R. Adenomyosis: clinicist’s tactics through the prism of domestic and international guidelines. Clinical review for general practice. 2025; 6 (2): 10–15 (In Russ.). DOI: 10.47407/kr2025.6.2.00564


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