Adenomyosis: Unravelling the causes and exploring treatment strategies among patients seeking conception

Abstract

Adenomyosis is benign uterine, estrogen-dependent disorder and characterized by symptoms like abnormal uterine bleeding, dysmenorrhoea, chronic pelvic pain and infertility as well. It was traditionally considered a disorder predominantly affecting the woman of perimenopausal age, with definitive diagnosis reliant upon histopathological evaluation following hysterectomy. The diagnostic preference for adenomyosis is ultrasonography and MRI, and the treatment options include surgery and medical therapies, but ambiguity exists for selecting patients and treatment strategies among the clinicians themselves. Unfortunately, a robust treatment protocol for adenomyosis and related infertility among the patients remains undeveloped. In addition to discussing prevalence, pathophysiology and conventional treatments of adenomyosis, the review highlights the use of aromatase inhibitor (Letrozole) as an option to treat adenomyosis and associated symptoms like dysmenorrhoea, heavy menstrual bleeding in females. Thus, this drug seems to be a safer and effective for the treatment of adenomyosis, especially patients seeking fertility treatments. However, widespread applicability, side effects and robustness of this regime needs in-depth scientific evidence and clinical proofs for better health care. The article provides firsthand practical information on treating the patients, seeking fertility treatments through assisted reproduction, offering clinicians, insight into selecting pharmacological option for patients suffering from adenomyosis, without the need of surgical intervention.