Study on Efficacy and Safety of GnRH-a Combined with Norethindrone in the Treatment of Adenomyosis

Objective: To study the efficacy and safety of combining gonadotropin-releasing hormone agonist (GnRH-a) with norethindrone in the treatment of adenomyosis. Methods: Sixty women with adenomyosis were randomized into two groups. Group A( n =30) were treated with GnRH-a plus norethindrone and group B( n =30) received only GnRH-a. Symptoms and signs were recorded before and after the treatment. Liver and renal functions, lipid, bone metabolism, and BMD in the lumbar were also examined at the same time. All datas were analyzed using paired and grouped student's t-tests. Results: Total subjective symptom scores and uterine volume decreased after treatment in two groups. After treatment, liver and renal functions, and fast blood sugar of both groups were all in normal range. Compared with pre-treatment and group A, serum trigyceride (TG), apolipoprotein A (ApoA), serum calcium and phosphorus, and alkaline phosphatase levels, and BMD in group B were significantly lower. There were less low-estrogenic symptoms in group A. Conclusions: GnRH-a combined with norethindrone is an effective therapy in the treatment of adenomyosis. It could also improve the symptom of hypoestrogenemia, decrease hemorrhage rate and bone turn-over, and increase the pregnant rate.