Chronic abnormal uterine bleedings and quality of women’s life. How to significantly improve the result?

Н. Ю. Педаченко, T.М. Tutchenko, Р. А. Тухтарян
In: REPRODUCTIVE ENDOCRINOLOGY · 2020 · pp. 14–22 · doi:10.18370/2309-4117.2020.51.14-22 · W3021172062
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

Combining dienogest therapy for abnormal uterine bleeding with vitamin and iron supplements significantly improved women's physical and psychological quality of life by increasing hemoglobin, ferritin, and vitamin D levels.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This randomized study in 114 women with chronic abnormal uterine bleeding (including adenomyosis and adenomyosis with endometrial polyps) compared etiopathogenetic treatment with or without an added vitamin complex containing iron and vitamin D3, assessing hemoglobin, ferritin, and 25(OH)D before and 3 months after therapy and quality of life using the SF-36. In the main group, dienogest-based etiopathogenetic therapy plus the vitamin complex was associated with increases in hemoglobin, ferritin, and vitamin D levels, alongside improvements in SF-36 physical and psychological health summary indicators. The paper’s caveat is the relatively short follow-up (only 3 months) and the fact that multiple micronutrients were given together, making it difficult to isolate the contribution of iron versus vitamin D. Relevance to endometriosis: the included adenomyosis subgroup received dienogest-based treatment, which is directly tied to endometriosis-spectrum pathology involving adenomyosis, though endometriosis itself is not the primary focus.

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Abstract

Purpose of the study: to determine the effect of iron and vitamin D subsidies on the quality of women’s life who receive pathogenetic therapy for abnormal uterine bleedings (AUB) caused by adenomyosis and/or endometrial polyps.Materials and methods. 114 patients with chronic AUB were randomized into two groups. The main group consist of 58 women, including 46 women with chronic AUB and adenomyosis (AUB-A), 12 women with adenomyosis and endometrial polyps (AUB-A,P). Women with AUB-A were prescribed 2 mg dienogest daily for the treatment of adenomyosis, similarly to patients with AUB-A,P after hysteroresection. All women in the main group also took a vitamin complex (iron, folate, iodine, vitamin D3, docosahexaenoic acid). The control group included 56 patients (43 women with AUB-A, 13 women with AUB-A,P) who were prescribed etiopathogenetic treatment (dienogest 2 mg per day and/or hysteroresection for endometrial polyps) without a vitamin complex subsidy. Quality of life was assessed using the SF-36 questionnaire. All patients received serum concentrations of hemoglobin, ferritin and 25(OH)D before and 3 months after treatment.Results. Iron-free dienogest therapy led to an increase serum hemoglobin levels after 3 months (p = 0.001). After three months vitamin complex Pregna-5 added there were significantly increased of hemoglobin levels, ferritin and 25(OH)D. This is accompanied by an improvement in the overall indicator of physical (r = 0.421, p <0.05) and psychological health (r = 0.385, p <0.05) on the SF-36 scale. An increase in serum ferritin greatly improves the psychological (r = 0.660, p <0.05) and physical components of women’s health (r = 0.522, p <0.05). Optimization of serum vitamin D levels improves physical health (r = 0.494, p <0.05). Conclusions. It is necessary to combine etiopathogenetic therapy with additional sources of vitamin D and iron for successful therapy of AUB and restoration of deficient conditions. This is significantly improves the quality of life.

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