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

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.