EFFECT OF LNG IUCD (MIRENA) VS DIENOGEST IN ADENOMYOSIS: A RANDOMIZED CONTROL TRIAL

Background: Adenomyosis, a common gynecological condition in reproductive-aged women, causes dysmenorrhea, menorrhagia, and pelvic pain, significantly affecting quality of life. Hormonal therapies like LNG-IUS and dienogest offer uterus-preserving treatment options. Objectives: To compare the clinical efficacy, symptom control, and adverse effect profile of oral dienogest versus levonorgestrel-releasing intrauterine device (LNG-IUS) in the management of adenomyosis. Methods: Arandomized controlled trial (RCT) was conducted on 100 women diagnosed with adenomyosis. Participants were randomly divided into two groups: oral dienogest (2 mg daily) and LNG-IUS (Mirena), and followed up at 3, 6, and 12 months. VAS scores, PBAC scores, uterine volume, and adverse effects were analyzed. Results: Dienogest showed superior reduction in pain and menstrual volume at 6 and 12 months. LNG-IUS was more effective in reducing uterine volume. Irregular bleeding and device expulsion were higher with LNG-IUS. Conclusion: Dienogest demonstrated better long-term symptom control and tolerability, making it a favorable conservative option for adenomyosis.