THE ROLE OF HORMONAL THERAPY IN THE MANAGEMENT OF ADENOMYOSIS

Adenomyosis is a common estrogen-dependent gynecological disorder characterized by the presence of endometrial glands and stroma within the myometrium. The disease is frequently associated with heavy menstrual bleeding, dysmenorrhea, chronic pelvic pain, infertility, and impaired quality of life. Hormonal therapy has become the cornerstone of conservative management due to its ability to suppress estrogen-dependent proliferation and reduce inflammatory activity within adenomyotic lesions. This review analyzes the role of hormonal therapy in the treatment of adenomyosis, focusing on its mechanisms of action, clinical efficacy, and therapeutic benefits. Current evidence indicates that levonorgestrel-releasing intrauterine systems (LNG-IUS), progestins such as dienogest, gonadotropin-releasing hormone (GnRH) agonists, and combined oral contraceptives effectively control symptoms, reduce uterine volume, and preserve reproductive function. Individualized treatment strategies based on patient age, symptom severity, reproductive goals, and disease extent are essential for achieving optimal outcomes.