Medical treatment of a grossly enlarged adenomyotic uterus with the levonorgestrel-releasing intrauterine system

Adenomyosis is an important cause of menorrhagia. Besides hysterectomy, the treatment options for adenomyosis have been limited. Presented here is the successful treatment of adenomyosis in a woman presenting with menorrhagia , dysmenorrhea, and an enlarging uterus, for whom conservative therapy init iated with mefenamic acid was unsatisfactory, The patient had insertion of the levonorg estrel-releasing intrauterine system (LNG-IUS). A marked decre ase in uterine size occurred within 12 months of insertion accompanied by r esolution of the menorrhagia and dysmenorrhea. Thus, the LNG-IUS is a viabl e option and represents a real advance in the treatment of adenomyosis. (C) 1999 Elsevier Science Inc. All rights reserved.