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Review
. 2025 Jun 30:7:1550814.
doi: 10.3389/frph.2025.1550814. eCollection 2025.

Risk factors and countermeasures for abnormal uterine bleeding during dienogest therapy for adenomyosis: a review

Shiyu Zhang  1 , Hua Duan  1
Affiliations
Review

Risk factors and countermeasures for abnormal uterine bleeding during dienogest therapy for adenomyosis: a review

Shiyu Zhang et al. Front Reprod Health. .

Abstract

Adenomyosis, an estrogen-dependent disorder, requires long-term therapy as current treatments (GnRH agonists, danazol, etc.) show symptom recurrence post-discontinuation. Dienogest (DNG), a selective progesterone receptor agonist, effectively reduces adenomyosis-related pain but causes abnormal uterine bleeding (AUB) in some patients, likely due to pseudodecidual breakthrough bleeding, significantly impacting treatment compliance. This review examines risk factors for DNG-associated AUB and advances in management strategies to improve patient adherence during prolonged therapy.

Keywords: abnormal uterine bleeding; adenomyosis; countermeasures; dienogest; risk factors.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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