A case of hemorrhagic shock occurred during dienogest therapy for uterine adenomyosis
article
OA: closed
CC0
⤵ 7 in-corpus citations
AI-generated summary
A 45-year-old woman on dienogest for adenomyosis experienced hemorrhagic shock requiring hysterectomy due to persistent abnormal uterine bleeding.
One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works
Abstract
We present a case of hemorrhagic shock occurred during dienogest therapy for uterine adenomyosis which necessitated an emergency hysterectomy. The patient was a 45-year-old woman with adenomyosis. Magnetic resonance imaging showed type I adenomyosis measuring 10 cm. She had a history of intimal thrombectomy of pulmonary embolism and had been receiving warfarin and aspirin until the onset of the hemorrhagic shock. Following 6-month of gonadotropin-releasing hormone analogue, dienogest was commenced. Nine months after switching to dienogest, the patient experienced a persistent abnormal uterine bleeding for 2 weeks, eventually causing a massive bleeding and was transferred to our emergency room. A diagnosis of hemorrhagic shock with a severe anemia (hemoglobin 3.6 g/dL) was made. Despite blood transfusion and warfarin antagonization, continuous bleeding ≥150 g/h was not controlled. Emergent hysterectomy was opted and enabled hemostasis. Although the number of patients with adenomyosis who can avoid surgery by dienogest is increasing, care must be taken during dienogest therapy, especially in patients with anticoagulants and after gonadotropin-releasing hormone analogue treatment. To prevent such a critical event, careful management including patient education should be carried out.
My notes (saved in your browser only)
Condition tags
Citation neighborhood
Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.
References (17)
- A dose‐ranging study to determine the efficacy and safety of 1, 2, and 4 mg of dienogest daily for endometriosis via openalex
- Dienogest is as effective as intranasal buserelin acetate for the relief of pain symptoms associated with endometriosis—a randomized, double-blind, multicenter, controlled trial via openalex
- Dysfunctional coagulation and fibrinolysis systems due to adenomyosis is a possible cause of thrombosis and menorrhagia via openalex
- Effective salvage of acute massive uterine bleeding using intrauterine balloon tamponade in a uterine adenomyosis patient on dienogest via openalex
- Efficacy of dienogest in the treatment of symptomatic adenomyosis: a pilot study via openalex
- Evaluation of the efficacy and safety of dienogest in the treatment of painful symptoms in patients with adenomyosis: a randomized, double-blind, multicenter, placebo-controlled study via openalex
- Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification via openalex
- Long‐term dienogest administration in patients with symptomatic adenomyosis via openalex
- Maintenance therapy with dienogest following gonadotropin-releasing hormone agonist treatment for endometriosis-associated pelvic pain via openalex
- Reduced pelvic pain in women with endometriosis: efficacy of long-term dienogest treatment via openalex
- Risk factors of treatment discontinuation due to uterine bleeding in adenomyosis patients treated with dienogest via openalex
- Severe hemoperitoneum due to endometriosis in a non-pregnant woman under dienogest therapy: a case report via openalex
- Subtype I (intrinsic) adenomyosis is an independent risk factor for dienogest-related serious unpredictable bleeding in patients with symptomatic adenomyosis via openalex
- W2101417341 via openalex
- W2091852776 via openalex
- W2080144899 via openalex
- W2026767091 via openalex
Cited by (7)
- Adenomyosis with abnormal uterine bleeding complicated by venous thrombosis: a case series and literature review 2025
- A systematic review and Bayesian analysis of the adverse effects of dienogest 2024
- Fertility sparing treatment in an infertile patient with severe adenomyosis and a uterine fibroid: a case report 2023
- Establishment of a novel mouse model of adenomyosis suitable for longitudinal and quantitative analysis and perinatal outcome studies 2022
- Establishment of a Novel Mouse Model of Adenomyosis Suitable for Longitudinal and Quantitative Analysis and Perinatal Outcome Studies 2022
- Establishment of a novel mouse model of adenomyosis suitable for longitudinal and quantitative analysis and perinatal outcome studies 2022
- Proposal for developing treatment algorithms of women with symptomatic adenomyosis: A single‐center experience 2021
Source provenance
- europepmc
- last seen: 2026-06-04T01:30:01.192114+00:00
- openalex
- last seen: 2026-06-04T00:00:01.174412+00:00
- pubmed
- last seen: 2026-05-13T22:21:36.268089+00:00
- unpaywall
- last seen: 2026-06-02T02:00:03.124865+00:00
License: CC0
· commercial use OK