Effects of Leuprorelin combined with Mirena on endocrine function, emotion, quality of life, and endometrial receptivity in patients with adenomyosis.

OBJECTIVE: To evaluate the combined effects of Leuprorelin and Mirena on endocrine profiles, emotional well-being, quality of life, and endometrial receptivity (ER) in patients with adenomyosis. METHODS: This is a retrospective cohort study involving 144 patients with adenomyosis, in which 81 received Mirena alone and 63 received the combination of Mirena and Leuprorelin. Primary outcomes included menstrual volume, dysmenorrhea, uterine volume, hormone levels, emotional status, quality of life, and ER, assessed via clinical scales and ultrasound. RESULTS: Combination therapy significantly reduced menstrual volume, dysmenorrhea, and uterine volume compared to Mirena alone (all P < 0.05). Endocrine hormone levels were notably lower in the combination group (P < 0.05). Anxiety improved significantly (P = 0.012), with trends toward improved depression outcomes. Psychological health and social quality of life also showed significant improvement (P < 0.05). ER was enhanced, with better endometrial characteristics and blood flow (P < 0.05). Adverse events were similar between groups. CONCLUSION: The combination of Leuprorelin and Mirena offers superior efficacy over Mirena alone in managing adenomyosis. This regimen provides enhanced symptom relief, reduces endocrine disruptions, and improves emotional well-being and quality of life without increasing adverse events.