Although the pathophysiology of
adenomyosis has not been clarified, it is thought to be related to ectopic endometrium, which depends on hormonal regulation. The
levonorgestrel-releasing intrauterine system (LNG-IUS) is effective for the medical treatment of
adenomyosis. However, the underlying molecular mechanisms by which LNG-IUS ameliorates
adenomyosis pathology remain unclear. This study was designed to compare the expression levels of
steroid receptor coregulators in human endometrium of control and participants with
adenomyosis and to determine whether LNG-IUS modulated their expression. Immunohistochemistry with H-scores was performed.
Steroid receptor coactivators were shown to have significantly decreased expressions at the secretory phase in the LNG-IUS group when compared to the other groups. Expression of transcriptional intermediary factor 2 was lower in the LNG-IUS group than in both the control group (P = .015) and the untreated
adenomyosis group (P = .019) during the secretory phase. Amplified in
breast cancer 1 expression was higher in the stromal cells of the untreated
adenomyosis group than in those of the controls (P = .017) during the secretory phase; however, levels were lower in the LNG-IUS group (P = .005).
Nuclear receptor corepressor expression increased during the proliferative phase and decreased during the secretory phase in untreated
adenomyosis; this pattern was reversed in the control and LNG-IUS groups. Thus, an altered expression of
steroid receptor coregulators may play a role in
adenomyosis development and treatment.