First line therapy in women with Adenomyosis who wants to preserve feility is

AUB-A (Adenomyosis) Recommendations for management of AUB-A For managing adenomyosis-A, it is suggested to consider the age, symptomology (AUB, pain and infeility) and association with other conditions (leiomyomas, polyps and endometriosis) In women with AUB-A, desirous of preserving feility but unwilling for immediate conception, progestogens especially LNG-IUS is recommended as first-line therapy. In patients with AUB-A, desirous of preserving feility and resistant to LNG-IUS/ unwilling to use LNG-IUS, gonadotropin releasing hormone (GnRH) agonists with add-back therapy is recommended as second-line therapy. In patients with AUB-A, and not desirous of preserving feility, medical management using long-term GnRH agonists and add-back therapy can be initiated. Combined oral contraceptives, danazol, NSAIDs, and progestogens can be offered for symptomatic relief where LNG-IUS and GnRH agonists cannot be indicated. In case of failure/refusal for medical management, vaginal or laparoscopic hysterectomy is indicated.Reference: NICE Guidelines