Appendix 1. Differences between adenomyosis and endometriosis

• Site of endometriotic tissues. In endometriosis, the endometrium abnormally develops outside the uterus. In adenomyosis, instead of lining the uterus, the endometrium grows into the muscular walls of the uterus.

• Aetiology. Endometriosis is thought to be due to retrograde menstruation back into the fallopian tube instead of exiting from the body. Adenomyosis is thought to be due to uterine damage from childbirth or surgery. However, there is no agreed aetiology for either of these conditions.

• Symptoms. Both conditions share symptoms such as heavy menstrual bleeding and painful periods. However, in adenomyosis the pain occurs during menstruation, whereas in endometriosis it may be present before and after menstruation, and also cause painful intercourse. In addition, adenomyosis may be associated with a tender and enlarged uterus.

• Endometriosis occurs during a woman's childbearing years, but it can also occur in women who have never given birth. This can also cause infertility. Adenomyosis can also occur later in a woman's childbearing years.

Appendix 2. Glossary of terms

Adenomyosis: uterine thickening that occurs when endometrial tissue, which normally lines the uterus, moves into the outer muscular walls of the uterus.

Dysmenorrhoea: pain associated with menstruation.

Endometriosis: a condition in which the tissue that lines the inside of the uterus (called the endometrium or endometrial lining) is found growing in other areas outside of the uterus (commonly the ovaries, fallopian tubes and nearby structures of the pelvis).

Hysterectomy: refers to surgical removal of the uterus.

Iatrogenic : refers to illness caused by medical examination or treatment.

Menorrhagia: heavier and increased amount of flow occurring at regular intervals or loss of > 80 mL of blood.

Multiparous : refers to a woman having borne more than one child.

Myometrium : the middle layer of the uterine wall, consisting mainly of smooth muscle cells

Stroma : refers to connective or supporting tissue of the endometrial cell.

Appendix 3. MDSG search string

Menstrual disorders and subfertility database search for KN1930 20.01.14

Title CONTAINS "Adenomas " or "adenomyosis" or Title CONTAINS "Adenomas " or "adenomyosis"

Appendix 4. CENTRAL search strategy

1 Gonadotropin‐releasing hormone agonist$.tw.
2 Gonadotrophin‐releasing hormone agonist$.tw.
3 GnRH agonist$.tw. (684)
4 buserelin/ or goserelin/ or leuprolide/ or nafarelin/ or triptorelin pamoate/
5 histrelin.tw.
6 (buserelin or goserelin or leuprolide or nafarelin or triptorelin).tw.
7 (Lupron or Eligard).tw.
8 (Suprefact or Suprecor).tw.
9 (Supprelin or Vantas).tw.
10 Zoladex.tw.
11 (Suprelorin or Ovuplant).tw.
12 Synarel.tw.
13 decapeptyl.tw.
14 or/1‐13
15 exp Danazol/
16 Danazol.tw.
17 danoval.tw.
18 danatrol.tw.
19 Danocrine$.tw.
20 17‐alpha‐ethinyl testosterone.tw.
21 or/15‐20
22 exp Levonorgestrel/
23 levonorgestrel.tw.
24 norplant.tw.
25 mirena$.tw.
26 (LNG IUS or LNG IUD).tw.
27 Norgestrel.tw.
28 or/22‐27
29 exp aromatase inhibitors/ or aminoglutethimide/ or fadrozole/
30 aromatase inhibitor$.tw.
31 aminoglutethimide.tw.
32 fadrozole.tw.
33 (Testolactone or Teslac).tw.
34 (Anastrozole or arimidex).tw.
35 (Letrozole or Femara).tw.
36 (Exemestane or Aromasin).tw.
37 (Vorozole or Rivizor).tw.
38 (Formestane or Lentaron).tw.
39 (Fadrozole or Afema).tw.
40 or/29‐39
41 14 or 21 or 28 or 40
42 adenomyoma$.tw.
43 Adenomyosis.tw.
44 Endometriosis interna.tw.
45 42 or 43 or 44
46 41 and 45

Appendix 5. MEDLINE search strategy

1 exp Adenomyosis/
2 adenomyoma$.tw.
3 Adenomyosis.tw.
4 adenomyoses.tw.
5 Endometriosis interna.tw.
6 Adenomyotic.tw.
7 or/1‐6
8 Gonadotropin‐releasing hormone agonist$.tw.
9 Gonadotrophin‐releasing hormone agonist$.tw.
10 GnRH agonist$.tw.
11 buserelin/ or goserelin/ or leuprolide/ or nafarelin/ or triptorelin pamoate/
12 histrelin.tw.
13 (buserelin or goserelin or leuprolide or nafarelin or triptorelin).tw.
14 (Lupron or Eligard).tw.
15 (Suprefact or Suprecor).tw.
16 (Supprelin or Vantas).tw.
17 Zoladex.tw.
18 (Suprelorin or Ovuplant).tw.
19 Synarel.tw.
20 decapeptyl.tw.
21 or/8‐20
22 exp Danazol/
23 Danazol.tw.
24 danoval.tw.
25 danatrol.tw.
26 Danocrine$.tw.
27 17‐alpha‐ethinyl testosterone.tw.
28 or/22‐27
29 exp Levonorgestrel/
30 levonorgestrel.tw.
31 norplant.tw.
32 mirena$.tw.
33 (LNG IUS or LNG IUD).tw.
34 Norgestrel.tw.
35 or/29‐34
36 exp aromatase inhibitors/ or aminoglutethimide/ or fadrozole/
37 aromatase inhibitor$.tw.
38 aminoglutethimide.tw.
39 fadrozole.tw.
40 (Testolactone or Teslac).tw.
41 (Anastrozole or arimidex).tw.
42 (Letrozole or Femara).tw.
43 (Exemestane or Aromasin).tw.
44 (Vorozole or Rivizor).tw.
45 (Formestane or Lentaron).tw.
46 (Fadrozole or Afema).tw.
47 or/36‐46
48 21 or 28 or 35 or 47
49 7 and 48
50 randomized controlled trial.pt.
51 controlled clinical trial.pt.
52 randomized.ab.
53 randomised.ab.
54 placebo.tw.
55 clinical trials as topic.sh.
56 randomly.ab.
57 trial.ti.
58 (crossover or cross‐over or cross over).tw.
59 or/50‐58
60 exp animals/ not humans.sh.
61 59 not 60
62 49 and 61

Appendix 6. EMBASE search strategy

1 exp adenomyosis/
2 endometrial adenoma$.tw.
3 adenomyoma$.tw.
4 Adenomyosis.tw.
5 adenomyoses.tw.
6 Endometri$ interna.tw.
7 Adenomyotic.tw.
8 or/1‐7
9 exp gonadorelin agonist/
10 Gonadotropin‐releasing hormone agonist$.tw.
11 Gonadotrophin‐releasing hormone agonist$.tw.
12 GnRH agonist$.tw.
13 exp buserelin acetate/ or exp buserelin/
14 exp goserelin/
15 exp leuprorelin/
16 exp nafarelin acetate/ or exp nafarelin/
17 exp triptorelin/
18 exp histrelin/
19 histrelin.tw.
20 (buserelin or goserelin or leuprolide or nafarelin or triptorelin).tw.
21 (Lupron or Eligard).tw.
22 (Suprefact or Suprecor).tw.
23 (Supprelin or Vantas).tw.
24 Zoladex.tw.
25 (Suprelorin or Ovuplant).tw.
26 Synarel.tw.
27 decapeptyl.tw.
28 or/9‐27
29 exp danazol/
30 Danazol.tw.
31 danoval.tw.
32 danatrol.tw.
33 Danocrine$.tw.
34 17‐alpha‐ethinyl testosterone.tw.
35 or/29‐34
36 exp levonorgestrel/
37 levonorgestrel.tw.
38 norplant.tw.
39 mirena$.tw.
40 (LNG IUS or LNG IUD).tw.
41 (LNGIUS or LNGIUD).tw.
42 Norgestrel.tw.
43 or/36‐42
44 exp aromatase inhibitor/
45 exp aminoglutethimide/
46 exp fadrozole/
47 aromatase inhibitor$.tw.
48 aminoglutethimide.tw.
49 fadrozole.tw.
50 (Testolactone or Teslac).tw.
51 (Anastrozole or arimidex).tw.
52 (Letrozole or Femara).tw.
53 (Exemestane or Aromasin).tw.
54 (Vorozole or Rivizor).tw.
55 (Formestane or Lentaron).tw.
56 (Fadrozole or Afema).tw.
57 or/44‐56
58 28 or 35 or 43 or 57
59 8 and 58
60 Clinical Trial/
61 Randomized Controlled Trial/
62 exp randomization/
63 Single Blind Procedure/
64 Double Blind Procedure/
65 Crossover Procedure/
66 Placebo/
67 Randomi?ed controlled trial$.tw.
68 Rct.tw.
69 random allocation.tw.
70 randomly allocated.tw.
71 allocated randomly.tw.
72 (allocated adj2 random).tw.
73 Single blind$.tw.
74 Double blind$.tw.
75 ((treble or triple) adj blind$).tw.
76 placebo$.tw.
77 prospective study/
78 or/60‐77
79 case study/
80 case report.tw.
81 abstract report/ or letter/
82 or/79‐81
83 78 not 82
84 59 and 83

Appendix 7. CINAHL search strategy

CINAHL search strategy for KN1930