Clinical observation data on the use of levonorgestrel intrauterine delayed-release system (Manuelle) for the treatment of adenomyosis at Peking Union Medical College Hospital From January 2004 to October 2008, a total of 83 patients with adenomyosis were treated by placing Manuelle at Peking Union Medical College Hospital, and after 2008, as the treatment experience continues to mature and the treatment method continues to be recognized by the majority of obstetricians and gynecologists, the number of treated The number of patients receiving treatment has been increasing, and a rough estimate is that there should be more than 200 cases. A summary of the early treated patients with complete follow-up data is presented. Some of them were treated with gonadotropin-releasing hormone agonists (GnRH-a for short, the three commonly used products in China are: Norad, Daphylline and Inhibiton) before the IUD was released, which is what we usually say when we communicate online, and some of them were treated by direct placement of Mannitol, and we will We will follow up the patients at 3 months, 6 months, 1 year, 2 years and 3-5 years after IUD placement to observe and record the size of the uterus, serum CA125, pain score, menstrual changes, renewal rate, and to record all kinds of adverse reactions in detail. At the follow-up starting from 6 months after IUD release until 1 year after treatment, 2 years and 3 to 5 years, the uterine size, CA125, and pain score of patients in both groups decreased significantly compared with those before treatment, and this decrease was not a sporadic but a strictly statistically different improvement, and a large proportion of patients avoided hysterectomy, had a significantly better quality of life, and returned to social positions. Patients who received the injection followed by IUD had a significantly higher rate of menstrual pain relief at the 3-month post-release review than those who received the IUD directly. The most frequent complaint that patients responded to after receiving treatment was bleeding problems, which took two main forms, one being prolonged and dripping menstrual periods. The normal menstrual period usually lasts no more than 7 days, but after IUD placement the period may be extended to 10 days. The other manifestation is irregular bleeding, that is, vaginal bleeding on days when menstruation should not occur. The former two types of bleeding patterns are more common, mostly manifesting as dripping, dark brown or coffee-colored discharge, and individual patients need to use small sanitary pads. The above is most evident in the three months after IUD placement, and as the placement time increases, the patient’s irregular bleeding and prolonged menstrual periods are relieved. In the cases enrolled in our hospital, patients had normal menstrual cycles and periods before treatment. 78 patients completed follow-up and prolonged periods and irregular bleeding were the most common phenomena after IUD placement, 50% and 22.97% at 3 months, 37.04% and 11.1% at 6 months, and 25.9% and 11.1% at 1 year, respectively. Two patients had amenorrhea, but the three important female hormone levels, E2, FSH, and LH, were within the normal range, and the patients had no menopausal symptoms, probably due to the continuous action of the medication on the endometrium, and the ovarian function was normal, so theoretically it did not affect the women’s health. 78 patients had a significant reduction in total menstrual flow after IUD release, and those with slight anemia had an improvement in their physical condition. The physical condition of the patients was improved. In 5 patients, there was more transient vaginal bleeding with moderate to severe abdominal pain during the treatment, at this time, the ultrasound was repeated and the endometrium was found to be 0.5 to 0.8 cm and there was no significant thickening. There were 20 cases (25.64%) in the treatment group in which cysts were found during the follow-up, 4 of which were suspected to be coarctation cysts, which were small, about 3 cm in diameter, with no obvious symptoms due to the history of previous coarctation removal surgery and regular follow-up observation by ultrasound; 2 cases had a history of previous surgery and were highly suspected to be encapsulated effusions by ultrasound. The other 14 cases were simple cysts, about 2-3 cm in diameter, and 12 cysts disappeared after 3 months of follow-up, while 2 cases persisted but the cysts were reduced in size. Mild weight gain was observed in a total of 19 cases (23.1%), breast distension in 10 cases (12.8%), mild abdominal pain in 8 cases (10.3%), and other rare complications including headache, lumbago, acne, and lactation, all of which were seen in individual patients. The overall renewal rate for both groups was 88.6% at 6 months; 74% at 1 year, and most patients removed the ring because of downward movement of the ring. The above objective material suggests that the long-term efficacy of Mannorrhea in relieving dysmenorrhea symptoms in patients with adenomyosis is positive. Preoperative injections can be used in combination as induction medication before IUD release and can improve the effectiveness of treatment. For the physician, a thorough evaluation of each patient, a systematic and comprehensive pre-use consultation is needed to select the right patient to truly benefit the patient, and at the same time, to deal with the side effects and not to easily terminate the treatment by unnecessary IUD removal.