Chronic pelvic pain (CPP) syndrome is one of the most common syndromes that accompanies a number of diseases of various systems and organs, including adenomyosis. The frequency of the CPP combination with adenomyosis, according to different authors, varies in the range from 16.3 to 80%. This necessitates the development of a unified terminology, consistent classifications and diagnostic criteria. The absence of the consensus with respect to the pathogenesis of this diseases and the development of pain syndrome has engendered a great variety of theories: for example, about the inflammatory, nociceptive, neuropathic and central mechanisms of pain. Nevertheless, the currently available evidence permits to find the crosspoints of these topical. Hysterectomy is the only radical method of management of symptomatic adenomyosis. It must be admitted, however, that this method is not good for patients, whose adenomyosis is manifested by chronic pelvic pain, when nonsurgical treatment is the priority option. Among a variety of treatments for adenomyosis the use of progestin dienogest (Zafrilla®) is one of the most acceptable options for a prolonged and effective use. © 2020, Dynasty Publishing House. All rights reserved.