Diagnosis and treatment of adenomyosis
This paper defines adenomyosis as a benign gynecological disorder involving endometrial tissue within the myometrium, which causes inflammation and neuroangiogenesis.
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This CMAJ paper reviews what is known about diagnosing and treating adenomyosis, describing women presenting with dysmenorrhea or heavy menstrual bleeding and summarizing evidence from imaging and treatment studies. It states that transvaginal ultrasound is first-line for assessing adenomyosis and has reported sensitivity of 83.8% and specificity of 63.9%, with MRI usually not required, and that medical management controls symptoms for most women, with the levonorgestrel intrauterine system showing comparable improvement versus hysterectomy in a randomized trial at 6 months. The paper notes important caveats, including that adenomyosis can co-exist with other conditions and thus cloud presentation, and that a proportion of women are asymptomatic and do not require management, as symptoms resolve after menopause. Relevance to endometriosis: it defines adenomyosis via aberrant endometrial gland/stroma development within the myometrium and discusses overlap in clinical presentation with other gynecological conditions that can include endometriosis, though the paper’s main focus is diagnosis and treatment of adenomyosis rather than endometriosis.
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Cites (4)
- Diagnosing adenomyosis: an integrated clinical and imaging approach 2020
- Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis 2018
- Adenomyosis incidence, prevalence and treatment: United States population-based study 2006–2015 2020
- Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review 2019
Cited by (4)
- Nonsurgical management of adenomyosis: an overview of current evidence 2022
- Adenomiose: aspectos epidemiológicos, fisiopatológicos e manejo terapêutico 2023
- Clinical efficacy and safety of trimonthly administration of goserelin acetate 10.8 mg in premenopausal Chinese females with symptomatic adenomyosis: a prospective cohort study 2022
- Comparison of safety and efficacy of hysteroscopic LNG-IUS fixation surgery and conventional LNG-IUS placement in the treatment of adenomyosis: A retrospective cohort study 2025
References (5)
- Adenomyosis incidence, prevalence and treatment: United States population-based study 2006–2015 via openalex
- Diagnosing adenomyosis: an integrated clinical and imaging approach via openalex
- Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review via openalex
- Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis via openalex
- W2790094279 via openalex
Cited by (4)
- Comparison of safety and efficacy of hysteroscopic LNG-IUS fixation surgery and conventional LNG-IUS placement in the treatment of adenomyosis: A retrospective cohort study 2025
- Adenomiose: aspectos epidemiológicos, fisiopatológicos e manejo terapêutico 2023
- Nonsurgical management of adenomyosis: an overview of current evidence 2022
- Clinical efficacy and safety of trimonthly administration of goserelin acetate 10.8 mg in premenopausal Chinese females with symptomatic adenomyosis: a prospective cohort study 2022
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