The Incidence and Clinical Significance of Adenomyosis
Adenomyosis diagnosis has advanced with imaging, but inconsistencies in definition and reliance on hysterectomy specimens challenge understanding and diagnostic accuracy.
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This paper reviews how adenomyosis incidence and clinical correlates have been studied over time, noting that diagnosis historically relied on hysterectomy pathology but is now possible using transvaginal ultrasound and MRI. It highlights that, despite many publications using these imaging approaches, there is no consensus on how to define adenomyosis or the imaging cut-off separating it from normal uteri, and many studies remain dependent on hysterectomy-based case series. A key limitation explicitly raised is that this lack of standardization and study design challenge the accuracy of imaging diagnosis and hinder a clear understanding of adenomyosis’ true impact. This paper is centrally about endometriosis and adenomyosis research—specifically, it focuses on adenomyosis and discusses diagnostic and epidemiologic gaps that are relevant to how pelvic pain conditions such as endometriosis are distinguished.
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