[Adenomyosis as a social problem]

In a retrospective investigation of 149 patients from 1979-1988 with histologically confirmed adenomyosis the authors proved by comparison with a regional population sample (n = 198) that it is a disease of above average fertile women (3.7 pregnancies per woman). The operated women had in their case-history 1.3 times more deliveries, 1.9 times more spontaneous abortions, twice as many induced abortions and 5.3 times as many extrauterine pregnancies. The group comprises 1.4 times more women using intrauterine contraception in the past and only 2.7% were sterile. The authors were unable to prove a relationship of some causes of relative hyperoestrogenism (early menarche, postponed first childbirth) and this disease. The higher rate of pregnancies terminated by curettage (spontaneous and induced abortions) and the greater preference of IUD in this group of women support the hypothesis that intrauterine manipulations are the main predisposing factor of endometrial cells into the myometrium. The inhibiting effect of pregnancies terminated by lactation on this disease. similarly as hormonal contraception, are of little importance, as apparent from our material.