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Adenomyosis: Diagnosis and Management.
Sarina Schrager1, Lashika Yogendran1, Crystal M Marquez2
1University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
American Family Physician
|January 14, 2022
Summary
Adenomyosis is a uterine condition where endometrial glands invade the myometrium, causing symptoms like heavy bleeding and pain. Diagnosis involves imaging, and treatment ranges from hormonal suppression to hysterectomy.
Area of Science:
- Gynecology
- Reproductive Medicine
- Medical Imaging
Background:
- Adenomyosis is characterized by endometrial glands within the myometrium.
- It affects a significant portion of women, often presenting with heavy menstrual bleeding, pelvic pain, or infertility.
- Adenomyosis can coexist with endometriosis, complicating diagnosis and management.
Purpose of the Study:
- To provide a comprehensive overview of adenomyosis.
- To discuss the clinical presentation, risk factors, and diagnostic methods for adenomyosis.
- To outline current and potential treatment strategies for adenomyosis.
Main Methods:
- Review of existing literature on adenomyosis.
- Analysis of diagnostic criteria and imaging modalities, including transvaginal ultrasonography and pelvic MRI.
- Evaluation of treatment outcomes for hormonal suppression and surgical interventions.
Main Results:
- Heavy menstrual bleeding is the most prevalent symptom of adenomyosis.
- Increasing age, parity, and uterine procedures are identified risk factors.
- Diagnosis relies on clinical suspicion confirmed by imaging, with transvaginal ultrasonography and pelvic MRI being key.
Conclusions:
- Adenomyosis requires accurate diagnosis through advanced imaging techniques.
- Hormonal menstrual suppression, particularly levonorgestrel-releasing intrauterine systems, offers a primary treatment option.
- Hysterectomy remains a definitive treatment for refractory adenomyosis symptoms.
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