Clinical and demographic differences in adenomyosis patients with and without concurrent endometriosis: A...

Adenomyosis and endometriosis are gynecological conditions with overlapping symptoms but distinct pathologies. Both affect the women's reproductive system, but their interrelation and shared clinical pathways are underexplored. This study investigates the co-occurrence and potential shared pathophysiology of these conditions.

Utilizing a retrospective cohort design, this study analyzed the medical records of female patients diagnosed with adenomyosis at Changsha Hospital for Maternal & Child Health Care from January 2015 to December 2020. We divided these medical records into two groups: those diagnosed with both adenomyosis and endometriosis and those with adenomyosis alone. Data on demographics, symptoms, and diagnostics were extracted. Statistical analyses, including t-tests, chi-square tests, and multivariable logistic regression, identified significant differences and predictors.

Patients with both adenomyosis and endometriosis were older (mean age 48.88±17.57 years) compared to those with adenomyosis only (mean age 39.16±11.92 years; P = 0.001). Early menarche (<13 years) was more common in the concurrent group (62.6 % vs. 34.4 %; P < 0.001). Menorrhagia and dysmenorrhea were significantly more prevalent in patients with both conditions (72.1 % vs. 26.3 % and 67.3 % vs. 28.1 %, respectively; P < 0.001). Dyspareunia and spontaneous abortion rates were also higher in the concurrent group (59.2 % vs. 46.3 %, P = 0.023 and 69.2 % vs. 52.3 %, P = 0.007, respectively). Multivariable analysis identified older age and early menarche as significant predictors of concurrent endometriosis.

Adenomyosis patients with concurrent endometriosis experience more severe symptoms and different demographic profiles, with older age and early menarche as key predictors. Early screening and tailored management for this subgroup are crucial to improve clinical outcomes.