Systemic comorbidities in patients with adenomyosis

Area of Science:

• Gynecology
• Reproductive Medicine
• Clinical Epidemiology

Background:

• Adenomyosis and endometriosis are common gynecological conditions often co-existing.
• Understanding the comorbidity profiles of these conditions is crucial for comprehensive patient management.
• Previous studies have not fully elucidated the differences in comorbidities between isolated adenomyosis and co-existing adenomyosis and endometriosis.

Purpose of the Study:

• To compare the prevalence of comorbidities in premenopausal women diagnosed with adenomyosis alone versus those diagnosed with both adenomyosis and endometriosis.
• To investigate the association between the co-existence of endometriosis and the presence of specific comorbidity types (autoimmune, stress- and pain-related).

Main Methods:

• A prospective observational study involving 689 premenopausal women (aged 20-50) without malignant diseases.
• Diagnosis of adenomyosis and/or endometriosis confirmed via transvaginal ultrasound, MRI, or surgery.
• Comorbidities were categorized into autoimmune diseases and stress- and pain-related disorders.

Main Results:

• Patients with adenomyosis alone exhibited a significantly lower prevalence of overall comorbidities (44.7%) compared to those with both conditions (55.0%).
• Both autoimmune diseases (14% vs. 23.9%) and stress- and pain-related disorders (30.4% vs. 46.4%) were significantly less common in the adenomyosis-alone group.
• The co-existence of endometriosis was independently associated with a higher likelihood of comorbidities in patients with adenomyosis (OR=1.65).

Conclusions:

• Patients with adenomyosis alone demonstrate a lower comorbidity burden compared to those with co-existing endometriosis, indicating potentially distinct clinical phenotypes.
• The findings suggest that the presence of endometriosis significantly influences the comorbidity profile in women with adenomyosis.
• Further epidemiological research is recommended to explore the reasons behind the lower prevalence of certain systemic comorbidities in adenomyosis patients.