Adenomyosis Pathophysiology, Diagnostic Advances, and Therapeutic Options

Area of Science:

• Gynecology
• Reproductive Medicine
• Pathology

Background:

• Adenomyosis is a nonmalignant uterine disorder with ectopic endometrial tissue in the myometrium.
• It causes abnormal uterine bleeding, dysmenorrhea, pelvic pain, and subfertility.
• Previously thought to affect older women, it's now recognized in younger reproductive-aged patients due to improved imaging.

Purpose of the Study:

• To review the current understanding of adenomyosis pathogenesis, clinical presentation, diagnosis, and management.
• To highlight challenges in diagnosis and the need for standardized criteria.
• To discuss current and emerging therapeutic options, including medical, interventional, and surgical approaches.

Main Methods:

• Literature review of adenomyosis research, focusing on recent advances in imaging, pathology, and treatment.
• Analysis of current medical management strategies, including hormonal therapies and emerging agents.
• Evaluation of interventional and surgical options for symptom relief and uterine preservation.

Main Results:

• Adenomyosis pathogenesis involves complex mechanisms including sex steroids, inflammation, fibrosis, and stem cells.
• Diagnosis is challenging, but imaging techniques have improved noninvasive detection.
• Medical management efficacy is variable, and surgical/interventional options offer relief but have undefined fertility outcomes.

Conclusions:

• Adenomyosis significantly impacts women's physical, psychologic, and socioeconomic well-being.
• Advances in imaging and emerging therapies are changing management paradigms.
• There is a critical need for disease-specific trials and standardized diagnostic criteria for individualized, fertility-preserving care.