Clinical significance of adenomyosis

During the years 1968--1972, 903 patients with endometriosis were operated on in the Turku University Central Hospital, of whom 136 were found to have adenomyosis (endometriosis interna). The diagnosis of adenomyosis was usually made post-operatively from following examination of uterus; only 15% were suspected to have adenomyosis preoperatively. 24% of the patients also had external endometriosis. The symptoms and the clinical finding were analysed, but the results were quite unclear and were often easier to explain in terms of other simultaneous diseases or of menopausal disturbances. Adenomyosis, unlike external endometriosis, did not cause sterility. A study of the aetiology showed that only 6% had had no pregnancies. Adenomyosis is a benign disease with little clinical significance. Its symptoms are unclear and it is usually underdiagnosed, but it may actually appear in more than 50% of parous women over the age of 40. In this study, the only aetiology of adenomyosis appeared to be pregnancy and/or delivery. Finally it is suggested that adenomyosis may be a more or less physiological finding in parous women, with the highest frequency of occurrence in the female population over the age 30 years when childbearing is generally over.