What is the exact definition of these term?

A benign condition where endometrial tissue (the uterine lining) grows into the muscle wall of the uterus (myometrium). It can make the uterus enlarged, tender, and prone to heavy, painful periods.

Symptoms

Heavy or prolonged periods, severe cramps that worsen over time, pelvic pressure, bloating, pain with
intercourse, and sometimes infertility.

Who is affected by it and the risk factors?

Most often ages 30–50; more common in people who have given birth; can occur alongside fibroids or
endometriosis; prior uterine surgery may increase risk.

Diagnosis

Based on symptoms plus transvaginal ultrasound findings (e.g., asymmetric uterine walls, cystic spaces,
thickened junctional zone) and sometimes **MRI** for clarification. Definitive diagnosis is by pathology,
usually after hysterectomy, but non-invasive diagnosis is common in practice.

Management (guided by symptom severity and fertility goals):

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Medical: NSAIDs; hormonal therapies such as LNG-IUS, continuous combined pills or progestins (e.g., dienogest), and GnRH analogs/antagonists for short-term relief or as a bridge to surgery; tranexamic acid during menses.

Procedures: uterine artery embolization (selected cases), focused ultrasound in specialized centers, or conservative surgery (adenomyomectomy) when fertility is desired.

Definitive: Hysterectomy if childbearing is complete and symptoms are severe or refractory.

Living with adenomyosis

Keep a symptom/period diary, treat anemia, and consider pelvic floor and core-strengthening for pelvic pressure. We tailor therapy to minimize side effects and preserve fertility when possible.

Deep Dive

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Imaging hallmarks: on ultrasound, features can include a globular uterus, fan-shaped shadowing, myometrial cysts, and a thickened junctional zone; MRI further clarifies extent and coexisting fibroids.

Symptom pattern: pain and bleeding often worsen over years; some notice deep dyspareunia and back pain.

Medical therapy tips: dienogest and LNG-IUS can significantly reduce pain and flow; GnRH analogs/antagonists shrink lesions but are used short-term with add-back hormones to protect bones and reduce hot flashes.

Fertility considerations: adenomyosis may affect implantation; conservative surgery or pretreatment with medical suppression may be discussed in select fertility journeys.

Surgery expectations: adenomyomectomy aims to remove diseased tissue while rebuilding the uterine wall; recovery is similar to other laparoscopic procedures and requires individualized birth planning in future pregnancies.

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