It often coexists with pelvic endometriosis and invades the uterus. We recognize various types of adenomyosis (e.g. diffuse, focal, solid, cystic, etc.). It may be associated with severe dysmenorrhea (pain during menstruation), menorrhagia (heavy blood loss during menstruation), infertility and/or miscarriages. Although in the past, diagnosis of adenomyosis was mainly histological, it can now be reached with modern imaging modalities, such as transvaginal ultrasound and MRI, as long as these are performed and interpreted by clinicians specializing in endometriosis.
The definitive surgical treatment of adenomyosis is removal of the uterus (hysterectomy), which can be performed laparoscopically. However, more and more women want to keep their uterus. There are surgical options available for treating adenomyosis that do not involve hysterectomy, but they are technically challenging and, therefore, should only be performed by appropriately trained endometriosis surgeons. In cases where surgery is not desired, the administration of hormones, such as the Mirena intrauterine contraceptive device to alleviate symptoms of pain and bleeding, and in vitro fertilization to achieve pregnancy, may be discussed.
