Current Status of the Diagnosis and Treatment of Adenomyosis

Abstract

Adenomyosis refers to the endometrial glands and mesenchyme that invade the myometrium through the basal layer, and under the action of hormones, repeated bleeding, myofibrous connective tissue hyperplasia formed by diffuse or limited lesions. It is a common disease in women of childbearing age and is more common in women over 40 years of age with menstruation. In recent years, the age of onset of the disease tends to be younger, which may be related to the various uterine surgical operations in clinical work, such as abortion, childbirth, curettage, chronic endometritis, and so on. The mechanism of the disease is currently thought to be due to the invasion of the basal endometrium into the myometrium for growth, but the ectopic endometrium is immature, has reactive changes to estrogen, and is insensitive to progesterone. Its main symptoms are increased menstrual flow, dysmenorrhea, and low fertility, which seriously affect the quality of life of patients. Among them, the incidence of excessive menstrual flow is 40%–50% and the incidence of dysmenorrhea is 15%–30%. There are numerous treatments available for adenomyosis aimed at reducing menstrual flow, relieving dysmenorrhea, and improving fertility. A brief review of the various treatments available for adenomyosis in the clinic is as follows.