Prevalence of Adenomyosis Among Symptomatic Young Adults in Association with Patient-Reported Outcomes: A Pilot Study

Abstract

Study Objective To estimate the prevalence of adenomyosis among young adult patients with dysmenorrhea and/or heavy menstrual bleeding based on transvaginal ultrasounds (TVUS) and to assess various patient-reported outcome measures. Design Prospective cohort study. This abstract is an interim analysis of a larger ongoing study. Setting Outpatient minimally invasive gynecologic l surgery (MIGS) clinic. Patients or Participants Patients ages of 18 to 27 presenting with dysmenorrhea and/or heavy menstrual bleeding (n=15). Interventions TVUS to evaluate menstrual complaints and study questionnaires including self-reported health and demographic information, as well as validated patient-reported outcome measures (PROMs) from the Menstrual Bleeding Questionnaire (MBQ), Endometriosis Health Profile-30, and the EQ-5D-3L to evaluate menstrual symptoms, health status, and impact on quality of life. Measurements and Main Results Data from 15 patients have been analyzed thus far. TVUS reports were assessed for markers associated with adenomyosis and based on the presence of these markers, were given a TVUS diagnosis of adenomyosis. The prevalence of TVUS-diagnosed adenomyosis among the sample was 33.3%. The most common ultrasound markers were a heterogenous myometrium (60.0%) and asymmetrical thickening (26.7%). Patients with TVUS-diagnoses of adenomyosis had higher EHP-30 pain scores (59.1±28.3 vs. 42.1±20.2; p=0.249), EHP-30 emotional well-being scores (43.8±30.9 vs. 26.7±17.4; p=0.205), and higher EHP-30 composite scores, which includes impact on quality of life (53.1±29.8 vs. 36.9±20.2; p=0.258) than patients without TVUS-diagnoses of adenomyosis. Patients with TVUS-diagnoses of adenomyosis had similar MBQ scores as patients without the TVUS diagnoses (18±9.8 vs. 23.1±10.7; p=0.938). Conclusion Findings of this pilot study support a higher prevalence of adenomyosis among young adults than has been reported in previous literature. Patients with TVUS-diagnosed adenomyosis trended towards worse dysmenorrhea, physical and mental health statuses and overall quality of life. Current research gaps in adenomyosis among this age group necessitate further research, especially as we learn more about true prevalence rates.