Risk Factors For Adenomyosis Research Articles

Adenomyosis and endometriosis in adolescents and young women with pelvic pain: prevalence and risk factors.

The aim of this study was to evaluate the prevalence of ultrasound diagnosis of adenomyosis and endometriosis in young women complaining of pelvic pain and to find the symptoms and clinical characteristics associated with these diseases in young women. Cross-sectional study, including 100 young women (14-24 years) with a history of chronic pelvic pain. Women were asked detailed medical hystory and pain symptoms scores (Visual Analogue Scale) and underwent gynecological examination and ultrasound evaluation. The prevalence of endometriosis and adenomyosis in young women amounted to 25.0% and 46.0%, respectively. A significant correlation was found between ovarian endometriosis and adenomyosis. Dysmenorrhea and dyspareunia were risk factors for adenomyosis. Dyschezia, dyspareunia, chronic pelvic pain, presence of sonographic soft markers suggestive of pelvic adhesions, being a worker and having a previous surgery were risk factors for endometriosis. Young women (20-24 years) had a higher incidence of both adenomyosis and endometriosis than adolescents (14-19 years). Our outcomes strengthen the hypothesis of a progressive and common course of the natural history of endometriosis, which initially may manifest with symptoms, then with signs of pelvic adhesions and finally as adenomyosis, ovarian endometriomas or deep infiltrating endometriosis.

Induced Abortion: A Risk Factor for Adenomyosis.

Abortion, the medical and surgical termination of a pregnancy,is becoming a more common medical procedure among women in Nepal. Adenomyosis is one of the common gynecological problems among women of reproductive age. However, little is known about the relationship between abortion and adenomyosis. Therefore, our study aims to explorerisk factor for adenomyosis in among women who havehadabortions. A comparative study was carried out among women who visited at thedepartment of Obstetrics and Gynecologyof the Tribhuvan University of Teaching Hospital, Kathmandu, between 13th April 2016 to 14th July 2017. Adenomyosis were confirmed through histological examination after hysterectomy. Data wereanalyzed by using Statistical Package for Social Sciences (SPSS software)21.0 version. Odd ratio with their 95% confidence interval and P-value were calculated and analyzed. A P-value equal or below 0.05 was considered as statistically significant. Of the total 255 women, 85were confirmed adenomyosisby histological examination. Of the 85 cases, 39% (33/85) had a history of abortion, while only 25 % (44/170)women had abortion among non-adenomyosis group. Overall, women who had abortion were1.8 timesmore likely to have adenomyosis (95% CI 1.04- 3.17, P value=0.03) compared to women who had no history of abortion. Women with surgical abortions were 2.5 times more likely to develop adenomyosis (95% CI- 1.03- 6.21, P value=0.03) compared towomen with no abortion history. This study found that women,who had abortions,aremore likely to have been diagnosed with adenomyosis compared to women without abortions.Further studies, however, need to be carried out in order toextend findings of this study.

Adenomyosis and endometriosis in adolescents and young women with pelvic pain: prevalence and risk factors.

To evaluate the prevalence of ultrasound diagnosis of adenomyosis and endometriosis in young women complaining of pelvic pain and to find the symptoms and clinical characteristics associated with these diseases in young women. Cross-sectional study, including 100 young women (14-24 years) with a history of chronic pelvic pain. Women were asked detailed medical hystory and pain symptoms scores (Visual Analogue Scale) and underwent gynecological examination and ultrasound evaluation. The prevalence of endometriosis and adenomyosis in young women amounted to 25.0% and 46.0%, respectively. A significant correlation was found between ovarian endometriosis and adenomyosis. Dysmenorrhea and dyspareunia were risk factors for adenomyosis. Dyschezia, dyspareunia, chronic pelvic pain, presence of sonographic soft markers suggestive of pelvic adhesions, being a worker and having a previous surgery were risk factors for endometriosis. Young women (20-24 years) had a higher incidence of both adenomyosis and endometriosis than adolescents (14-19 years). Our outcomes strengthen the hypothesis of a progressive and common course of the natural history of endometriosis, which initially may manifest with symptoms, then with signs of pelvic adhesions and finally as adenomyosis, ovarian endometriomas or deep infiltrating endometriosis.

Dysmenorrhea in patients with adenomyosis: A clinical and demographic study

ObjectiveTo identify the risk factors associated with dysmenorrhea in adenomyosis and to discuss the potential hormone-based understanding of pain mechanisms. Study designAdenomyosis patients with mild or no dysmenorrhea (n = 40, Group 1) and moderate-to-severe dysmenorrhea (n = 80, Group 2) were recruited. Charts of all patients were recorded. An immunohistochemistry (IHC) analysis was performed to detect the cellular levels of estrogen receptor-α (ER-α), estrogen receptor-β (ER-β), gonadotropin-releasing hormone receptor (GnRH-R), and neurofilaments (NFs) in 60 cases. ResultsA history of cesarean section (CS) was positively related to the degree of dysmenorrhea in adenomyosis (OR (95 % CI): 4.397 (1.371–14.104)). The ER-α levels in the eutopic endometrium (EUE) of Group 2 were higher than those in the ectopic endometrium (ECE) of Group 1. Group 2 had higher NF levels in the ECE than in the EUE. ConclusionA history of CS is a risk factor for adenomyosis with moderate-to-severe dysmenorrhea. For patients with adenomyosis, high ER-α levels in the EUE and high NF levels in the ECE may be related to moderate-to-severe dysmenorrhea. These hormone-based mechanisms may contribute to our understanding of the pathogenesis of dysmenorrhea in adenomyosis.

Vaginal Bromocriptine Improves Pain, Menstrual Bleeding, and Quality of Life in Women With Adenomyosis: A Pilot Study

(Abstracted from Acta Obstet Gynecol Scand 2019;98:1341–1350) Animal models suggest that increased uterine prolactin concentration is a risk factor for adenomyosis. Prolactin is produced in the human endometrium, myometrium, and the pituitary gland and acts as a smooth muscle cell mitogen in vitro.

Concomitant gynecological pathologies and risk factors for Adenomyosis

Concomitant gynecological pathologies and risk factors for Adenomyosis

Evaluation of the relationship between prior uterine surgery and the incidence of adenomyosis in the Shariati Hospital in Bandar-Abbas, Iran, from 2001 to 2011.

Background:Adenomyosis is a common benign disorder in pre-menopausal women that presents with uterine enlargement, pelvic pain, heavy menstrual bleeding, and dysmenorrhea. However, its risk factors have not been clearly determined. The aim of this study was to determine whether prior uterine surgery is a risk factor for adenomyosis.Methods:In this cross-sectional study, we reviewed the medical records of all women who had hysterectomies for benign and a non-emergency, gynecological condition during 2001–2011 at Shariati Hospital in Bandar-Abbas, Iran. The variables in the study included age, gravidity, parity, abortion, prior uterine surgery, and the size of the uterus before hysterectomy. The data were analyzed by Microsoft Excel and SPSS version 16, by conducting descriptive statistics, by the t-test, and by Analysis of Variance (ANOVA).Results:Of the 191 participants, 72 women (37.7%) had pathologically-confirmed adenomyosis. Women with adenomyosis reported a history of prior uterine surgery more frequently than women without adenomyosis (P = 0.01), but age, menarche, gravidity, parity, and history of abortion were similar between the two groups (P > 0.05).Conclusion:History of prior uterine surgery is a risk factor for adenomyosis.

Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: Results from a prospective multicentric study in Italy

Objective We conducted a cross-sectional study on the frequency and risk factors for adenomyosis in women who underwent hysterectomy for benign gynecological conditions. Study design All women who consecutively underwent hysterectomy during the study period for benign gynecological conditions at 18 gynecological departments were eligible for the study. A total of 820 women entered the study. Pathological data were collected prospectically. Results Adenomyosis was identified in 231 women (28.2%, 95% confidence interval, CI, 24.6–32.5). The frequency of adenomyosis was similar in women with indication for surgery fibroids/menorrhagia (143 cases, 28.5%) or genital prolapse (69 cases, 28.2%). The rate ratio (RR) of adenomyosis was 1.9 (95% CI 1.2–2.8) in women reporting one or more induced abortions, in comparison with those reporting no induced abortion. Women with adenomyosis reported more frequently dysmenorrhoea and chronic pelvic pain, but not dyspareunia. Conclusions This study shows that adenomyosis is common in women who undergo hysterectomy and that it is more frequent among women reporting induced abortions dysmenorrhoea and chronic pelvic pain.

Disruption of the endometrial-myometrial border during pregnancy as a risk factor for adenomyosis

We assessed surgical disruption of the endometrial-myometrial border during pregnancy as a risk factor for adenomyosis in a cohort of 1850 women undergoing hysterectomy during 1978 to 1981. Women who had 3 or more abortions when sharp curettage was common were at increased risk for adenomyosis; women who had curettage procedures or cesarean deliveries were not. (Am J Obstet Gynecol 2002;187:543-4.)

Surgery: Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics

To evaluate the prevalence and risk factors for adenomyosis, the clinical records of consecutive women undergoing hysterectomy during a 3 year period were retrieved. Data were collected on indication for the intervention, general sociodemographic characteristics of the patients, age at menarche, parity, abortions, and menopausal status at surgery. Adenomyosis was diagnosed in 332 of the 1334 cases (24.9%). The condition was present in 146 of the 627 patients (23.3%) with fibroids and menorrhagia, 68 of the 265 (25.7%) with prolapse, 21 of the 98 (21.4%) with ovarian cysts, 19 of the 100 (19%) with cervical cancer, 31 of the 110 (28.2%) with endometrial cancer, 16 of the 57 (28.1%) with ovarian cancer, and 19 of the 77 (24.7%) with miscellaneous indications. These differences were not statistically significant (chi 2(6) = 11.14). In comparison with nulliparous women, the odds ratio was 1.3 and 1.5 respectively in women with one and > or = two births (chi 2(1) trend = 5.76 P < 0.05). No relationship was found between age at surgery, age at menarche, indications for surgery, menopausal status at intervention, and presence of endometriosis. Our findings do not support the notion that adenomyosis is more frequently related to particular clinical conditions, and suggest that parity may be associated with an increased frequency of adenomyosis.