Versions
- 2026-01-26 (2)
- 2025-03-20 (1)
Keywords
pelvic pain
abnormal uterine bleeding
infertility
endometriosis
Categories
How to Cite
Abstract
Adenomyosis is a gynecological condition characterized by symptoms such as pelvic pain, abnormal uterine bleeding, and infertility, which significantly impact women’s health. This article aims to present a review of the existing literature focused on its etiopathogenesis, clinical manifestations, imaging diagnostic tools, and therapeutic options, to provide updated information for a better understanding of this disease.
The definitive diagnosis is based on histological studies, but imaging techniques such as transvaginal ultrasound and magnetic resonance imaging have led to significant advances in its detection. Regarding its etiopathogenesis, two main theories exist: endometrial invagination and metaplasia of embryonic remnants.
Therapeutic approaches range from conservative medical treatments, such as the use of hormonal intrauterine devices, to surgical interventions, such as hysterectomy. Clinically, adenomyosis negatively affects fertility and increases obstetric risks, highlighting the need for comprehensive and specialized management.
References
1.- Bulun, S. E., Yildiz, S., Adli, M., & Wei, J. J. (2021). Adenomyosis pathogenesis: insights from next-generation sequencing. Human reproduction update, 27[6], 1086–1097. https://doi.org/10.1093/humupd/dmab017
2.- Antero, M. F., Ayhan, A., Segars, J., & Shih, I. M. (2020). Pathology and Pathogenesis of Adenomyosis. Seminars in reproductive medicine, 38(2-03), 108–118. https://doi.org/10.1055/s-0040-1718922
3.- Alcalde, A. M., Martínez-Zamora, M. A., & Carmona, F. (2021). Adenomiosis. Una gran desconocida: ¿Qué debemos saber? Clínica e Investigación en Ginecología y Obstetricia, 48[2], 184-189. https://doi.org/10.1016/j.gine.2020.08.007
4.- Upson, K., & Missmer, S. A. (2020). Epidemiology of Adenomyosis. Seminars in reproductive medicine, 38(2-03), 89–107. https://doi.org/10.1055/s-0040-1718920
5.- García-Solares, J., Donnez, J., Donnez, O., & Dolmans, M. M. (2018). Pathogenesis of uterine adenomyosis: invagination or metaplasia?. Fertility and sterility, 109[3], 371–379. https://doi.org/10.1016/j.fertnstert.2017.12.030
6.- Wang, Y., Nicholes, K., & Shih, I. M. (2020). The Origin and Pathogenesis of Endometriosis. Annual review of pathology, 15, 71–95. https://doi.org/10.1146/annurev-pathmechdis-012419-032654
7.- Gordts, S., Grimbizis, G., & Campo, R. (2018). Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis. Fertility and sterility, 109[3], 380–388.e1. https://doi.org/10.1016/j.fertnstert.2018.01.006
8.- Chen, Q., Li, Y. W., Wang, S., Fan, Q. B., Shi, H. H., Leng, J. H., Sun, D. W., Lang, J. H., & Zhu, L. (2019). Clinical Manifestations Of Adenomyosis Patients With Or Without Pain Symptoms. Journal of pain research, 12, 3127–3133. https://doi.org/10.2147/JPR.S212117
9.- Vercellini, P., Viganò, P., Bandini, V., Buggio, L., Berlanda, N., & Somigliana, E. (2023). Association of endometriosis and adenomyosis with pregnancy and infertility. Fertility and sterility, 119[5], 727–740. https://doi.org/10.1016/j.fertnstert.2023.03.018
10.- Kolovos, G., Dedes, I., Imboden, S., & Mueller, M. (2024). Adenomyosis-A Call for Awareness, Early Detection, and Effective Treatment Strategies: A Narrative Review. Healthcare (Basel, Switzerland), 12[16], 1641. https://doi.org/10.3390/healthcare12161641
11.- Tsikouras, P., Kritsotaki, N., Nikolettos, K., Kotanidou, S., Oikonomou, E., Bothou, A., Andreou, S., Nalmpanti, T., Chalkia, K., Spanakis, V., Tsikouras, N., Chalil, M., Machairiotis, N., Iatrakis, G., & Nikolettos, N. (2024). The Impact of Adenomyosis on Pregnancy. Biomedicines, 12[8], 1925. https://doi.org/10.3390/biomedicines12081925
12.- Nirgianakis, K., Kalaitzopoulos, D. R., Schwartz, A. S. K., Spaanderman, M., Kramer, B. W., Mueller, M. D., & Mueller, M. (2021). Fertility, pregnancy and neonatal outcomes of patients with adenomyosis: a systematic review and meta-analysis. Reproductive biomedicine online, 42[1], 185–206. https://doi.org/10.1016/j.rbmo.2020.09.023
13.- Horton, J., Sterrenburg, M., Lane, S., Maheshwari, A., Li, T. C., & Cheong, Y. (2019). Reproductive, obstetric, and perinatal outcomes of women with adenomyosis and endometriosis: a systematic review and meta-analysis. Human reproduction update, 25[5], 592–632. https://doi.org/10.1093/humupd/dmz012
14.- Tellum, T., Nygaard, S., & Lieng, M. (2020). Noninvasive Diagnosis of Adenomyosis: A Structured Review and Meta-analysis of Diagnostic Accuracy in Imaging. Journal of minimally invasive gynecology, 27[2], 408–418.e3. https://doi.org/10.1016/j.jmig.2019.11.001
15.- Tsikouras, P., Kritsotaki, N., Nikolettos, K., Kotanidou, S., Oikonomou, E., Bothou, A., Andreou, S., Nalmpanti, T., Chalkia, K., Spanakis, V., Tsikouras, N., Chalil, M., Machairiotis, N., Iatrakis, G., & Nikolettos, N. (2024). The Impact of Adenomyosis on Pregnancy. Biomedicines, 12[8], 1925. https://doi.org/10.3390/biomedicines12081925
16.- Bordonné, C., Puntonet, J., Maitrot-Mantelet, L., Bourdon, M., Marcellin, L., Dion, E., Plu-Bureau, G., Santulli, P., & Chapron, C. (2021). Imaging for evaluation of endometriosis and adenomyosis. Minerva obstetrics and gynecology, 73[3], 290–303. https://doi.org/10.23736/S2724-606X.21.04710-9
17.- Knorren, E. R., de Ridder, L. A., Nijholt, I. M., Dijkstra, J. R., Braat, M. N. G. J. A., Huirne, J. A. F., Boomsma, M. F., & Schutte, J. M. (2024). Effectiveness and complication rates of high intensity focused ultrasound treatment for abdominal wall endometriosis: A systematic review. European journal of obstetrics, gynecology, and reproductive biology, 297, 15–23. https://doi.org/10.1016/j.ejogrb.2024.03.029
18.- Bourdon, M., Oliveira, J., Marcellin, L., Santulli, P., Bordonne, C., Maitrot Mantelet, L., Millischer, A. E., Plu Bureau, G., & Chapron, C. (2021). Adenomyosis of the inner and outer myometrium are associated with different clinical profiles. Human reproduction (Oxford, England), 36[2], 349–357. https://doi.org/10.1093/humrep/deaa307
19.- Khan, K. N., Fujishita, A., & Mori, T. (2022). Pathogenesis of Human Adenomyosis: Current Understanding and Its Association with Infertility. Journal of clinical medicine, 11[14], 4057. https://doi.org/10.3390/jcm11144057
20.- Guo S. W. (2020). The Pathogenesis of Adenomyosis vis-à-vis Endometriosis. Journal of clinical medicine, 9[2], 485. https://doi.org/10.3390/jcm9020485
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2025 Contemporary Midwifery Journal