I saw a typical history of the development of adenomyosis dysmenorrhea and brought it for explanation. This narrative shows us not only the evolution of her dysmenorrhea, but also the development of adenomyosis from nothing to something. I will also analyze it and answer it according to her situation. Here is her narrative: “I had menstrual cramps last year, but it was to the extent that I could get by on painkillers, and it hurt for two or three days just for the high volume, so it was okay. I went for a checkup last year, but nothing was found. At the end of last year, I was not sure and I had another checkup, saying that there was a small fibroid. Then in January of this year, I started to have severe menstrual cramps, and I kept having pains even after my period ended. After January, February is more serious, every day in the middle of the night to run to the emergency room, to the hospital doctor and there is no way, painkillers to eat more effect is not good, with the anal plug, hanging a long time of anti-inflammatory water, but also until the menstruation clean still in pain, and then finally a hospital suspected that I am meibomian gland disease. I started taking medication and went to the provincial Chinese hospital for a checkup and was diagnosed with meibomian gland disease. At that time, I didn’t know that this disease was so troublesome and untreatable, so I was optimistic and started drinking Chinese medicine in February. The pain was excruciating in March and April, and I started moxibustion from the end of February. I thought the pain was getting better in May, but when I thought it was getting better, it started to hurt again in June, so I wanted to # eat painkillers, acupuncture, and everything else, but it didn’t work. Now that it’s clean, it still hurts for hours every day, with severe pain. The arm is full of bite marks from their own pain, bites.” From the beginning of dysmenorrhea last year, only at the end of last year was a small myoma detected, and in January this year, pelvic inflammatory disease was detected, still no adenomyosis, and then began to suspect adenomyosis, to now confirm that it is adenomyosis, a full two years have passed. Some patients may not even be diagnosed with adenomyosis for 4 or 5 years. Because there is a misconception that menstrual pain is a normal phenomenon for women, eight out of ten women have menstrual pain. And menstrual cramps, in the words of the elderly, “just have a baby and you’ll be fine, no more pain.” But did you know that there are many causes of dysmenorrhea? Dysmenorrhea is divided into primary dysmenorrhea, and secondary dysmenorrhea. Generally speaking, primary dysmenorrhea may disappear after giving birth to a child, from this point of view, the words of the old man are not completely unreasonable, but you should not believe them all. Primary dysmenorrhea is the pain that occurs when a girl gets her period. In addition, secondary dysmenorrhea is generally caused by some organic diseases, such as fibroids, endometriosis, adenomyosis, pelvic inflammatory disease… Today we will focus on adenomyosis dysmenorrhea. Adenomyosis dysmenorrhea is usually characterized by no pain at first, then a little pain, then more and more pain, and even some patients end up in pain until they can only lie in bed, unable to work and live normally. It is a progressive aggravation of dysmenorrhea, accompanied by a gradual increase in the volume of menstruation, a slow increase in the size of the uterus, and even later nausea and vomiting, anal swelling, back pain, leg pain and back pain… Why does this happen? Because adenomyosis is caused by the invasion of the endometrium into the muscle layer. Every time when menstruation comes, these ectopic endometrial cells will thicken, bleed and shed on their own as normal endometrium does during the menstrual cycle, but they cannot be discharged from the woman’s cervix like normal menstruation. This can lead to menstrual pain. Then there is the onset of menstruation once a month, which stimulates the ectopic endometrium to grow and it will slowly grow and the uterus will increase in size, so the dysmenorrhea will also become more and more severe. In addition, the dilation of blood vessels in the myometrium, increased blood volume and spasmodic contraction of the uterus during the patient’s menstrual period can also cause severe dysmenorrhea. If you have dysmenorrhea, and the dysmenorrhea is getting more and more severe, and the volume of menstruation is gradually increasing, you should consider if you have adenomyosis. At this time, it is recommended to go to the hospital to do an ultrasound and check the ca125, basically to determine if the dysmenorrhea is caused by adenomyosis.