Adenomyosis is a common disease in women of childbearing age, due to the invasion of endometrial glands and mesenchymal growth into the myometrium, accompanied by hyperplasia and hypertrophy of the surrounding muscle cells, forming a diffuse or limited lesion. (Too technical to understand?) Some gynecologists liken the endometrium to a restless wanderer that wreaks havoc wherever it goes. Ectopic to the ovaries can form coeliacs, and ectopic to the myometrium, causing adenomyosis. It has also been compared to the bark growing into the trunk of a tree, both described more graphically. The incidence of adenomyosis is reported in the literature to be about 20% to 30%, but the reported incidence varies widely depending on the population and statistics. The disease occurs mostly in women aged 30-50 years who have given birth, while in recent years, there is a clear trend of increasing incidence and younger age of onset of adenomyosis. The incidence of adenomyosis can be asymptomatic in 35% of patients, combined with endometriosis in 15% of patients and fibroids in 50% of patients. Why do you get adenomyosis? The occurrence of adenomyosis is related to the restless endometrium, so what causes the displacement of these “vagrants”? The endometrium is directly above the myometrium and lacks the protection of a submucosal layer, making it anatomically easy for the basal endometrium to invade the myometrium. Multiple pregnancies and deliveries, abortions, curettage, chronic endometritis, etc. can cause damage to the endometrium or superficial myometrium, and the basal endometrium invades the myometrium to grow and develop. In addition, studies have shown that the onset of adenomyosis is related to estrogen and progesterone in the body, and even to immune and genetic factors. What are the manifestations of adenomyosis? 1. Menstrual disorders: 40% to 50% of patients have prolonged periods and increased menstrual flow, and some patients may have spot bleeding before and after menstruation. This is caused by the increase in the size of the uterus, the increase in the area of the endometrium of the uterine cavity and the contraction of the uterine muscle fibers caused by intermyometrial lesions. In severe cases, it can lead to anemia. 2. Dysmenorrhea: The incidence is 15%-30%, characterized by secondary progressive aggravation of dysmenorrhea, that is, one time more painful than another. It often starts to appear a week before the menstrual period and is relieved when the period ends. It can occur before, during and after menstruation. Some menstrual cramps are so severe that they require bed rest or medication to relieve the pain, and even seriously affect life. The pain often worsens with the menstrual cycle. With the prolongation of the disease, it can be complicated by increased menstruation and enlarged uterus, and the dysmenorrhea can get worse with the aggravation of the disease, but there are also cases where the dysmenorrhea and the enlarged lesion are not proportional. Infertility: Severe adenomyosis, especially in patients with endometriosis, can easily cause infertility. These patients have thickened uterus and often combined with pelvic adhesions, which is not conducive to ovulation and embryo implantation, the natural pregnancy rate is significantly reduced. However, once pregnancy occurs, the ectopic endometrium is suppressed and shrinks, and the treatment effect can be achieved.