ABSTRACT
This chapter examines the clinical features that may suggest a diagnosis of adenomyosis and the medical and surgical approaches to management. Adenomyosis is implicated as a cause of both heavy and painful menstruation, but because the diagnosis is most often made retrospectively and based on histological appearance, most published data relate to women who have undergone hysterectomy. The adenomyotic tissue is presumed to be derived from the endometrium by abnormal ingrowth and invagination of its basal layer triggered by a weakness at the endometrial-myometrial junction. Most women with menstrual disorders are managed symptomatically in the first instance and therapies which are effective in the management of heavy menstrual bleeding, dysmenorrhoea and endometriosis should be beneficial for women with adenomyosis. Hysterectomy is effective for relief of menstrual symptoms associated with adenomyosis in women who have completed child-bearing.
