Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about adenomyosis.

And you can find written notes on this topic at zero tofinals.com slash adenomyosis

or in the gynecology section of the Zero definals obstetrics and gynecology book.

So let's get straight into it.

Adinomyosis refers to endometrial tissue inside the myometrium, which is the muscle layer of the uterus.

It's more common in later reproductive years and those that have had several pregnancies,

which we call multi-paris.

It occurs in around 10% of women overall, and it may occur alone or it may occur alongside endometriosis or fibroids.

The cause is not fully understood and multiple factors are involved, including the sex

hormones, trauma and inflammation.

The condition is hormone dependent, meaning that symptoms tend to resolve after menopause

similar to endometriosis and fibroids.

Let's talk about the presentation.

Adinomyosis typically presents with painful periods, which are called dysmenorrhea,

heavy periods, which is called menorrhager, and pain during intercourse, which is called

dysparanunia.

It may also present with infertility or pregnancy-related complications.

Around a third of patients are completely asymptomatic.

Examination can demonstrate an enlarged and tender uterus, and it will feel more soft than a uterus that contains fibroids.

Let's talk about diagnosis. A transvaginal ultrasound of the pelvis is the first line

investigation for suspected adenomyosis. The alternative investigations where a transvaginal ultrasound scan is not suitable

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