Pathology and physiopathology of adenomyosis
Abstract
Adenomyosis is defined by the presence of endometrial mucosa within the myometrium. This probably occurs by invagination of the basalis endometrium into the myometrium. The process of invagination and intramyometrial spreading may be facilitated by the non-cyclic, anti-apoptotic activity of the basalis associated with relative hyper-oestrogenic states. Most cases of adenomyosis are discovered in multiparous women during the 'transitional' years (40-50 years), and the condition is associated with menorrhagia, dysmenorrhoea, endometrial polyps and leiomyomata uteri. Endometrioid adenocarcinoma is often associated with adenomyosis, is frequently of early stage and low histological grade, is hormone-sensitive, and has an excellent prognosis. Extension of malignant growth into foci of adenomyosis has no adverse effect on prognosis. Definite diagnosis and treatment of adenomyosis are obtained by hysterectomy. Although adenomyotic endometrial glands are hormone-sensitive, exogenous progestogenic agents are ineffective for the treatment of adenomyosis. Anti-oestrogenic danazol and gonadotrophin-releasing hormone (GnRH) analogues induce suppression of adenomyosis, but their use must be of short duration. Surgical extirpation, therefore, is the best therapeutic option.
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Adenomyosis is a common gynecologic disorder with poorly understood pathogenesis and pathophysiology.
“Adenomyosis, defined as the presence of endometrial glands and stroma infiltrated deep and haphazardly into the myometrium [1], is a common gynecologic disorder with poorly understood pathogenesis and pathophysiology [2,3,4].”
From The Pathogenesis of Adenomyosis vis-à-vis Endometriosis (2020) · cites this paper as [2]
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- Authors
- Bergeron, C., Amant, F., & Ferenczy, A.
- Affiliations
- Processus d'Activation Sélective par Transfert d'Énergie Uni-électronique ou Radiatif (FR)
- Jewish General Hospital (CA)
- Corresponding author
- Bergeron, Christine
- ORCID
- Bergeron, Christine
- Venue
- Best Practice & Research Clinical Obstetrics & Gynaecology
- Publisher
- Elsevier BV
- Published
- 2006-08
- Volume
- 20
- Issue
- 4
- Pages
- 511-521
- ISSN
- 1521-6934 (ISSN-L)
- OpenAlex
- W2038354928
- Cited by
- 359
- References
- 54
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 19 · 2023: 33 · 2022: 25 · 2021: 36 · 2020: 35 · 2019: 26 · 2018: 19 · 2017: 20 · 2016: 19 · 2015: 27 · 2014: 18 · 2013: 10 · 2012: 11
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Best Practice & Research Clinical Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- adenomyosis, anti-apoptotic effects, hyperoestrogenism, menorrhagia, dysmenorrhea, endometrial polyps, uterine fibroids, endometrioid carcinoma, hysterectomy, danazol, GnRH analogues, progestogens, surgical treatment
- MeSH terms
- Adult, Danazol, Endometrial Hyperplasia, Endometriosis, Estrogen Antagonists, Female, Humans, Hysterectomy, Leiomyoma, Gonadotropin-Releasing Hormone, Middle Aged, Polyps, Uterine Diseases, Uterine Neoplasms, Endometrial Neoplasms, Carcinoma, Endometrioid
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