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May 18, 2017

Adenomyosis is a condition in which the lining of the uterus appears to grow within the muscle of the uterus (myometrium). The term utilized in the past was “endometriosis interna” due to location of this tissue within the myometrium. The only way to diagnose adenomyosis with absolute certainty would be through pathologic confirmation (where a physician inspects the tissue with a microscope). This condition is very common and usually presents in the mid 30’s but can be present at other times. Symptoms consist of heavy, painful cycles so many women and physicians may overlook it during the treatment of endometriosis. There are certain changes on imaging such as ultrasound in conjunction with a thorough history and exam that allow us to increase our clinical suspicion. We feel confident that we are able to predict its presence. Many timesadenomyosis is diffuse, however, it can also appear similar to a fibroid when it is consolidated in one area. We evaluate women for both endometriosis and adenomyosis because it is extremely important to treat both conditions in women electing to proceed with surgical intervention. Although hysterectomy has been the treatment many have recommended in the past for the management of adenomyosis, it is not an option for women desiring to retain their ability to have children. We have had great success with peritoneal excision of endometriosis and pre sacral neurectomy, a procedure designed to “interrupt” one of the pathways for pain transmission from the uterus. It has allowed many women to proceed with building their family without struggling with pain from month to month. Other medical therapies have included continuous birth control pills or an IUD when not contraindicated; of course, these options are not useful in women while attempting to conceive.

Christopher W. Lipari, M.D.
Reproductive Endocrinology and Infertility
Jacksonville Center for Reproductive Medicine
7051 Southpoint Parkway, Suite 200 Jacksonville, Florida
Phone: (904) 493-2229

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