Adenomyosis a variant, not a disease? Evidence from hysterectomized menopausal women in the Study of Women's Health Across the Nation (SWAN).
OBJECTIVE
Our study evaluates the symptoms commonly attributed to adenomyosis in women undergoing the menopausal transition. We hypothesized that adenomyosis is more commonly seen in women with fibroids, pelvic pain, abnormal uterine bleeding, and in the presence of endometriosis.


METHODS
Retrospective cohort.


METHODS
Multisite community-based study.


METHODS
Enrollees in the Study of Women's Health Across the Nation who had hysterectomies.


METHODS
None.


METHODS
Relationship of adenomyosis to presenting symptoms and other patient characteristics.


RESULTS
Adenomyosis was found in 48% of 137 patients. Frequencies of presenting symptoms were similar in those with and without evidence of adenomyosis. The same prevalence of fibroids was seen in the presence or absence of adenomyosis: 37% versus 43%, endometriosis, 3% versus 5%, abnormal bleeding, 27% versus 33%, or chronic pelvic pain in the presence of fibroids 12% versus 17%.


CONCLUSIONS
Adenomyosis is a common diagnosis seen in hysterectomized specimens from women undergoing the perimenopausal transition. Adenomyosis is equally common in women who also have fibroids, endometriosis, pelvic pain, or abnormal uterine bleeding, and women who do not. Therefore, adenomyosis is an incidental finding, not the source of the symptomatology. It appears not to be a "disease" per se but rather a normal variant.
Weiss
Gerson
G
Department of Obstetrics, Gynecology, and Women's Health, New Jersey Medical School, Newark, New Jersey 07103, USA. weissge@umdnj.edu
Maseelall
Priya
P
Schott
Laura L
LL
Brockwell
Sarah E
SE
Schocken
Miriam
M
Johnston
Janet M
JM
D004522:Educational Status; D004715:Endometriosis / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D014644:Genetic Variation; D006801:Humans; D007044:Hysterectomy; D007258:Informed Consent; D008499:Medical Records; D009215:Myometrium / Q000473:pathology / Q000503:physiopathology; D047648:Perimenopause; D015995:Prevalence; D044469:Racial Groups