Clinical characteristics indicating adenomyosis coexisting with leiomyomas: a retrospective, questionnaire-based study

Objective: To elucidate the clinical profile of a concomitant diagnosis of adenomyosis in women with leiomyomas. Design: Retrospective questionnaire-based study. Setting: Academic medical center. Patient(s): The study sample comprised a total of 560 women: 159 women with adenomyosis and leiomyomas and 401 women with leiomyomas alone. Intervention(s): Mailing of a symptom questionnaire. Main Outcome Measure(s): Comparison of women undergoing hysterectomy with adenomyosis and leiomyomas and women with leiomyomas alone. Result(s): Women with a concomitant diagnosis of adenomyosis and leiomyomas had significantly higher scores for disease burden during the menstrual period before surgery: heavy bleeding episodes and passing blood clots. Furthermore, women with adenomyosis and leiomyomas reported higher scores of distress regarding pelvic pain occurring during the menstrual period and pelvic pain not associated with the menstrual cycle. Moreover, in multivariate analysis, older age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.04-1.18), gravidity (OR 1.44, 95% CI 1.12-1.74), and pelvic pain occurring during the menstrual period (OR 1.27, 95% CI 1.06-1.54) increase the odds of having adenomyosis and not only leiomyomas. Conclusion(s): Adenomyosis contributes to symptomatology in women with concomitant adenomyosis and leiomyomas. (Fertil Steril (R) 2014; 101: 237-41. (C) 2014 by American Society for Reproductive Medicine.)