Adenomyosis: Why we need to reassess our understanding of this condition

CASE Painful, heavy menstruation and recurrent pregnancy loss A 37-year-old woman (G3P0030) with a history of recurrent pregnancy loss presents for evaluation. She had 3 losses-most recently a miscarriage at 22 weeks with a cerclage in place. She did not undergo any surgical procedures for these losses. Hormonal and thrombophilia workup is negative and semen analysis is normal. She reports a history of painful, heavy periods for many years, as well as dyspareunia and occasional post-coital bleeding. Past medical history was otherwise unremarkable. Pelvic magnetic resonance imaging (MRI) revealed focal thickening of the junctional zone up to 15 mm with 2 foci of T2 hyperintensities suggesting adenomyosis (FIGURE 1, page 36).