{"paper_id":"62ed15df-9882-497b-8e88-73adbe6a8263","body_text":"Abstract\nThe complex pathogenesis and different manifestations of adenomyosis make it a difficult cause of abnormal uterine bleeding to be diagnosed and treated. Adenomyosis can be divided generally into three types: intrinsic, extrinsic, and intermediate. Different types have different clinical presentations. In terms of intrinsic type, the cause of abnormal uterine bleeding is more obvious, and dysmenorrhea may not occur at the same time. It is because the abnormal uterine bleeding may be closely related to abnormal angiogenesis or other factors. The uterine bleeding is characterized by heavy menstrual flow and irregular bleeding, which is often encountered even during drug treatment, such as placing levonorgestrel-releasing intrauterine system (LNG-IUS) or GnRHa injection or taking dienogest. MRI can guide the detailed classification of adenomyosis with refractory bleeding and the treatment options.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nDeneris A. PALM-COEIN nomenclature for abnormal uterine bleeding. J Midwifery Womens Health. 2016;61(3):376–9.\nCheng AS, Deng S. New advances in uterine adenomyosis from pathogenesis to drug selection. Chinese J Obstet Gynecol. 2019;54(6):421–24.\nCunningham RK, et al. Adenomyosis: a sonographic diagnosis. Radiographics. 2018;38(5):1576–89.\nReinhold C, et al. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology. 1996;199(1):151–8.\nPontis A, et al. Adenomyosis: a systematic review of medical treatment. Gynecol Endocrinol. 2016;32(9):696–700.\nMarnach ML, Laughlin-Tommaso SK. Evaluation and management of abnormal uterine bleeding. Mayo Clinic Proc. 2019. Elsevier;94(2):326–35.\nShaaban OM, et al. Levonorgestrel-releasing intrauterine system versus a low-dose combined oral contraceptive for treatment of adenomyotic uteri: a randomized clinical trial. Contraception. 2015;92(4):301–7.\nLi L, et al. A prospective cohort study on effects of levonorgestrel-releasing intrauterine system for adenomyosis with severe dysmenorrhea. Zhonghua Fu Chan Ke Za Zhi. 2016;51(5):345–51.\nAndersson K, Odlind V, Rybo G. Levonorgestrel-releasing and copper-releasing (Nova T) IUDs during five years of use: a randomized comparative trial. Contraception. 1994;49(1):56–72.\nBackman T, et al. Advance information improves user satisfaction with the levonorgestrel intrauterine system. Obstet Gynecol. 2002;99(4):608–13.\nAgostinho L, et al. MRI for adenomyosis: a pictorial review. Insights Imaging. 2017;8(6):549–56.\nKishi Y, et al. Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification. Am J Obstet Gynecol. 2012;207(2):114.e1–7.\nBazot M, Daraï E. Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis. Fertil Steril. 2018;109(3):389–97.\nLazzeri L, et al. A sonographic classification of adenomyosis: interobserver reproducibility in the evaluation of type and degree of the myometrial involvement. Fertil Steril. 2018;110(6):1154–1161.e3.\nSun Y, et al. Prevalence of abnormal uterine bleeding according to new International Federation of Gynecology and Obstetrics classification in Chinese women of reproductive age: a cross-sectional study. Medicine. 2018;97(31):e11457.\nShazly SA, et al. Intraoperative predictors of long-term outcomes after radiofrequency endometrial ablation. J Minim Invasive Gynecol. 2016;23(4):582–9.\nPhilip C-A, et al. Evaluation of NovaSure® global endometrial ablation in symptomatic adenomyosis: a longitudinal study with a 36 month follow-up. Eur J Obstet Gynecol Reprodu Biol. 2018;227:46–51.\nTaran F, Stewart EA, Brucker S. Adenomyosis: epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy. Geburtshilfe Frauenheilkd. 2013;73(09):924–31.\nCheung VY. Current status of high-intensity focused ultrasound for the management of uterine adenomyosis. Ultrasonography. 2017;36(2):95.\nBenetti-Pinto CL, et al. Pharmacological treatment for symptomatic Adenomyosis: a systematic review. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics. 2019;41(09):564–74.\nOsuga Y, Fujimoto-Okabe H, Hagino A. Evaluation of the efficacy and safety of dienogest in the treatment of painful symptoms in patients with adenomyosis: a randomized, double-blind, multicenter, placebo-controlled study. Fertil Steril. 2017;108(4):673–8.\nOsuga Y, Watanabe M, Hagino A. Long-term use of dienogest in the treatment of painful symptoms in adenomyosis. J Obstet Gynaecol Res. 2017;43(9):1441–8.\nNeriishi K, et al. Long-term dienogest administration in patients with symptomatic adenomyosis. J Obstet Gynaecol Res. 2018;44(8):1439–44.\nMatsushima T, et al. Recurrence of uterine adenomyosis after administration of gonadotropin-releasing hormone agonist and the efficacy of dienogest. Gynecol Endocrinol. 2019;22:1–4.\nOta K, et al. Combination of microwave endometrial ablation and postoperative dienogest administration is effective for treating symptomatic adenomyosis. J Obstet Gynaecol Res. 2018;44(9):1787–92.\nAuthor information\nAuthors and Affiliations\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.\nAbout this chapter\nCite this chapter\nDeng, S., Leng, J. (2021). Adenomyosis and Abnormal Uterine Bleeding. In: Xue, M., Leng, J., Wong, F. (eds) Adenomyosis. Springer, Singapore. https://doi.org/10.1007/978-981-33-4095-4_6\nDownload citation\nDOI: https://doi.org/10.1007/978-981-33-4095-4_6\nPublished:\nPublisher Name: Springer, Singapore\nPrint ISBN: 978-981-33-4094-7\nOnline ISBN: 978-981-33-4095-4\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}