ORIGINAL ARTICLE Gynaecology Is adenomyosis associated with menorrhagia?

study question: Is the presence of adenomyosis associated with menorrhagia? summaryanswer: Therewas no significant association between adenomyosis andmenorrhagia, but therewas a significant positive correl-ation between the severity of adenomyosis on ultrasound and the amount of menstrual loss estimated using pictorial blood loss assessment charts. what is knownalready: There isnoconsensus in the literaturewith regards to theassociationbetweenadenomyosis andmenorrhagia. Previous studies have been limited to retrospective studies of highly selected populations which mainly included women who underwent hysterec-tomy. There are no large prospective studies evaluating the association between adenomyosis andmenorrhagia, either in the general population of women or in a general gynaecology clinic setting. study design, size, duration: This was a prospective observational study set in the general gynaecology clinic of a university teaching hospital between January 2009 and January 2010. participants/materials, setting, methods: There were 714 consecutive premenopausal women who attended the clinic and underwent structured clinical and transvaginal ultrasound examination in accordancewith the study protocol. Morphological features of adeno-myosis were systematically recorded on ultrasound scan. Menorrhagia was determined subjectively by direct questioning and objectively by com-pletion of pictorial blood loss analysis charts. mainresults andthe roleof chance: Adiagnosisofadenomyosiswasmade in157/714women[22.0%(95%CI: 19.1–25.2%)]. Multivariable analysis showed significant associations between submucous fibroids [OR 5.60 (95 % CI: 2.69–11.6)], any fibroids [OR 1.53 (95 % CI: