Influential Factors on the Incidence of Dysmonorrhea Caused by Uterine Adenomyosis

Objective To analyze the associated factors of dysmonorrhea caused by uterine adenomyosis.Methods The pathological and clinical materials of 133 patients with adenomyosis confirmed by pathological analysis admitted from January 2004 to June 2010 were retrospectively analyzed.Results One hundred and three cases(77.4%) had dysmonorrhea.① 39 cases(29.3%) has above 80% adenoma infiltration into the uterine muscle,among whom 37 had severe dysmonorrhea and 2 had moderate dysmonorrhea.94 cases(70.7%) has less than 80% adenoma infiltration,among whom 4 had severe dysmonorrhea,24 had moderate dysmonorrhea and 36 had mild dysmonorrhea.②47 cases with bleeding in the infiltrated endometrium and 56 of 86 cases without bleeding had dysmonorrhea(χ2=21.171,P=0.000).③ 35 of 51 cases with small endometriosial islands fewer than 3,31 of 41 cases with 3-5 islands and 37 of 41 cases with more than 5 islands had dysmonorrhea(χ2=6.194,P=0.045).④The average blood estrogen was 722.5 pmol/L,and 952.7 pmol/L,673.8 pmol/L,541.1 pmol/L in the patients with severe,moderate and mild dysmonorrhea respectively(F=6.984,P=0.001).The average progestion level was 18.1 μg/L,and 21.8 μg/L,17.6 μg/L,14.8 μg/L in the patients with severe,moderate and mild dysmonorrhea respectively(F=2.929,P=0.058).⑤32,22,28 patients with uterus bigger than 6 weeks′ pregnance had severe,modereate and mild dysmonorrhea respectively(χ2=0.537,P=0.764).Conclusion Dysmonorrhea is positively related with the depth of adenoma infiltration,the bleeding of the infiltrated adenoma,the number of endometriosial islands and the level of peripheral blood estrogen,while irrelevant with the uterus volume and the level of peripheral blood progestion.