The pathophysiology of uterine adenomyosis: an update

Giuseppe Benagiano; Marwan Habiba; Ivo Brosens

doi:10.1016/j.fertnstert.2012.06.044

The pathophysiology of uterine adenomyosis: an update

Giuseppe Benagiano, Marwan Habiba, Ivo Brosens

Fertility and sterility · 2012 · vol. 98(3) , pp. 572–579 · doi:10.1016/j.fertnstert.2012.06.044 · PMID:22819188 · W1969979700

review OA: closed CC0 ⤵ 135 in-corpus citations

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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review provides an updated overview of the current understanding of uterine adenomyosis pathophysiology, covering key aspects of its development and progression.

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Condition tags

mesh:D004715adenomyosis

MeSH descriptors

Endometriosis Uterine Diseases Animals Endometriosis Endometriosis Endometriosis Endometriosis Female Humans Neovascularization, Physiologic Uterine Diseases Uterine Diseases Uterine Diseases Uterine Diseases

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References (100)

Adenomyosis and ‘endometrial– subendometrial myometrium unit disruption disease’ are two different entities via openalex
Adenomyosis and junctional zone changes in patients with endometriosis via openalex
Adenomyosis and leiomyoma: differential diagnosis with MR imaging. via openalex
Adenomyosis and risk of preterm delivery via openalex
Adenomyosis as a disorder of the early and late human reproductive period via openalex
Adenomyosis: epidemiological factors via openalex
Adenomyosis: Evidence for genetic cause via openalex
Adenomyosis in endometriosis – prevalence and impact on fertility. Evidence from magnetic resonance imaging via openalex
Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging via openalex
Adenomyosis: the pathophysiology of an oestrogen-dependent disease via openalex
Adenomyosis uteri via openalex
Adenomyosis With Sparse Glands:<i>A Potential Mimic of Low-Grade Endometrial Stromal Sarcoma</i> via openalex
A murine model of adenomyosis: the effects of hyperprolactinemia induced by fluoxetine hydrochloride, a selective serotonin reuptake inhibitor, on adenomyosis induction in Wistar albino rats. via openalex
Animal model of uterine adenomyosis: Is prolactin a potent inducer of adenomyosis in mice? via openalex
An update on adenomyosis in the adolescent via openalex
Association between genetic polymorphisms in fibroblast growth factor (FGF)1 and FGF2 and risk of endometriosis and adenomyosis in Chinese women via openalex
Cell proliferation effect of GnRH agonist on pathological lesions of women with endometriosis, adenomyosis and uterine myoma via openalex
Clinical usefulness of determination of estradiol level in the menstrual blood for patients with endometriosis. via openalex
Comparison of the effect of oestradiol, tamoxifen and raloxifene on nerve growth factor-alpha expression in specific neonatal mouse uterine cell types using laser capture microdissection via openalex
Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis via openalex
Differential regulation of the neurotrophins, NGF and BDNF, and their receptors in the myometrium of women affected by adenomyosis via openalex
Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. via openalex
Duration of dysmenorrhoea and extent of adenomyosis visualised by magnetic resonance imaging via openalex
Effects of prenatal exposure of mice to “low-dose” diethylstilbestrol and the development of adenomyosis associated with evidence of hyperprolactinemia via openalex
Endometrial-Myometrial Interface: Relationship to Adenomyosis and Changes in Pregnancy via openalex
Endometrial Tissue in Myometrial Vessels not Associated with Menstruation via openalex
Endometriosis: a dysfunction and disease of the archimetra via openalex
Endometriosis, assisted reproduction technology, and risk of adverse pregnancy outcome via openalex
Endometriosis: the pathophysiology as an estrogen-dependent disease via openalex
Enhanced invasion of stromal cells from adenomyosis in a three-dimensional coculture model is augmented by the presence of myocytes from affected uteri via openalex
Estrogen and progesterone receptor isoform distribution through the menstrual cycle in uteri with and without adenomyosis via openalex
Estrogen biosynthesis in human uterine adenomyosis via openalex
Experimental adenomyosis via openalex
Expression of Aromatase Cytochrome P450 Protein and Messenger Ribonucleic Acid in Human Endometriotic and Adenomyotic Tissues but not in Normal Endometrium1 via openalex
Gray scale ultrasonography in the diagnosis of endometriosis and adenomyosis via openalex
History of adenomyosis via openalex
Imaging features of adenomyosis via openalex
Immunohistologic localization of estrone sulfatase in uterine endometrium and adenomyosis via openalex
Increased matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-1 secretion but unaffected invasiveness of endometrial stromal cells in adenomyosis via openalex
Increased microvessel density in adenomyosis uteri via openalex
Is adenomyosis an immune disease? via openalex
Is adenomyosis the neglected phenotype of an endomyometrial dysfunction syndrome? via openalex
Laparoscopy-guided myometrial biopsy in the definite diagnosis of diffuse adenomyosis via openalex
Luteal phase transvaginal scan examinations have better diagnostic potential for showing focal subendometrial adenomyosis via openalex
Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis via openalex
Matrix Metalloproteinase-2 and -9 Expression Correlated with Angiogenesis in Human Adenomyosis via openalex
MRI Characteristics of the Uterine Junctional Zone: From Normal to the Diagnosis of Adenomyosis via openalex
Neonatal administration of tamoxifen causes disruption of myometrial development but not adenomyosis in the C57/BL6J mouse via openalex
Neonatal tamoxifen treatment of mice leads to adenomyosis but not uterine cancer via openalex
Nonmalignant epithelial cells, potentially invasive in human endometriosis, lack the tumor suppressor molecule E-cadherin. via openalex
Pathogenetic role of the stromal cells in endometriosis and adenomyosis via openalex
Pathophysiology of adenomyosis via openalex
Patients with adenomyosis are more likely to have deep endometriosis via openalex
Phenotypic Characterisation of the Inner and Outer Myometrium in Normal and Adenomyotic Uteri via openalex
Polymorphisms in the matrix metalloproteinase‐2 and tissue inhibitor of metalloproteinase‐2 and the risk of human adenomyosis via openalex
Preterm birth, ovarian endometriomata, and assisted reproduction technologies via openalex
Prevalence and risk factors for obstetric haemorrhage in 6730 singleton births after assisted reproductive technology in Victoria Australia via openalex
Prevalence and risk factors of adenomyosis at hysterectomy via openalex
Smooth muscle differentiation at endometrio-myometrial junction via openalex
Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging via openalex
The elusive adenomyosis of the uterus—revisited via openalex
The endometrial–myometrial junction: a fresh look at a busy crossing via openalex
The Endometrium in Adenomyosis via openalex
The pathophysiology of endometriosis and adenomyosis: tissue injury and repair via openalex
The potential value of magnetic resonance imaging in infertility via openalex
The symptomatology of adenomyosis via openalex
The utility of MRI for the surgical treatment of women with uterine fibroid tumors via openalex
Transvaginal Sonographic Criteria for the Diagnosis of Adenomyosis Based on Histopathologic Correlation via openalex
Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis via openalex
Transvaginal ultrasound guided biopsies in the diagnosis of pelvic lesions via openalex
Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology via openalex
Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy via openalex
Uterine adenomyosis: a need for uniform terminology and consensus classification via openalex
Uterine adenomyosis in the infertility clinic via openalex
Uterine Peristaltic Activity and the Development of Endometriosis via openalex
Vascular endothelial growth factor gene polymorphisms are associated with the risk of developing adenomyosis via openalex
W2072770901 via openalex
W2071601292 via openalex
W2056479931 via openalex
W2047454105 via openalex
W2035633938 via openalex
W2034864360 via openalex
W2033945601 via openalex
W2025501503 via openalex
W86461427 via openalex
W2157162135 via openalex
W2014463766 via openalex
W2009307286 via openalex
W2007963957 via openalex
W2006356335 via openalex
W1992297132 via openalex
W1982489497 via openalex
W2166798905 via openalex
W2166826551 via openalex
W2167375387 via openalex
W1976506071 via openalex
W1969978086 via openalex
W1966488185 via openalex
W1965039757 via openalex
W2394566517 via openalex

Cited by (50)

Source provenance

europepmc: last seen: 2026-06-04T01:30:01.192114+00:00
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pubmed: last seen: 2026-05-13T22:16:04.919516+00:00

License: CC0 · commercial use OK

[1] Adenomyosis and ‘endometrial– subendometrial myometrium unit disruption disease’ are two different entities via openalex

[2] Adenomyosis and junctional zone changes in patients with endometriosis via openalex

[3] Adenomyosis and leiomyoma: differential diagnosis with MR imaging. via openalex

[4] Adenomyosis and risk of preterm delivery via openalex

[5] Adenomyosis as a disorder of the early and late human reproductive period via openalex

[6] Adenomyosis: epidemiological factors via openalex

[7] Adenomyosis: Evidence for genetic cause via openalex

[8] Adenomyosis in endometriosis – prevalence and impact on fertility. Evidence from magnetic resonance imaging via openalex

[9] Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging via openalex

[10] Adenomyosis: the pathophysiology of an oestrogen-dependent disease via openalex

[11] Adenomyosis uteri via openalex

[12] Adenomyosis With Sparse Glands:<i>A Potential Mimic of Low-Grade Endometrial Stromal Sarcoma</i> via openalex

[13] A murine model of adenomyosis: the effects of hyperprolactinemia induced by fluoxetine hydrochloride, a selective serotonin reuptake inhibitor, on adenomyosis induction in Wistar albino rats. via openalex

[14] Animal model of uterine adenomyosis: Is prolactin a potent inducer of adenomyosis in mice? via openalex

[15] An update on adenomyosis in the adolescent via openalex

[16] Association between genetic polymorphisms in fibroblast growth factor (FGF)1 and FGF2 and risk of endometriosis and adenomyosis in Chinese women via openalex

[17] Cell proliferation effect of GnRH agonist on pathological lesions of women with endometriosis, adenomyosis and uterine myoma via openalex

[18] Clinical usefulness of determination of estradiol level in the menstrual blood for patients with endometriosis. via openalex

[19] Comparison of the effect of oestradiol, tamoxifen and raloxifene on nerve growth factor-alpha expression in specific neonatal mouse uterine cell types using laser capture microdissection via openalex

[20] Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis via openalex

[21] Differential regulation of the neurotrophins, NGF and BDNF, and their receptors in the myometrium of women affected by adenomyosis via openalex

[22] Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. via openalex

[23] Duration of dysmenorrhoea and extent of adenomyosis visualised by magnetic resonance imaging via openalex

[24] Effects of prenatal exposure of mice to “low-dose” diethylstilbestrol and the development of adenomyosis associated with evidence of hyperprolactinemia via openalex

[25] Endometrial-Myometrial Interface: Relationship to Adenomyosis and Changes in Pregnancy via openalex

[26] Endometrial Tissue in Myometrial Vessels not Associated with Menstruation via openalex

[27] Endometriosis: a dysfunction and disease of the archimetra via openalex

[28] Endometriosis, assisted reproduction technology, and risk of adverse pregnancy outcome via openalex

[29] Endometriosis: the pathophysiology as an estrogen-dependent disease via openalex

[30] Enhanced invasion of stromal cells from adenomyosis in a three-dimensional coculture model is augmented by the presence of myocytes from affected uteri via openalex

[31] Estrogen and progesterone receptor isoform distribution through the menstrual cycle in uteri with and without adenomyosis via openalex

[32] Estrogen biosynthesis in human uterine adenomyosis via openalex

[33] Experimental adenomyosis via openalex

[34] Expression of Aromatase Cytochrome P450 Protein and Messenger Ribonucleic Acid in Human Endometriotic and Adenomyotic Tissues but not in Normal Endometrium1 via openalex

[35] Gray scale ultrasonography in the diagnosis of endometriosis and adenomyosis via openalex

[36] History of adenomyosis via openalex

[37] Imaging features of adenomyosis via openalex

[38] Immunohistologic localization of estrone sulfatase in uterine endometrium and adenomyosis via openalex

[39] Increased matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-1 secretion but unaffected invasiveness of endometrial stromal cells in adenomyosis via openalex

[40] Increased microvessel density in adenomyosis uteri via openalex

[41] Is adenomyosis an immune disease? via openalex

[42] Is adenomyosis the neglected phenotype of an endomyometrial dysfunction syndrome? via openalex

[43] Laparoscopy-guided myometrial biopsy in the definite diagnosis of diffuse adenomyosis via openalex

[44] Luteal phase transvaginal scan examinations have better diagnostic potential for showing focal subendometrial adenomyosis via openalex

[45] Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis via openalex

[46] Matrix Metalloproteinase-2 and -9 Expression Correlated with Angiogenesis in Human Adenomyosis via openalex

[47] MRI Characteristics of the Uterine Junctional Zone: From Normal to the Diagnosis of Adenomyosis via openalex

[48] Neonatal administration of tamoxifen causes disruption of myometrial development but not adenomyosis in the C57/BL6J mouse via openalex

[49] Neonatal tamoxifen treatment of mice leads to adenomyosis but not uterine cancer via openalex

[50] Nonmalignant epithelial cells, potentially invasive in human endometriosis, lack the tumor suppressor molecule E-cadherin. via openalex

[51] Pathogenetic role of the stromal cells in endometriosis and adenomyosis via openalex

[52] Pathophysiology of adenomyosis via openalex

[53] Patients with adenomyosis are more likely to have deep endometriosis via openalex

[54] Phenotypic Characterisation of the Inner and Outer Myometrium in Normal and Adenomyotic Uteri via openalex

[55] Polymorphisms in the matrix metalloproteinase‐2 and tissue inhibitor of metalloproteinase‐2 and the risk of human adenomyosis via openalex

[56] Preterm birth, ovarian endometriomata, and assisted reproduction technologies via openalex

[57] Prevalence and risk factors for obstetric haemorrhage in 6730 singleton births after assisted reproductive technology in Victoria Australia via openalex

[58] Prevalence and risk factors of adenomyosis at hysterectomy via openalex

[59] Smooth muscle differentiation at endometrio-myometrial junction via openalex

[60] Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging via openalex

[61] The elusive adenomyosis of the uterus—revisited via openalex

[62] The endometrial–myometrial junction: a fresh look at a busy crossing via openalex

[63] The Endometrium in Adenomyosis via openalex

[64] The pathophysiology of endometriosis and adenomyosis: tissue injury and repair via openalex

[65] The potential value of magnetic resonance imaging in infertility via openalex

[66] The symptomatology of adenomyosis via openalex

[67] The utility of MRI for the surgical treatment of women with uterine fibroid tumors via openalex

[68] Transvaginal Sonographic Criteria for the Diagnosis of Adenomyosis Based on Histopathologic Correlation via openalex

[69] Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis via openalex

[70] Transvaginal ultrasound guided biopsies in the diagnosis of pelvic lesions via openalex

[71] Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology via openalex

[72] Ultrasound scan and magnetic resonance imaging for the diagnosis of adenomyosis: systematic review comparing test accuracy via openalex

[73] Uterine adenomyosis: a need for uniform terminology and consensus classification via openalex

[74] Uterine adenomyosis in the infertility clinic via openalex

[75] Uterine Peristaltic Activity and the Development of Endometriosis via openalex

[76] Vascular endothelial growth factor gene polymorphisms are associated with the risk of developing adenomyosis via openalex

[77] W2072770901 via openalex

[78] W2071601292 via openalex

[79] W2056479931 via openalex

[80] W2047454105 via openalex

[81] W2035633938 via openalex

[82] W2034864360 via openalex

[83] W2033945601 via openalex

[84] W2025501503 via openalex

[85] W86461427 via openalex

[86] W2157162135 via openalex

[87] W2014463766 via openalex

[88] W2009307286 via openalex

[89] W2007963957 via openalex

[90] W2006356335 via openalex

[91] W1992297132 via openalex

[92] W1982489497 via openalex

[93] W2166798905 via openalex

[94] W2166826551 via openalex

[95] W2167375387 via openalex

[96] W1976506071 via openalex

[97] W1969978086 via openalex

[98] W1966488185 via openalex

[99] W1965039757 via openalex

[100] W2394566517 via openalex