The Endometrium in Adenomyosis
Previous adenomyosis endometrium research has reported differences compared to controls but suffers from methodological weaknesses, cautioning against interpretation.
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This paper reviews evidence that the endometrium in adenomyosis differs from control endometrium, building on longstanding observations of continuity between eutopic and ectopic endometrial glands and on reports of increased invasiveness. It also highlights reported differences between eutopic endometrium in adenomyosis versus endometriosis, drawing attention to a range of molecular and structural findings reported in the literature. The authors emphasize a major caveat: many studies have methodological weaknesses, particularly inadequate control for cycle phase and symptom status, which limits how confidently results can be interpreted for adenomyosis pathophysiology. This paper is centrally about adenomyosis — it focuses specifically on how the endometrium (eutopic and ectopic/within junctional zone contexts) is altered in adenomyosis and how prior evidence should be interpreted.
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