Fibroids, Adenomyosis, and Chronic Pelvic Pain

Adenomyosis and fibroids are two uterine pathologies that have long been clinically associated with chronic pain in reproductive-aged women. However, data confirming a cause and effect relationship are sparse. Adenomyosis is a poorly defined and poorly investigated disorder. It is difficult to diagnose, and in most cases is not clearly pathologic; where the line is drawn between physiologic findings and a pathologic disorder is unknown. The scientific validity for specifically treating adenomyosis in the presence of pelvic pain is minimal. Uterine fibroids are common gynecologic findings but are unlikely to represent a source of chronic pelvic pain. Pressure symptoms and other repercussions from an enlarged uterus are more likely to be seen, and occasionally dyspareunia may be reported. Numerous treatments are available, but data regarding the successful treatment of chronic pelvic pain are nonexistent.