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Tests and diagnosis
By Mayo Clinic staffYour doctor may suspect adenomyosis based on:
- Signs and symptoms
- A pelvic exam that reveals an enlarged, tender uterus
- Ultrasound imaging of the uterus
- Magnetic resonance imaging (MRI) of the uterus
In some instances, your doctor may take a biopsy of endometrial tissue — a sample of cells from your uterine lining for testing — to verify that your abnormal uterine bleeding isn't associated with any other serious condition. However, such a biopsy won't help your doctor confirm a diagnosis of adenomyosis. The only way to be certain of adenomyosis is to examine uterine tissue using a microscope after removal of the uterus (hysterectomy).
Many women have other uterine diseases that cause signs and symptoms similar to adenomyosis, making adenomyosis more difficult to diagnose. Such conditions include fibroid tumors (leiomyomas), uterine cells growing outside the uterus (endometriosis) and growths in the uterine lining (endometrial polyps). Your doctor may diagnose adenomyosis only after he or she determines there are no other causes for your signs and symptoms.
- Stewart EA. Uterine adenomyosis. http://www.uptodate.com/index. Accessed April 18, 2012.
- Garcia L, et al. Adenomyosis: A review of the literature. Journal of Minimally Invasive Gynecology. 2011;18:428.
- Schorge JO, et al. Williams Gynecology. New York, N.Y.: The McGraw-Hill Companies; 2008. http://accessmedicine.com/resourceTOC.aspx?resourceID=514. Accessed April 23, 2012.
- Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-06986-1..C2009-0-48752-X--TOP&isbn=978-0-323-06986-1&uniqId=325227117-5. Accessed April 24, 2012.
- Dysmenorrhea. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/home/womens_health_issues/menstrual_disorders_and_abnormal_vaginal_bleeding/dysmenorrhea.html. Accessed April 19, 2012.
- Dysfunctional uterine bleeding. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/home/womens_health_issues/menstrual_disorders_and_abnormal_vaginal_bleeding/dysfunctional_uterine_bleeding.html. Accessed April 23, 2012.
- Meredith SM, et al. Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: Systematic review and metaanalysis. American Journal of Obstetrics & Gynecology. 2009;201:107.e1.
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