UPDATE ON CLINICAL DIAGNOSIS AND MANAGEMENT OF ADENOMYOSIS

To support this idea, there is no consensus on management or guideline for this particular disease in Romania. Because of the particularities of diagnosis and treatment of endometriosis, a lot of patients are diagnosed with a delay of as much as 10 years since the beginning of the symptoms14. MAIN TEXT Adenomyosis often coexists with other uterine pathologies like leiomyoma and, especially, deep and superficial peritoneal and ovarian endometriosis. Because of the frequent coexistence with endometriosis, we must always look for peritoneal endometriosis lesions in patients with adenomyosis and vice-versa. For women with mild to severe symptoms and who have future plans for pregnancy, one can either choose no treatment with observation of progression every 6 months, or hormonal treatment - starting with oral combined contraceptives, progestin only pills or a levonorgestrel intrauterine device. Symptoms may vary in intensity and can be heavy menstrual bleeding, dysmenorrhea, chronic pelvic pain, dyspareunia, bloating - all of which can determine a low quality of life, depression, anxiety and infertility.