Adenomyosis: New Guidance for the Overlooked Uterine Condition

A physician at the University of Hawaiʻi at Mānoa is leading an effort to improve the diagnosis and treatment of adenomyosis, a gynecologic condition that affects approximately one in three women but frequently remains underdiagnosed.

Kimberly Kho, who holds the first professorship in advanced gynecological surgery in the United States at the John A. Burns School of Medicine (JABSOM), has authored a clinical expert series review on the condition in the journal Obstetrics & Gynecology.

The publication is designed to synthesize existing medical literature into practical clinical guidance that physicians can apply immediately in their medical practices.

Understanding Adenomyosis

Adenomyosis occurs when tissue similar to the lining of the uterus grows into the uterine muscle wall. This biological process can lead to several severe health challenges for women, including chronic pelvic pain, fertility issues and severe menstrual bleeding.

Despite the prevalence of the condition, Kho notes that it is often overlooked and misunderstood within the medical community.

It’s astonishing how common it is. But if you look at the research funding for adenomyosis, which then correlates to our scientific understanding of the disease and specific therapies, it’s just a drop in the proverbial bucket compared to how much and how many this disease impacts.

Kimberly Kho

Evolution of Diagnostic Approaches

Historically, confirmation of adenomyosis often relied on a hysterectomy. However, Kho’s review highlights a significant paradigm shift toward noninvasive diagnostic methods.

The move toward modern imaging tools allows for diagnosis without the need for surgical intervention. These tools include:

• Ultrasound imaging
• Magnetic Resonance Imaging (MRI)

According to Kho, the evolution of these technologies has allowed the medical community to change how the disease is identified and managed.

Clinical Impact and Guidance

The review published in Obstetrics & Gynecology serves as a roadmap for OB-GYN physicians. It covers the mechanisms of the disease, advances in diagnosis, and contemporary treatment options.

By providing a structured synthesis of the available research, the guidance aims to bridge the gap between scientific literature and the actual care provided to patients in a clinical setting.

The effort is part of a broader need to address the under-researched nature of the condition, which has historically received significantly less funding and attention than its impact on the female population would suggest.