Ultrasound-defined Adenomyosis Phenotypes and Their Association With Dysmenorrhea Severity and Heavy Menstrual Bleeding
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Adenomyosis is a common benign uterine disorder associated with dysmenorrhea and heavy menstrual bleeding (HMB). Ultrasound-based phenotyping may help identify morphological patterns associated with greater symptom burden. Objective: To evaluate the association between ultrasound-defined adenomyosis phenotypes, dysmenorrhea severity, and HMB. Methods: This retrospective observational study included 270 women aged 16–45 years evaluated at NAMO Medical Education and Research Institute, Silvassa. Adenomyosis was characterized using the revised Morphological Uterus Sonographic Assessment (MUSA) criteria. Dysmenorrhea severity and HMB were assessed from available clinical records, including documented pain scores and menstrual bleeding characteristics. Results: In the illustrative dataset, dysmenorrhea was present in 72.6% and HMB in 55.9% of patients. Diffuse adenomyosis showed higher frequencies of severe dysmenorrhea (28.9% vs. 14.4%) and HMB (62.7% vs. 45.2%) compared with focal disease. Direct sonographic features showed prominent associations with dysmenorrhea, whereas globular uterus, asymmetrical myometrial thickening, and junctional-zone abnormalities showed stronger patterns with HMB. Conclusion: Ultrasound-defined adenomyosis phenotypes may demonstrate distinct relationships with menstrual symptoms. Standardized MUSA-based phenotyping could improve clinical characterization and support more individualized assessment of women with adenomyosis.
Institution: NAMO Medical Education & Research Institute
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7220709103