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Turkey Medicals member and hospital head of department Obstetrics and Gynecology Professor Doctor explained the differences between endometriosis and adenomyosis diseases and what is curious about adenomyosis.

Adenomyosis and endometriosis diseases are tissue disorders that line the inside of uterus (endometrium). But they develop differently and have some different symptoms.

In adenomyosis, cells similar to those found in the inner november of the uterus develop in the muscles of the uterus. These incorrectly located and developing cells can cause thickening of the uterine wall, causing pain and heavy bleeding. although the incidence is higher in women in their 40s, it can also occur at a young age and has recently been associated with infertility in women.

In endometriosis, cells located in the inner tissue of the uterus are located outside the uterus in different organs or regions and multiply. The tissue is usually located in the ovaries, the ligaments that support the uterus, and the pelvic bone (pelvic) cavities. Cells continue to follow the menstrual cycle in the tissues where they are located, they bleed every month. This bleeding can cause pain and affect fertility.

Adenomyosis and endometriosis are quite common. However, the increase in the awareness of these diseases in recent years has led to extensive delays in the diagnosis and treatment of diseases, especially in the previous period.

What are the similarities and differences between the symptoms? Decubitus?

Symptoms of adenomyosis and endometriosis, including pain, dec from mild to severe. But some people with endometriosis have no symptoms at all. About a third of women with adenomyosis show no symptoms at all. Some symptoms may mimic those caused by other conditions, such as ovarian cysts or uterine fibroids.

Symptoms of adenomyosis include:

– Painful periods (dysmenorrhea),

– Painful sexual intercourse (dyspareunia),

– Chronic pelvic pain,

– Abnormal bleeding or prolonged menstrual periods,

– Infertility,

– An enlarged uterus.

Symptoms of endometriosis include:

– Painful periods (dysmenorrhea),

– Painful sexual intercourse (dyspareunia),

– Painful bowel movements,

– Painful urination,

– The pelvis (pelvic) pain,

– Fatigue, nausea and diarrhea (especially during menstruation).

The exact causes of adenomyosis and endometriosis are still unknown

Possible mechanisms and risk factors for the occurrence of adenomyosis and endometriosis are:

– Adenomyosis and endometriosis can be caused by tissue damage and repair after uterine trauma. In this process, the production of the hormone estrogen takes place.

– Stem cells can be activated by damaging endometrial tissue. Then they can grow out of their usual position in adenomyosis and endometriosis.

– Menstrual blood passing through the fallopian tubes can leave endometrial-like tissue in the pelvis or other areas.

– Genetic factors may be involved.

– Immune system problems can cause failure to find and regulate endometrial-like tissue in both adenomyosis and endometriosis.

– Problems with the body’s hormone system and estrogen can turn embryonic cells in your stomach into endometrial cells.

– Your lymph system can carry endometrial-like cells to other areas.

What are the similarities and differences in risk factors?

The higher risk for adenomyosis is associated with:

– People with more than one child,

– Having undergone uterine surgery such as dilatation and abortion,

– Antidepressant use for depression and similar reasons,

– Studies on the relationship of adenomyosis with smoking and ectopic pregnancy have mixed results.

The higher risk for endometriosis is associated with:

– Early onset of menstruation,

– Shorter menstrual cycle (less than the typical 28-day cycle),

– Heavy menstrual bleeding,

– Obstruction of menstrual flow,

– Excessive consumption of alcohol and caffeine,

– Family history of endometriosis (this increases your risk sevenfold),

– Late menopause.

A reduced risk of endometriosis is associated with:

– Normal body mass index (BMI),

– Use of oral contraceptives,

– Regular exercise,

– Omega-3 dietary fatty acids.

How are they diagnosed?

They are physically examined and imaging tests can be performed. A urine test, pregnancy test, Pap test, or vaginal swab may be requested to rule out other possible causes.

Adenomyosis causes the uterus to grow, so a physical examination is performed to find out if the uterus is swollen or sensitive. Sonohysterography can be used in some cases where a more precise image is required.

A medical history and family history are taken to diagnose endometriosis. To feel the cyst or other abnormalities, its pelvic region is examined. Imaging tests, including a sonogram and MRI, are likely to be requested.

Laparoscopic surgery can also be performed to look for endometrial-like tissue outside the uterus. If the diagnosis is not clear, a tissue sample can be taken during surgery to confirm the diagnosis or to be examined under a microscope.

What are the differences and similarities in treatment?

Treatment for both conditions dec from minimal (over-the-counter medications) to more invasive (hysterectomy). This is due to the differences in the location of the misplaced endometrial-like tissue.

Treatment of adenomyosis

If your symptoms of adenomyosis are mild, anti-inflammatory drugs may be recommended immediately before and during your period. Hormones can be used to help control the increased levels of estrogen that contribute to symptoms. These may include oral birth control pills, high-dose progestins, intrauterine devices.

Endometrial ablation, which is an outpatient procedure that uses laser or other ablation techniques to destroy the uterine lining, excisional procedures using laparoscopy can be performed to cut the affected adenomyosis areas of the uterus.

Uterine artery embolization is a minimally invasive procedure which, energy focused ultrasound transmitted to the skin tissue without damaging the surrounding tissue that uses a non-invasive procedure, which is MRI-Guided Focused Ultrasound surgery can be applied. Hysterectomy, complete removal of the uterus, that is, the elimination of adenomyosis, is not suitable for those who want to have children.

Treatment of endometriosis

For mild symptoms, over-the-counter anti-inflammatory drugs may help. There are other options for more severe symptoms; anti-inflammatory drugs can be combined with hormonal treatments, and hormone supplements can help.

The second stage of treatment includes progestins, androgens and GNRH. These drugs have been shown to reduce the pain of non-advanced stage endometriosis.

Hormonal contraceptive treatments can stop your periods and relieve symptoms as long as you take them. When you stop taking it, your periods will return. If you want to get pregnant, there is evidence that taking and stopping hormonal treatments can increase the chances of IVF fertility in Turkey.

Conservative surgery can remove tissues with endometriosis laparoscopically, while keeping your uterus intact. This treatment can alleviate the symptoms, but endometriosis can return. Laparoscopy can also be used in combination with heat, current, or laser treatments to eliminate endometriosis. Hysterectomy (removal of the uterus) and possible removal of your ovaries are considered a last resort.

What are the benefits of treatment?

Both adenomyosis and endometriosis can be painful over time. Both are progressive diseases, but they are treatable and not life-threatening. Early detection and treatment can lead to a better outcome for pain and symptom relief.

Menopause usually relieves the symptoms of adenomyosis. Some people with endometriosis may still have symptoms after menopause, but this condition is not very common.


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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.


Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.


Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.


Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.
Medically Reviewed by Professor Doctor Alper Demirbaş
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