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Origin and Pathogenic Mechanisms of Uterine Adenomyosis: What Is Known So Far

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Abstract

Uterine adenomyosis is a benign disease, commonly encountered in reproductive-age women and responsible for chronic pelvic pain, abnormal uterine bleeding, and infertility. Although the exact origin and pathogenic mechanisms involved in adenomyosis still need to be elucidated, significant progress has been made over recent years. Ever since the theory of endometrium invaginating the myometrium via a traumatized interface was first proposed, numerous molecular mechanisms have been reported to participate in this process. At the same time, an alternative theory has suggested de novo development of adenomyotic lesions from metaplasia of Müllerian remnants or adult stem cells. Hence, our understanding of the pathogenesis of adenomyosis has been greatly enhanced and is anticipated to pave the way for development of an effective and safe treatment. The goal of this review is to analyze current knowledge on the origin and pathogenic mechanisms of adenomyosis, ranging from the most widely accepted theories to newly reported data.

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Acknowledgements

The authors thank Mira Hryniuk for reviewing the English language of the article.

Funding

This work was supported by grants from the Fonds National de la Recherche Scientifique de Belgique (5/4/150/5 grant awarded to Marie-Madeleine Dolmans), PregLem via the Fondation Saint-Luc (grant awarded to Christina Anna Stratopoulou) and donations of the Ferrero Family.

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  1. Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium

    Christina Anna Stratopoulou & Marie-Madeleine Dolmans

  2. Société de Recherche pour l’Infertilité, Brussels, Belgium

    Jacques Donnez

  3. Gynecology Department, Cliniques Universitaires Saint Luc, Brussels, Belgium

    Marie-Madeleine Dolmans

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  1. Christina Anna Stratopoulou
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  2. Jacques Donnez
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Correspondence to Marie-Madeleine Dolmans.

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Stratopoulou, C.A., Donnez, J. & Dolmans, MM. Origin and Pathogenic Mechanisms of Uterine Adenomyosis: What Is Known So Far. Reprod. Sci. 28, 2087–2097 (2021). https://doi.org/10.1007/s43032-020-00361-w

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