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7379799 
Journal Article 
Review 
Origin and Pathogenic Mechanisms of Uterine Adenomyosis: What Is Known So Far 
Stratopoulou, CA; Donnez, J; Dolmans, MM 
2020 
1 
Reproductive Sciences
ISSN: 1933-7191
EISSN: 1933-7205 
English 
33090375 
WOS:000582379800004 
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. 
Adenomyosis; Pathogenesis; Invagination; Metaplasia; Disease mechanisms