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There Is Adenomyosis Without Dysmenorrhea, Is It Possible?
The uterus is divided into three layers. The inner layer is the endometrium; the middle layer is the muscle layer which is the thickest, and the outer layer is the skinny serous layer. Adenomyosis occurs when the endometrium invades the muscular layer. 
The etiology and pathogenesis of adenomyosis have not been clearly understood. Trauma to the uterine wall during multiple pregnancies and chronic endometritis may be the leading causes of this disease. Pregnancy trauma can cause adenomyosis. adenomyosis usually occurs in women of reproductive age from 30 to 50 years old.
Early adenomyosis may be asymptomatic or simply menorrhagia. But most patients appear with lower abdominal pain and discomfort, heave or mild dysmenorrhea, or other symptoms. Every menstrual increase and progressive dysmenorrhea aggravation of women should think of the possibility of this disease. All women should consider the case of this disease if they have symptoms of increased menstruation and progressive dysmenorrhea.
In addition, the disease can lead to infertility. When doctors examine patients with adenomyosis, they may find that the uterus's homogeneity increases and  Localized tuberous eminence. It's hard and painful when you touch it. Diagnosis can generally be made through a B ultrasound. adenomyosis is benign, but it gets worse.
The most common symptom of adenomyosis is the effect of menstruation, with increased menstrual volume and severe dysmenorrhea. Among them, increased menstrual volume is a more common clinical manifestation. And dysmenorrhea is the symptom that most affects the patient's quality of life. Many patients think adenomyosis dysmenorrhea is very painful and seriously affects their normal life and work.
Most women's pain time is 2-3 days before and after menstruation, and about one week is the most painful. Having individual females before menstruation 1-2 weeks can ache; some can ache after menstruation. This type of dysmenorrhea is most common in deep endometriosis(DIE). Some lesions can even implant into the vaginal wall and posterior fornix, causing painful intercourse during sex. But it's rare.
Most of the patients had pain before menstruation and about one week after menstruation. And the pain gets worse, often requiring medication or even injections.
People with adenomyosis do not necessarily experience dysmenorrhea, but the vast majority of people have dysmenorrhea to varying degrees. But women's dysmenorrhea is not necessarily adenomyosis caused; there may be ovarian chocolate cysts. At the same time, many women may have primary dysmenorrhea without any lesions of the genitals. In the examination of ultrasound, the uterus and accessories are not any abnormal situations, just pain during menstruation, and more from the beginning of menarche will appear.
Medication or placement of Mirena may be considered for young patients with fertility requirements, those in near-menopause, those who are unwilling to undergo surgical treatment, or those whose symptoms recur after conservative surgical treatment. However, these drugs have specific side effects and must be used under the guidance of a doctor.
If you need fertility, you can choose conservative surgery and drug therapy. You can select the herbal medicine Fuyan Pill. It effectively regulates the menstrual cycle, reduces inflammation in the uterus, and relieves women's pain. 
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