ArticleReproductive medicine and biology
How does the extent of fibrosis in adenomyosis lesions contribute to heavy menstrual bleeding?
Article in Reproductive medicine and biology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 46 citations in OpenAlex.
- Endometriosis and Adenomyosis: Mechanotransduction, Microenvironment, and Mechanisms Beyond Lesions.Reproductive sciences (Thousand Oaks, Calif.) · 2026Review
- Spatial transcriptomics uncovers the hybrid molecular identity, ciliated phenotype, and immune signature of adenomyosis lesions.Science advances · 2026Article
- Identification of Misplaced Endometrial Glands and Stroma in the Myometrium of Foetal Uteri Evocative of Developmental Adenomyosis.International journal of molecular sciences · 2026Article
- Impaired PIEZO1 function drives uterine hypercontractility in adenomyosis-associated dysmenorrhea.Human reproduction open · 2026Article
- Phenotypic heterogeneity in adenomyosis: internal and external subtypes.Archives of gynecology and obstetrics · 2025Observational
- A narrative review on the role of IL-1β, IL-8, and the endometrial matrix in heavy menstrual bleeding pathogenesis.Annals of medicine and surgery (2012) · 2025Review
- How Women Discuss Heavy Menstrual Bleeding in Online Forums ("It's Like Revenge of the Uterus"): Template Approach to Thematic Analysis.Journal of medical Internet research · 2025Article
- Progressively Diminished Prostaglandin E2 Signaling in Concordance with Increasing Fibrosis in Ectopic Endometrium.Reproductive sciences (Thousand Oaks, Calif.) · 2025Article
- FOXA2 loss results in an increase of endometriosis development and LIF reveals a therapeutic effect for endometriosis.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025Article
- Hypermethylation of Klotho and Peroxisome Proliferator-Activated Receptor γ Concomitant with Overexpression of DNA Methyltransferase 1 in Adenomyosis.Reproductive sciences (Thousand Oaks, Calif.) · 2025Article
- Progressively diminished estrogen signaling concordant with increased fibrosis in ectopic endometrium.Human reproduction open · 2025Article
- New MUSA classification of adenomyosis: correlation of symptoms and clinical severity with direct and indirect features.Przeglad menopauzalny = Menopause review · 2024Article
- Hypoxia and the endometrium: An indispensable role for HIF-1α as therapeutic strategies.Redox biology · 2024Review
- Adenomyosis and Abnormal Uterine Bleeding: Review of the Evidence.Biomolecules · 2024Review
- Role of ultrasonography in the evaluation of disease severity and treatment efficacy in adenomyosis.Archives of gynecology and obstetrics · 2024Review
- Are Adenomyosis and Endometriosis Phenotypes of the Same Disease Process?Biomolecules · 2023Review
- Application of elastography to diagnose adenomyosis and evaluate the degree of dysmenorrhea: a prospective observational study.Reproductive biology and endocrinology : RB&E · 2023Observational
- Contemporary evaluation of women and girls with abnormal uterine bleeding: FIGO Systems 1 and 2.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023Article
- Cyclic processes in the uterine tubes, endometrium, myometrium, and cervix: pathways and perturbations.Molecular human reproduction · 2023Review
- From Retrograde Menstruation to Endometrial Determinism and a Brave New World of "Root Treatment" of Endometriosis: Destiny or a Fanciful Utopia?Biomolecules · 2023Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
Purpose: To investigate how the extent of fibrosis in adenomyosis lesions contributes to heavy menstrual bleeding (HMB). Methods: We recruited 57 women with histologically confirmed adenomyosis, 29 of whom reported moderate/heavy bleeding (MHB) (menstrual blood loss (MBL) ≥20 but <100 mL) and the remaining 28, excessive MBL (EXB; ≥100 mL). Lesional stiffness was measured by transvaginal elastosonography. Full-thickness uterine tissue columns containing the lesion and its neighboring endometrial-myometrial interface (EMI) and endometrial tissues were evaluated for tissue fibrosis and immunohistochemical analysis of HIF-1α, COX-2, EP2, and EP4. Results: The lesional stiffness in the EXB group was significantly higher than that of MHB, and consistently, the extent of lesional fibrosis and the extent of tissue fibrosis in both EMI and eutopic endometrium were also significantly higher. In adenomyotic lesions and their neighboring EMI and eutopic endometrial tissues, the immunostaining of HIF-1α, COX-2, EP2, and EP4 was significantly reduced. The extent of fibrosis and the immunostaining levels of HIF-1α, COX-2, EP2, and EP4 were negatively correlated in all tissues. Conclusions: Lesional fibrosis begets stiffening matrix, propagating fibrosis to neighboring EMI and eutopic endometrium, resulting in reduced PGE
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