benign disease. endometrial basal tissue communicating with myometrium → proliferation and hypertrophy

“cousin of endometriosis”

demographics: Female 35–50 years (symptoms often resolve after menopause)

Aetiology: unknown. (?pregnancy/childbirth ?uterine surgery)

Pathophysiology: endometrial tissue within the myometrium due to hyperplasia of the endometrial basal layer

Risk Factors

• commonly occurs with fibroids
• increased oestrogen exposure
• uterine surgery
• ?genetics
• ? multiparity (controversial)

Clinical features

• May be asymptomatic
• Dysmenorrhea
• menorrhagia
• deep dyspareunia