Woman in her late 30s with previous pregnancies presents with progressive menstrual pain and a soft, diffusely enlarged uterus most consistent with adenomyosis (abnormal endometrial tissue within the uterine myometrium)
Key idea: Adenomyosis can lead to dysmenorrhea, heavy menstrual bleeding and chronic pelvic pain
Key idea: Risk factors for adenomyosis includes age > 40, multiparity and/or prior uterine surgery
Key idea: For the NBME exams, a diffusely enlarged uterus is either pregnancy or adenomyosis, whereas an enlarged irregular uterus is consistent with fibroids
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