Which symptom might indicate severe adenomyosis during an examination?

Severe adenomyosis is characterized by the presence of endometrial tissue within the uterine muscle wall, leading to various symptoms due to the associated inflammation and abnormal uterine growth. Marked tenderness and a feeling of bloating during an examination can be significant indicators of this condition. Patients with adenomyosis often report dysmenorrhea (painful periods), heavy menstrual bleeding, and pelvic discomfort, which can manifest as tenderness upon palpation. This marked tenderness is a clue that the uterine tissue is involved in inflammatory processes, causing sensitivity and discomfort.

The feeling of bloating might result from uterine enlargement, which is a common feature in cases of adenomyosis. It reflects the structural changes occurring within the uterus rather than benign conditions.

Other symptoms associated with this condition, such as increased menstrual pain and heavy bleeding, complement the findings of tenderness and bloating, reinforcing the notion that these physical manifestations help confirm the suspicion of severe adenomyosis.