<prompt> A 45-years-old multipara presents with dysmenorrhea and menorrhagia. Uterus is symmetrically enlarged upto 14 weeks. What is the probable diagnosis?Intramural fibroidAdenomyosisEndometrial hyperplasiaPelvic inflammatory disease  <response>: AdenomyosisCommon in women above 40 years.Often co-exists with fibroid, endometriosis and endometrial cancer.Uterus is symmetrically enlarged to not more than 14 weeks size.Histology - Islands of endometrial glands surrounded by stroma seen in the myometrial tissue beyond the endomyometrial junction.The distance between basal endometrium and the endometrial gland should be 2.5 mm.Common complaint--Menorrhagia and progressive dysmenorrhoea.Clinical examination reveals symmetrical enlargement of uterus and tender uterus.Treatment is localized excision, hysterectomy.Medical treatment includes danazol, GnRH, Mirena IUCD.Refer: Shaw;s Textbook of Gynaecology, 15th edition, pg no: 407, 475 