Association of Ultrasound Features of the Myometrium Suggestive of Adenomyosis and Clinical Symptoms

Inclusion Criteria: * Women of pre- and perimenopausal age presenting for gynaecologic ultrasound exam giving voluntary informed written consent. * Symptomatic and asymptomatic women * Patients with hormonal contraceptives and Hormone Replacement Therapy (HRT) can be included, but information will be noted. Exclusion Criteria: * Missing written consent (study consent) * Any serious underlying medical, psychiatric or psychological condition, which may interfere with the patient's capacity of discernment. * Postmenopausal women * Pregnancy * History of pelvic urogynaecologic surgery (TVT, mesh surgery, etc.) * Malignancy or premalignancy of uterus/cervix * Prior myomectomy for FIGO 3-6 fibroids * Patients with coagulation disorders under current anticoagulation medication * Prior history of diagnosed intraabdominal adhesions (surgery) * Prior diagnosis of pelvic congestion syndrome * Psychiatric disease precluding a reliable estimation of pain * Prior surgery or treatment for deep infiltrating endometriosis * Acute other symptoms: * Urinary symptoms (dysuria, urgency, grade III stress incontinence) * Acute of chronic pelvic infection (cervicitis, endometritis, salpingitis, frozen pelvis) * Ovarian lesions * Sonographic signs of deep infiltrating endometriosis (DIE) * Intracavitary pathology (Fibroid 0-2, polyp, adhesions) * Retained products of conception * \>3 small fibroids below 2 cm in largest diameter FIGO 3-8 (i.e. the presence of three fibroids below 2cm is NOT considered an exclusion criterion) * Presence of any fibroid \>2cm.