Womens experiences of disrespectful maternity care and its consequences during childbirth in Spain.

One of the most accepted pathogenetic hypotheses involves disruption or absence of the endometrial–myometrial junctional zone, allowing endometrial mucosa to invaginate into the underlying myometrium. Although the pathogenesis is multifactorial, experimental studies have highlighted a potential role for prolactin: elevated serum prolactin may promote endometrial gland growth and activity, and in the presence of ovarian steroids, it can induce myometrial cell injury, facilitating endometrial invasion. The burden of adenomyosis extends beyond individual symptoms, imposing substantial long-term healthcare costs comparable to chronic conditions such as diabetes and rheumatoid arthritis. Consequently, it represents both a clinical and economic challenge in gynecology. Medical therapy remains the cornerstone of symptom management and disease modulation; however, no standardized treatment guideline has been established. Current medical options—including gonadotropin-releasing hormone (GnRH) agonists, oral contraceptives, and progestins—often yield modest efficacy, limited tolerability, and considerable expense. For many women, these shortcomings culminate in hysterectomy; in the United States, approximately 82% of patients with adenomyosis undergo hysterectomy for symptom relief, resulting in permanent loss of fertility. Given the substantial impact on quality of life and the therapeutic limitations of existing modalities, the search for new, effective, and well-tolerated interventions remains imperative. Prolactin synthesis occurs not only in the pituitary gland but also in endometrial and myometrial tissues, where it acts as a mitogenic factor for smooth muscle cells under experimental conditions. Evidence suggests a strong correlation between serum prolactin levels and the progression of adenomyosis, implying that prolactin-lowering agents may represent a rational therapeutic approach. Bromocriptine—an ergot-derived, sympatholytic dopamine D₂-receptor agonist with potent biological activity—has been used for over three decades to treat hyperprolactinemia, prolactinomas, Parkinson’s disease, acromegaly, and other hormone-dependent pituitary adenomas, as well as certain metabolic disorders such as diabetes mellitus.