How to distinguish endometriosis from adenomyosis?

Patient's question:

Here is the English translation of the provided text:
"Enter key to line break does not need to be translated, return as is, all other Chinese text should be translated into English: Laparoscopic surgery (chocolate cyst) was performed in July of this year, and a vaginal ultrasound in November for follow-up was diagnosed as consistent with the sonographic changes of adenomyosis. What is the difference between adenomyosis and endometriosis?"

Doctor's answer:

It is necessary to comprehensively evaluate and speculate based on clinical diagnostic symptoms and careful examination results such as ultrasound. The menstrual pain symptoms are similar, but adenomyosis is usually more severe, with pain located in the middle of the lower abdomen. During gynecological examinations, the uterus is often uniformly reduced in size, spherical in shape, and hard. During menstrual periods, the uterus shows significant tenderness upon palpation. Moreover, adenomyosis is often associated with endometriosis. It is important to maintain a good routine and increase physical exercise in daily life to enhance the body's resistance and immunity.

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