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Marco Zaccaria: Uterine Flexion Angle and the Risk of Adenomyosis
May 4, 2026, 18:02

Marco Zaccaria: Uterine Flexion Angle and the Risk of Adenomyosis

Marco Zaccaria, Global Product Manager at ESGE European Society Gynecology Endoscopy, shared a post on LinkedIn about a paper by Anjeza Xholli et al. published in Journal of Clinical Medicine:

“The uterine flexion angle – that is, the angle between the body of the uterus and the cervix – is a clinical factor closely associated with the prevalence and severity of adenomyosis symptoms

Recent studies indicate that a marked angle, particularly when the uterus is retroflexed (angle > 210°), can significantly increase the risk of developing this condition

What is the relationship between adenomyosis and the angle of uterine flexion

1. A flexion angle greater than 210° is associated with a prevalence of adenomyosis that is approximately six times higher than that observed with smaller angles

2. A marked curvature can obstruct menstrual flow, increasing intrauterine pressure during contractions: this elevated pressure may promote the infiltration of endometrial tissue into the myometrium, facilitating the development of adenomyosis

3. Extreme angles (both very narrow <150° and very wide >210°) are associated with more severe menstrual pain as like dysmenorrhea

Here is a 2022 study that explores this topic in greater depth:

Angle of Uterine Flexion and Adenomyosis – PubMed

Title: Angle of Uterine Flexion and Adenomyosis

Authors: Anjeza Xholli, Umberto Scovazzi, Ambrogio Pietro Londero, Giulio Evangelisti, Elena Cavalli, Maria Giulia Schiaffino, Ilaria Vacca, Francesca Oppedisano, Mattia Francesco Ferraro, Giorgio Sirito, Filippo Molinari, Angelo Cagnacci

Marco Zaccaria

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