Patient case (clinical description): A 43-year-old woman, gravida 3 para 3, comes to the clinic complaining of recently painful menstrual cycles.  The patient's last menstrual period was 2 weeks ago. Urine β-hCG is negative. Menarche was at age 12, and menstrual periods occur every 28 days and lasts for 5 days.  She is sexually active with her husband and does not have pain with intercourse. BMI is 23 kg/m2 and Vital signs are normal.  On physical examination, the uterus is uniformly enlarged and tender. She is candidate for hysterectomy with the diagnosis of adenomyosis.

Patient's own account: I'm 43, and I paid a visit to my doctor because my last few periods were insanely painful. My last periods were 2 weeks ago. I already had three pregnancies that gave me the three lovely children. I did a urine test to check for potential pregnancy, and it came back negative. I started to have my periods at the age of 12, and I have been pretty regular with periods every 28 days for 5 days. I'm sexually active with my husband and I do not have any pain when we have sex. My BMI is 23 and my vitals were normal. The doctor performed a physical exam and found that my uterus was tender and enlarged. She proposed me a hysterectomy and diagnosed me with adenomyosis.

Clinical trial: Women in Steady Exercise Research [Formerly Women, Oxidative Stress, Exercise and Estrogens (WOSEE)]

Eligibility criteria:
Inclusion Criteria:

          -  Healthy women

          -  Self-reported menstrual cycle length of 25-35 days within the past 2 months

          -  Nonsmoker

          -  Sedentary (exercise < 3 times weekly within the past 6 months)

          -  Intact ovaries and uterus

          -  No history of gynecological problems (e.g., fibroids, endometriosis, polycystic ovary
             syndrome)

          -  Female

          -  Premenopausal

          -  Body mass index 18.5 to 40

          -  Stable weight (no changes ≥ 10% within the past year)

        Exclusion Criteria:

          -  No pregnancy or breast feeding within the past 6 months

          -  No plans to become pregnant during study treatment

          -  No cancer within the past 5 years except for nonmelanoma skin cancers

          -  No medical condition that would prohibit participation in a vigorous program of
             weight-bearing aerobic exercise including, but not limited to, any of the following:

               -  Fibromyalgia

               -  Chronic fatigue syndrome

               -  Metabolic disorders

               -  Recent cardiovascular event

               -  Orthopedic limitations

               -  Psychiatric disorders requiring antipsychotic drugs

          -  No uncontrolled hypertension (systolic blood pressure [BP] > 160 mm Hg and/or
             diastolic BP > 99 mm Hg)

          -  No more than 7 alcoholic beverages per week

          -  No injected hormonal contraceptive use within the past year

          -  More than 6 months since prior use of intrauterine device

          -  More than 3 months since prior oral or patch hormone contraceptives

          -  No medication that would prohibit participation in a vigorous program of
             weight-bearing aerobic exercise
Female
Accepts Healthy Volunteers
Subject must be at least 18 Years old.
Subject must be at most 30 Years

Eligibility (NLI label): Contradiction