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Uterine flexion on the cervix, diameter and stiffness of the internal cervical orifice represent an obstacle to downstream menstrual flow, that when excessive increases the intensity of uterine contractions. Evidence indicates that intense uterine contractions damage the endometrial myometrial junction, favoring endometrial entrance into the myometrium, to induce adenomyosis, and retrograde menstrual flow into the peritoneal cavity, to induce endometriosis. As a consequence of local hyperestrogenism in women with adenomyosis the cervical mucus barrier is reduced. Because of an increased prevalence of non\u2010lactobacilli dominated vagino\u2010types, the ascent of vaginal pathogens is also increased. Richness of endometrial and pelvic microbiota, lead to a higher rate of endometritis, and subclinical chronic pelvic infections in women with adenomyosis and concomitant endometriosis, respectively. Studies targeting the cervix as an actor on the pathogenesis of adenomyosis and endometriosis are warranted.<\/jats:p>","DOI":"10.1002\/ijgo.70287","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T04:54:03Z","timestamp":1749012843000},"page":"1128-1134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A role of the uterine cervix in the pathogenesis of adenomyosis and endometriosis?"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2714-623X","authenticated-orcid":false,"given":"Angelo","family":"Cagnacci","sequence":"first","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS San Martino Hospital  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal, and Infant Health (DiNOGMI) IRCCS San Martino Hospital  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambrogio Pietro","family":"Londero","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal, and Infant Health (DiNOGMI) IRCCS San Martino Hospital  Genoa Italy"},{"name":"Obstetrics and Gynecology Unit IRCCS Ospedale Pediatrico Giannina Gaslini  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"Scovazzi","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS San Martino Hospital  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal, and Infant Health (DiNOGMI) IRCCS San Martino Hospital  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjeza","family":"Xholli","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS San Martino Hospital  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal, and Infant Health (DiNOGMI) IRCCS San Martino Hospital  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0174-173X(88)80022-0"},{"issue":"478","key":"e_1_2_13_3_1","first-page":"e1","article-title":"A new paradigm for the role of smooth muscle cells in the human cervix","volume":"215","author":"Vink JY","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_13_4_1","volume-title":"Colposcopy and Treatment of Cervical Precancer; 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