Second Opinion
On adenomyosis · An evidence-grounded appointment brief
The appointment
brief your doctor
didn’t give you.
For the one in three women told their treatment options end at hormonal contraceptives or a hysterectomy.
Second Opinion reads the most current adenomyosis literature ( Kho 2026 guidelines, HIFU outcome meta-analyses, GnRH antagonist trial data, real treatment-centre contacts ) and hands you the brief your specialist should have written. Cited by source. Designed to be handed to a clinician.
~30 sec · 52 sources · cite-backed
The pattern
“I went to four doctors in three years. First said heavy periods are normal. Second told me to take Advil. Third offered a hysterectomy. Fourth finally said the word adenomyosis —eleven years after my symptoms started.”
Composite patient experience · r/adenomyosis & Adenomyosis Fighters (11,000+ members)
Scrollytelling · The eleven-year average
skip ↓Year 0
Age 14
What the doctor said:
“Heavy periods are normal at your age. Some girls just have it worse.”
— Family physician · first appointment about the pain
Year 2
Age 16
What the doctor said:
“Take Advil before your period starts. Stay ahead of it.”
— Walk-in clinic · second time asking
Year 4
Age 18
What the doctor said:
“Let's try the pill. Most people see real improvement.”
— OB-GYN · first specialist referral
Year 6
Age 20
What the doctor said:
“If the pain is this bad, maybe a therapist could help with how you're processing it.”
— Family physician · same office, different doctor
Year 9
Age 23
What the doctor said:
“We can talk about hysterectomy when you're done having children.”
— OB-GYN · the standard offer
The diagnosis, finally
Adenomyosis.
Eleven years. Five doctors. One diagnosis you had to find for yourself.
And the brief your doctor still didn’t give you.
By the numbers
Global prevalence
Women globally live with adenomyosis. Most never know it has a name.
Source · Kho 2026, Clinical Expert Series, Obstetrics & Gynecology
Average diagnostic delay between first symptoms and confirmed diagnosis.
Source · Adenomyosis Advice Association
Have ever been developed and approved exclusively for adenomyosis. Every option borrowed from endometriosis or fibroids.
Source · FDA + EMA registries, 2024 review
Estimated true prevalence vs. confirmed cases. The 1 in 3 figure is what we know — the real burden is wider.
Source · Pooled epidemiologic estimates, 2023-2026
Live · the model at work
Watch Opus 4.7 reason across 52 clinical sources in real time.
A single agent’s stream — looped every fifteen seconds so you can see the corpus light up as it’s cited.
The full generator runs five Opus calls in concert: three specialist agents read the patient’s profile in parallel — an OB-GYN, a reproductive endocrinologist, a chronic pelvic pain specialist — then a synthesizer composes their notes, then a verifier fact-checks every claim against the corpus before you see the brief.
Live · Opus 4.7 reasoning
0 / 52 sources cited
Kho 2026 — Clinical Expert Series
April 2026 · Green Journal
Chen 2024 — HIFU Pregnancy Meta
n=557 · 53.4% pregnancy rate
Catherino 2025 — Relugolix LIBERTY
22.2% uterine volume reduction
Mount Sinai Toronto — Dr. Sobel
OHIP-covered · (416) 586-8273
Weill Cornell — Fibroid & Adeno Center
NYC · MRgFUS available
Akhigbe 2024 — Dienogest vs LNG-IUS
73% vs 29.5% remission
The gap, made visible
What patients are told vs
what the evidence says
✖ What your gynecologist offered
32F, dysmenorrhea
TVUS: ?adeno
—
plan:
1. trial OCP / hormonal BC
2. if fails → hysterectomy
—
discussed: pregnancy may
lighten symptoms
f/u 6mo
✓ What the Second Opinion brief gives you
Headline
Your specialist’s “contraceptives or hysterectomy” framing skips four evidence-based pathways the April 2026 Kho guidelines explicitly recommend for fertility-preserving patients.
MR-guided focused ultrasound (HIFU)
strong53.4% pregnancy rate post-treatment
cited: chen-2024 · cornell
Oral GnRH antagonist (relugolix)
moderate22.2% uterine volume reduction
cited: catherino-2025
“Try birth control. If that fails, hysterectomy.”
Red flag — contradicts Kho 2026 standard of care
+ 4 more options · 2 OHIP centres · 11 trials · doctor handoff page
→Same patient. Same imaging. Same OHIP coverage. The difference is whether someone bothered to read the 2024–2026 literature for you.
How it works
One profile in.
One brief out.
Share what you know
Paste your imaging report, list your symptoms and treatments tried, set your fertility goal, location, and coverage. Nothing is required. More detail produces a sharper brief.
Opus 4.7 reasons across 52 sources
The April 2026 Kho Clinical Expert Series, HIFU outcome meta-analyses, GnRH antagonist regulatory data, OHIP and cross-border treatment-centre contacts, and every actively recruiting adenomyosis trial worldwide. All in one 1M-context window. Cached for sub-thirty-second responses.
Walk into your appointment prepared
Treatment options ranked for your case. Specific questions to ask. Red flags to listen for. Care centres with phone numbers. A printable handoff page formatted for the clinician to read in under a minute.
Founder’s note
Why I built this.
My fiancée was diagnosed with adenomyosis last year. Her gynecologist offered her two treatment options, in this order: hormonal contraceptives now, and a hysterectomy later if those failed. There was no mention of pelvic MRI to confirm staging. No mention of GnRH antagonists. No mention of focused ultrasound. No reference to the April 2026 Kho Clinical Expert Series, which lays out a full medical, interventional, and surgical pathway any OB-GYN can apply.
When I read that paper for her, I learned there were at least four evidence-based options between “try the pill” and “remove the uterus” that her specialist had not put on the table. So I built her this. A tool that reads what her doctor doesn’t have time to read, and hands her the brief she should have walked into the appointment with.
She is not the only woman this is happening to. One in three women live with this condition. The diagnostic delay averages eleven years. Zero drugs have ever been developed exclusively for it. The whole field has left clinicians behind, and patients are paying for it. This is for them too.
JAMES OLUSOGA · TORONTO · APRIL 2026
Ready when you are
Build your brief in ~30 seconds.
Cited by source. Printable for your doctor. The conversation you should have had at your last appointment, rendered before your next.