<h4>Study question</h4>Does PIEZO1 play any role in adenomyosis-associated dysmenorrhea?<h4>Summary answer</h4>PIEZO1 downregulation in the myometrium reduces the expression of endothelial nitric oxide synthase (eNOS) and nitric oxide (NO) production, leading to increased and irregular contractility that contributes to dysmenorrhea in women with adenomyosis.<h4>What is known already</h4>Aberrant uterine contractility has long been documented in women with adenomyosis, but our knowledge of the molecular mechanisms governing uterine contractility is quite limited. The gene discussed is PIEZO1; the disease is adenomyosis.