Button at the bottom of the Adobe Print Dialog and clicking through the warning not to change things behind Adobe's back. Selecting a region changes the language and/or content on Reader 10.x does go out of it's way to hide the normal print options from OS X but you can still get to them by clicking on the Printer.

For more information, see Error | Save as PDF options unsupported | Create PDF | InDesign, Illustrator | Mac OS 10.6 or later Or, print to PostScript® file and open that file with Distiller, Acrobat Professional, or Apple's Preview application. For those cases, either save as (Illustrator) or export (InDesign) to a PDF file. Some versions of some Adobe products, such as InDesign and Illustrator CS4 or CS5, don't support the PDF menu in the Mac OS X print dialog box. Users of non-Adobe PostScript-based publishing applications cannot print directly to Adobe PDF, and must use another PDF creation method. The potential for adding functionality to PDFs, such as bookmarks, hyperlinks and watermarks.The ability to create PDFs that are compliant with Standards, such as PDF/X and PDF/A.

The benefits of a PDF-to-PDF print workflow include the following: By choosing Save As Adobe PDF from the PDF menu, Apple-based PDFs are converted to Adobe-quality PDFs using your JobOption settings. However, the new PDF workflow takes advantage of the PDF-based printing architecture already present in Mac OS X. Technical changes in Mac OS X Snow Leopard (v10.6) and the later editions prevent Adobe from delivering a PostScript-based printer module. Customers using earlier versions of Adobe Acrobat in Snow Leopard cannot use the Adobe PDF Printer.

Add, they add a Save As Adobe PDF command. Adobe Acrobat 9.1 Pro and later editions up to Acrobat 11.0.x Pro remove the Adobe PDF Printer.

Security features in Snow Leopard and later editions that disable the Adobe PDF Printer.

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