Photo from honorhealth.com
Adenomyosis occurs when the endometrial tissue that normally borders the uterus develops into the muscular wall of the uterus. During each menstrual cycle, the misplaced tissue continues to function normally, thickening, breaking down, and bleeding. An enlarged uterus and painful, heavy periods are possible outcomes.
The etiology of adenomyosis is unknown, however the illness normally resolves following menopause. Hormonal therapies can help ladies who are suffering from severe adenomyosis discomfort. Adenomyosis is cured by removing the uterus (hysterectomy).
WHAT ARE THE SYMPTOMS OF ADENOMYOSIS?
Adenomyosis can cause no symptoms or only minor discomfort in some cases. However, adenomyosis can result in:
- Menstrual bleeding that is excessive or protracted
- During menstruation, severe cramping or acute, knife-like pelvic pain (dysmenorrhea)
- Pelvic discomfort that persists
- Intercourse that is painful (dyspareunia)
Your uterus may grow in size. Although you may not be aware that your uterus is larger, you may experience soreness or pressure in your lower abdomen.
WHAT ARE THE CAUSES OF ADENOMYOSIS?
Adenomyosis has no recognized etiology. Many theories have been proposed, including:
- Tissue growth that is invasive: Endometrial cells from the uterine lining, according to some experts, enter the muscle that creates the uterine walls. Uterine incisions produced after an operation such as a cesarean section (C-section) may encourage endometrial cell invasion into the uterine wall.
- Developmental origins: Other specialists believe that endometrial tissue is deposited in the uterine muscle during the fetal development of the uterus.
- Childbirth-related uterine inflammation: Another notion proposes a connection between adenomyosis and delivery. Postpartum uterine lining inflammation may result in a disruption in the normal boundary of cells that line the uterus.
- Stem cell origins: According to one recent notion, bone marrow stem cells may infect the uterine muscle and cause adenomyosis.
The growth of adenomyosis is dependent on the amount of estrogen in the body.
WHAT ARE THE RISK FACTORS FOR ADENOMYOSIS?
Adenomyosis risk factors include:
- Previously performed uterine surgery, such as a C-section, fibroid excision, or dilatation and curettage (D&C)
- Childbirth
- Middle age
The majority of cases of adenomyosis, which is caused by estrogen, are discovered in women in their 40s and 50s. Adenomyosis in elderly women may be related to longer estrogen exposure than in younger women. However, new evidence reveals that the illness may also affect younger women.
WHAT ARE THE COMPLICATIONS OF ADENOMYOSIS?
Chronic anemia, which causes exhaustion and other health concerns, can occur if you experience prolonged, heavy bleeding during your periods on a regular basis.
Although not hazardous, the pain and heavy bleeding associated with adenomyosis can interfere with your daily activities. You might avoid activities you used to enjoy because you're in discomfort or afraid you'll start bleeding.
HOW IS ADENOMYOSIS DIAGNOSED?
Some other uterine disorders can mimic the signs and symptoms of adenomyosis, making it difficult to diagnose. Fibroid tumors (leiomyomas), uterine cells developing outside the uterus (endometriosis), and uterine lining growths are examples of these disorders (endometrial polyps).
After checking out other possible explanations of your signs and symptoms, your doctor may conclude that you have adenomyosis.
Your doctor may suspect adenomyosis based on any of the following:
- Symptoms and signs
- A pelvic exam revealing an enlarged, painful uterus
- Uterine ultrasound imaging
- Uterine magnetic resonance imaging (MRI)
In some cases, your doctor may harvest uterine tissue for testing (endometrial biopsy) to ensure that you do not have a more serious condition. An endometrial biopsy, however, will not help your doctor confirm a diagnosis of adenomyosis.
Although ultrasound and MRI can reveal adenomyosis, the only method to confirm it is to inspect the uterus after hysterectomy.
WHAT ARE THE TREATMENTS FOR ADENOMYOSIS?
Adenomyosis frequently disappears after menopause, therefore treatment may be determined by your age.
Adenomyosis treatment options include:
- Anti-inflammatory medications: To relieve discomfort, your doctor may prescribe anti-inflammatory drugs such as ibuprofen (Advil, Motrin IB, and others). You can reduce menstrual blood flow and relieve pain by starting an anti-inflammatory medication one to two days before your period and continuing it during your period.
- Hormone medications: Birth control pills that include both estrogen and progestin, as well as hormone patches or vaginal rings, may help to reduce the severe bleeding and pain associated with adenomyosis. Progestin-only contraception, such as an intrauterine device or continuous-use birth control pills, frequently result in amenorrhea (the absence of menstrual cycles), which may bring some relief.
- Hysterectomy: If your pain is severe and no other therapies have helped, your doctor may recommend uterine removal surgery. It is not required to remove your ovaries to treat adenomyosis.