What is it?
With adenomyosis, the tissue
that lines the uterus (endometrium) grows within the uterus' muscular outer
walls. This is most likely to happen from the age of 30-50.
Adenomyosis isn't the same as endometriosis, a
condition in which the uterine lining becomes implanted outside the uterus.
Although the cause of adenomyosis remains unknown, the disease typically
disappears after menopause. For women who experience severe discomfort from
adenomyosis, there are medical treatments that can help, but hysterectomy is the
only final cure.
Although adenomyosis can be quite painful, the condition usually carries no
Signs and symptoms
Among some women, adenomyosis is
"silent" — causing no signs or symptoms — or only mildly uncomfortable. But
other women with adenomyosis may experience:
bleeding; heavy or prolonged
Severe cramping pain during
Menstrual cramps that last
throughout your period and worsen as you get older
Pain during intercourse
Bleeding between periods
Passing blood clots during
Your uterus may increase to
double or triple its normal size. Although you might not know if your uterus is
enlarged, you may notice that your lower abdomen seems bigger or feels tender.
How is adenomyosis diagnosed?
Your doctor may suspect adenomyosis based on:
* Signs and symptoms
* A pelvic examination, which reveals an enlarged uterus that's painful to touch
* Ultrasound imaging of the uterus
* Magnetic resonance imaging (MRI) of the uterus
The only way to be certain about
a diagnosis of adenomyosis happens after the uterus has been removed (hysterectomy)
and biopsies have been studied.
Many women have other uterine
diseases that can be confused with the signs and symptoms of adenomyosis, making
adenomyosis more difficult to diagnose. Such conditions include
fibroid tumors (leiomyomas), uterine cells growing
outside the uterus (endometriosis) and growths
in the uterine lining (endometrial polyps). You may be evaluated first for other
conditions that cause abnormal uterine bleeding. Your doctor may diagnose
adenomyosis only after he or she determines there are no other causes for your
signs and symptoms.
What are the problems that adenomyosis causes?
Pain may be debilitating and
interfere with your day to day activities
Bleeding may lead to anaemia
Pain during sexual
intercourse may disrupt your sexual life
adenomyosis doesn't usually affect fertility.
Adenomyosis usually resolves after menopause, so treatment may depend on how
close you are to that stage of life. If you're nearing menopause, your doctor
may have you try anti-inflammatory medications to control the pain. By starting
an anti-inflammatory medicine two to three days before your period begins and
continuing to take it during your period, you can reduce menstrual blood flow in
addition to relieving pain.
Hormone therapy is another treatment option that may be helpful. Controlling
your menstrual cycle through combined estrogen-progestin oral contraceptives may
lessen the heavy bleeding and pain associated with adenomyosis. Progestin-only
contraception, such as an intrauterine device containing progestin [Mirena], or
a continuous-use birth control pill, often leads to amenorrhea — the absence of
your menstrual periods — which may provide relief.
If your pain is severe and menopause is years away, your doctor may suggest
removing your uterus (hysterectomy). Removing your ovaries isn't necessary to