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Adenomyosis is a condition where the endometrial tissue, which normally lines the uterus, develop into the uterine muscle wall. Throughout every menstrual cycle, the displaced tissue functions normally, thickening, degrading, and bleeding. Period pain, heavy menstrual bleeding, and pelvic or abdominal pain can all be symptoms of adenomyosis.
Adenomyosis doesn’t usually generate symptoms, many women are unaware that they have the disorder. However, adenomyosis symptoms typically worsen with time. The likelihood of anemia is increased by adenomyosis-related heavy menstrual flow. When the body doesn’t produce enough iron-rich red blood cells, anemia develops.
Although the cause of adenomyosis is unknown, the condition typically goes away after menopause. Hormonal therapies may help women who experience severe pain from adenomyosis. Adenomyosis is treated by having the uterus removed (hysterectomy).
Symptoms
The uterus might expand. Even though they might not be aware that their uterus is larger, they might feel pressure or soreness in their lower abdomen. Adenomyosis can occasionally go undetected or just cause minor pain. But adenomyosis can result in:
- Prolonged or heavy menstrual bleeding
- Abnormal menstruation
- Painful menstrual cramping (dysmenorrhea)
- Chronic pelvic pain with or without cramping
- Dyspareunia (painful intercourse)
Make an appointment to visit a healthcare provider if the person experiences excessive bleeding that lasts for a long time or severe abdominal pain during periods that interferes with their normal activities.
Causes
Adenomyosis has an unknown cause. There are several concepts thay may cause the condition, such as:
- Invasive tissue growth: According to some specialists, the muscle that makes up the uterine walls is invaded by endometrial cells from the uterus’ lining. Endometrial cells may directly invade the uterine wall as a result of uterine incisions produced during procedures like cesarean sections (C-sections).
- Developmental origins: According to other researchers when the uterus first develops in the fetus, endometrial tissue is thought to be deposited in the uterine muscle.
- Uterine inflammation related to childbirth: Adenomyosis and childbirth may be related. An interruption in the usual boundary of the cells that line the uterus may result from postpartum uterine lining inflammation.
- Stem cell origins: Adenomyosis may develop as a result of bone marrow stem cells penetrating the uterine muscle, according to a recent theory.
No matter how adenomyosis arises, the amount of circulating estrogen in the body is necessary for its development.
Risk factors
Adenomyosis risk factors includes the following:
- Age: The condition is common to people around 40 to 50 yearls old
- Childbirth: Women with history of childbirth increases the risk.
- History: surgery on the uterus before, such as a C-section, fibroid removal, or dilatation and curettage (D&C)
The majority of women in their 40s and 50s are affected by adenomyosis, which is an estrogen-dependent condition. These women’s higher estrogen exposure than younger women’s may be the cause of their adenomyosis. But according to recent study, younger women may also be more susceptible to the illness.
Diagnosis
Adenomyosis can have signs and symptoms that are similar to those of other uterine disorders, making it challenging to diagnose. These disorders include endometriosis, fibroid tumors, and growths in the uterine lining known as endometrial polyps.
After ruling out other potential causes for the patient’s signs and symptoms, the healthcare provider may come to the conclusion that the patient has adenomyosis.
- Pelvic examination: The uterus may appear larger, softer, tender or uncomfortable to the touch during a pelvic exam.
- Imaging test: Adenomyosis can be recognized by pelvic imaging, but it can only be definitively diagnosed by examining the uterus after surgery.
- Ultrasound: Images of the pelvic organs are created by sound waves during a transvaginal ultrasonography. Sometimes the uterine wall can be seen thickening in these images.
- MRI: A uterine enlargement and some uterine thickening can be seen on magnetic resonance imaging (MRI).
- Biopsy: In some cases, a healthcare provider may take an endometrial biopsy to get a sample of uterine tissue for testing in order to rule out the presence of a more serious ailment. The healthcare provider cannot definitively diagnose adenomyosis with an endometrial biopsy.
Treatment
The signs and symptoms of adenomyosis often go away following menopause because estrogen encourages the formation of endometrial tissue. While waiting, the following therapies can assist with additional symptoms, heavy bleeding, and pain:
- Anti-inflammatory drugs: To manage the discomfort, a healthcare provider may advise using anti-inflammatory medications such ibuprofen, according to the FDA. It can lessen menstrual blood flow and ease pain by starting an anti-inflammatory medication one to two days before the start of the period and taking it throughout the period.
- Hormonal medications: Birth control pills that contain both estrogen and progestin, hormone patches, or vaginal rings may alleviate the pain and severe bleeding that come with adenomyosis. Amenorrhea, the lack of menstrual cycles, is frequently caused by progestin-only contraception, such as an intrauterine device or continuous-use birth control pills, which may offer some relief.
- Adenomyomectomy: The uterine muscle will undergo surgery to be free of adenomyosis. A myomectomy—a technique used to remove uterine fibroids—is comparable to this one.
- Hysterectomy. The healthcare provider might advise removing the uterus surgically if the discomfort is severe and other therapies have failed. It is not required to remove the ovaries to manage adenomyosis. Patient won’t have a menstrual cycle or be able to become pregnant after a hysterectomy.
