Adenomyosis

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.