Adenomyosis is a condition of the uterus where the cells similar to the lining on the inside of the uterus are also present in the muscle wall of the uterus. This makes the uterine walls grow thicker. It may lead to painful sex and heavy or longer-than-usual periods. It’s estimated that about 1 in 5 women have this condition.
Considering this reproductive condition is so common, it’s surprising that we don’t hear more about it! Most of us have heard about Polycystic Ovarian Syndrome and Endometriosis, but what about Adenomyosis? I have a feeling this could be the first time you’ve heard of such a thing if you haven’t been diagnosed as having it. So let’s go deeper into this condition that affects so many women in our lives.
What Is Adenomyosis
The term Adenomyosis comes from the words:
- Adeo – Gland
- Myo – Muscle
- Osis – Condition
With adenomyosis, tissue from the lining of the uterus grows into the uterine wall, enlarging the uterus. This involves the encroachment, or movement, of the endometrial tissue that lines the uterus into the muscles of the uterus. The exact cause of this condition is unknown. However, it’s associated with increased levels of estrogen. It usually disappears after menopause when estrogen levels decline.
Although women with adenomyosis often have endometriosis, they are different conditions. With endometriosis, cells similar to those that line the uterus are found on other parts of the body such as the fallopian tubes, the ovaries or the tissue lining the pelvis, called the peritoneum. Adenomyosis is most likely to occur in the muscle layer of the back wall of the uterus but can occur anywhere in the muscle layer. If adenomyosis is concentrated in one area, it can lead to a non-cancerous growth called an adenomyoma.
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Symptoms of this condition can be mild to severe. Some women may not experience any at all. The most common symptoms include:
- prolonged menstrual cramps
- spotting between periods
- heavy menstrual bleeding
- longer menstrual cycles than normal
- blood clots during menstrual bleeding
- pain during sex
- tenderness in the abdominal area
- anaemia or iron deficiency which leads to dizziness and fatigue
Painful and prolonged periods are the most common symptom because the lining cells within the muscle wall behave the same as the lining cells of the uterus. This means when you have your period, these cells also bleed but because they are trapped in the muscle layer, they form little pockets of blood within the uterine muscle wall.
How Adenomyosis Is Diagnosed
A complete medical evaluation can help. Your doctor should first want to perform a physical examination to determine if your uterus is swollen. Many women with adenomyosis will have a uterus that’s double or triple the normal size. Unfortunately, adenomyosis may be difficult to diagnose, because there is no single set of agreed tests for confirming diagnosis.
The first test recommended is a transvaginal ultrasound where an ultrasound probe is gently placed in the vagina. If available, the test is ideally performed by a gynaecologist who specialises in ultrasound. An ultrasound is necessary to rule out the possibility of tumors on the uterus. An MRI – magnetic resonance imaging, may sometimes be needed to confirm the diagnosis and exclude other conditions such as fibroids. An MRI uses a magnet and radio waves to produce pictures of your internal organs. This procedure involves lying very still on a metal table that will slide into the scanning machine.
Women with mild forms of this condition may not require medical treatment. Your doctor may recommend treatment options if your symptoms interfere with your daily activities.
Treatments aimed at reducing the symptoms of adenomyosis include the following:
These medications, like ibuprofen, can help to reduce blood flow during your period while also relieving severe cramps. The Mayo Clinic recommends starting anti-inflammatory medication two to three days before the start of your period and continuing to take it during your period. You should not use these medications if you’re pregnant.
These include oral contraceptives or birth control pills. Progestin-only contraceptives, which can be administered orally, injection, or an intrauterine device. GnRH-analogs such as Lupron (leuprolide). Hormonal treatments can help to control increased estrogen levels that may be contributing to your symptoms. Intrauterine devices, such as Mirena, can last up to five years.
This involves techniques to remove or destroy the endometrium (lining of the uterine cavity). It’s an outpatient procedure with a short recovery time. However, this procedure may not work for everyone, since adenomyosis often invades the muscle more deeply.
Uterine Artery Embolisation
This is a procedure that prevents certain arteries from supplying blood to the affected area. With the blood supply cut off, the adenomyosis shrinks. Uterine artery embolization is typically used to treat another condition, called uterine fibroids. The procedure is performed in a hospital. It usually involves staying overnight afterward. Since it’s minimally invasive, it avoids scar formation in the uterus.
MRI-guided focused ultrasound surgery (MRgFUS)
MRgFUS uses precisely focused high-intensity waves to create heat and destroy the targeted tissue. The heat is monitored using MRI images in real time. Trusted sources have shown this procedure to be successful in providing relief of symptoms. However, more studies are needed.
This involves complete surgical removal of the uterus. It’s considered a major surgical intervention and is only used in severe cases and in women who don’t plan to have any more children. Your ovaries don’t affect adenomyosis and may be left in your body.
Anti-inflammatory foods are best to be avoided at all times, not just for people who suffer from Adenomyosis. Avoiding processed foods like bread, pasta, sugars and dairy is the way to go.
Diet suggestions for Adenomyosis from medical experts – here
10 natural home remedies for Adenomyosis – here
Adenomyosis isn’t necessarily harmful. However, the symptoms can negatively affect your lifestyle. Some people have excessive bleeding and pelvic pain that may prevent them from enjoying normal activities such as sexual intercourse.
Women with adenomyosis are at an increased risk of anemia. Anemia is a condition often caused by an iron deficiency. Without enough iron, the body can’t make enough red blood cells to carry oxygen to the body’s tissues. This can cause fatigue, dizziness, and moodiness. The blood loss associated with adenomyosis can reduce iron levels in the body and lead to anemia. The condition has also been linked with anxiety, depression, and irritability.
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Adenomyosis isn’t life-threatening. Many treatments are available to help alleviate your symptoms. There are so many women out there living a happy and fulfilling life with Adenomyosis. If your symptoms become extreme there is medical help available for you. But I always say, the best medicine is prevention. So making sure you have a healthy body and healthy mind by eating wholesome, nutritious foods, taking supplements and having a daily exercise routine!