About Adenomyosis
The cause of adenomyosis isn’t not fully understood. Researchers have theorized that the uterine lining tissue (the endometrial cells) gets into the uterine walls during childbirth, a uterine procedure, or trauma/injury to the uterus.
Risk factors for adenomyosis include:
- Age: Most people with adenomyosis are diagnosed in their 40s and 50s. Adenomyosis usually resolves after menopause
- Previous pregnancies: Having had multiple pregnancies is associated with a higher risk of adenomyosis.
- Uterine surgery: Previous surgery on the uterus, such as a cesarean delivery or surgery to remove uterine fibroids, may increase the risk.
- Hormonal factors: Conditions that increase exposure to estrogen, a higher body mass index, or past use of hormonal contraceptives, may play a role.
It's important to note that these risk factors are not definitive, and more research is needed to fully understand their impact on adenomyosis development. Some people with adenomyosis do not have risk factors. If you have concerns about your risk for adenomyosis, it's best to consult with your healthcare professional for personalized advice.
The most common early symptoms of adenomyosis include:
- Heavy or prolonged menstrual bleeding
- Painful menstrual cramps
- Blood clots during menstrual bleeding
- Pain during sexual intercourse
- Infertility
As adenomyosis progresses or reaches higher severity, the following symptoms may occur:
- Bleeding between periods
- Worsening uterine cramps
- Enlarged and tender uterus
- General pain in the pelvic area
- Feeling of pressure on the bladder and rectum
- Pain while having a bowel movement
It's important to note that symptoms can vary widely among individuals, and some may not experience any symptoms at all. If you are experiencing any concerning symptoms, it is recommended to consult with your healthcare professional for an accurate diagnosis and appropriate management.
To diagnose adenomyosis, several examinations, tests, and procedures may be performed:
- Physical and pelvic exam: During this exam, the healthcare provider will assess for physical signs of adenomyosis, such as pain, tenderness, or enlarged uterus.
- Ultrasound: A transvaginal ultrasound is often used to diagnose adenomyosis. It uses sound waves to create moving images of the uterus, helping the doctor visualize any abnormalities.
- MRI scan: This imaging test is the preferred method to diagnose adenomyosis. It provides detailed images of the inner muscle layer of the uterus.
- Endometrial biopsy: In some cases, a small sample of the endometrial tissue may be taken for testing. Although it cannot directly diagnose adenomyosis, it helps rule out other conditions with similar symptoms.
Additional examinations, tests, and procedures may include:
- Laboratory tests: Blood tests or other lab tests may be ordered to check for specific markers or to rule out other conditions that can mimic adenomyosis.
- Additional imaging studies: Depending on individual circumstances, additional imaging studies may be suggested to assess the extent and severity of adenomyosis.
Remember that these examinations and tests should be discussed with your healthcare provider to determine which ones are appropriate for your situation.
The goals of treatment for adenomyosis are to relieve symptoms and improve the quality of life for patients. Here are the different types of treatments and how they work to achieve these goals:
Medication:
- NSAIDs: These are pain relievers that can help manage the cramping pain associated with adenomyosis. Also, these may be recommended to start 1-2 days before the start of a menstrual period and through the menstrual period to help reduce menstrual blood flow.
- Hormone medications: Birth control pills, including patches or rings containing hormones and progestin-only pills may help lessen heavy bleeding and pain
Therapeutic Procedures:
- Adenomyomectomy: Surgical removal of adenomyosis from the uterus.
- Hysterectomy: Surgical removal of the entire uterus may be an option if other treatment options are ineffective and severe pain persists.
It's important to note that these recommendations may vary depending on factors such as age, reproductive status, and clinical symptoms. It's best to consult with a healthcare professional for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.