Adenomyosis is a condition affecting the uterus. It causes the inner lining of the uterus to grow into the muscular layer. It occurs in the late menstrual age (40s and 50s) and disappears following menopause.
The uterus has an inner lining (endometrium), which every woman sheds during menstrual cycles.
In adenomyosis, the endometrium grows inside the muscular layer of your uterine wall (myometrium). The invading endometrial tissues behave ordinarily within the muscles – thickening, bleeding, and shedding – during the menstrual cycles. It enlarges the uterus and causes painful and heavy menstrual flow.
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What can cause adenomyosis?
- ● Fetal growth
According to some experts, the endometrium encroaches into the uterine muscles as the fetus develops in the uterus.
- ● Childbirth
During childbirth, the uterine lining can get inflamed. The inflammation can cause a breach of the structure of your uterus. It can cause the endometrium to migrate deeper into the walls.
- ● Traumatic invasion
Trauma to the uterus, such as incisions made in the walls during surgeries involving the uterus, is another theory for causing adenomyosis. The incisions promote the inner lining to invade into the muscles as healing occurs.
- ● Stem cell
Some experts believe the bone marrow cells proliferate into the wall and exist within, causing symptoms.
Irrespective of the cause of adenomyosis, the symptoms depend on estrogen levels in your body. It is the reason why it occurs predominantly at late menstrual ages, as the hormonal exposure is higher.
What are the symptoms of adenomyosis?
- ● Prolonged period
- ● Heavy flow during periods
- ● Severe abdominal cramping and pain
- ● Pain during intercourse
- ● Enlarged uterus
- ● Tenderness on the lower abdomen
How to diagnose adenomyosis?
Imaging studies such as MRI and ultrasound scans may detect signs of adenomyosis.
Your doctor may also advise a biopsy study of the uterine lining in case of heavy bleeding to rule out severe conditions. However, a biopsy cannot confirm the diagnosis of adenomyosis.
The only means of a definitive diagnosis is through a uterus exam following hysterectomy (surgical removal of the uterus).
How is adenomyosis treated?
- ● Pain relievers
Anti-inflammatory drugs can manage your pain symptoms during the menstrual cycles. Your doctor can prescribe to take these medicines a few days before and during the period to help control the pain.
- ● Hormonal replacements
Hormonal replacement drugs can reduce the menstrual flow and also help with pain during menstrual cycles. A combination of estrogen-progestin oral contraceptive pills is a popular choice to relieve the symptoms. Intrauterine devices can also provide a hormonal replacement. These treatments help regulate the estrogen levels to manage your symptoms.
- ● Ablation therapy
Ablation therapy is a technique that removes the endometrial lining of your uterus. It can reduce the menstrual flow, even stopping the flow altogether in some cases. It is not always effective as the endometrium exists within the muscle layer in adenomyosis.
- ● Hysterectomy
In severe cases, the bleeding can cause chronic anemia and other life-threatening medical conditions. Hysterectomy is the only cure available for adenomyosis in such cases.
What is the result?
In extreme cases with severe bleeding, there is a health risk due to blood loss. A hysterectomy may be the only curative option in such cases.
What are the risks of surgery?
- ● Infection
- ● Excessive blood loss
- ● Reaction to anesthesia.
In the long term, loss of the uterus can cause:
- ● Prolapse of the pelvic floor
- ● Loss of control over urine, involuntary leakage
- ● Bowel incontinence
- ● Difficulties with intercourse
- ● Hormonal imbalance
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Is Adenomyosis Painful?
Is Adenomyosis the Same as Endometriosis?
Is Adenomyosis Serious?
Severe blood loss during periods can put you at risk of developing chronic anemia.