Adenomyosis 101

Adenomyosis is not a life-threatening condition. However, it causes a great deal of pain and heavy bleeding which has a negative impact on the quality of a woman’s life.  There are many symptoms including heavy, prolonged menstrual bleeding, severe menstrual cramps that can feel like a knife, chronic pelvic pain, and abdominal pressure or bloating.

Who Does Adenomyosis Effect

Adenomyosis is most often diagnosed in middle-aged women and women who have had children. Some studies also suggest that women who have had prior uterine surgery may be at risk for adenomyosis. The growth of adenomyosis depends on the amount of estrogen in a woman’s body.  There can be multiple causes which include:

  • Fetal development
  • Invasive tissue growth
  • Uterine inflammation
  • When bone marrow stem cells invade the uterine muscle

Diagnosing adenomyosis

Adenomyosis is often misdiagnosed as uterine fibroids. While fibroids are benign tumors growing in or on the uterine wall, adenomyosis is less of a defined mass of cells within the uterine wall. An accurate diagnosis is key in choosing the right treatment. When the patient is experiencing heavy, painful menstruation, the physician will perform a physical exam of the pelvis to determine if the uterus is enlarged.

Imaging technology has made it possible for the physician to diagnose with an MRI or a sonohysterography. A sonohysterography is when saline solution is injected through a tiny tube into the uterus as an ultrasound is performed.

Adenomyosis treatment

Complete removal of the uterus such as a hysterectomy was for many years the only solution. It remains the only definitive treatment. However, there are other means of treatment that can be prescribed:

  • Anti-inflammatory medications
  • Hormonal medications
  • Uterine artery embolization

When to see a doctor for treatment

Typical it is recommended a woman sees her physician when there is heavy bleeding and cramping that interferes with her usual activities. Adenomyosis and endometriosis are similar, but adenomyosis is typically seen in women in their 40s and 50s.  Adenomyosis will go away when a woman reaches menopause.