Adenomyosis is a common disorder in which the tissue that normally lines the womb grows inside the muscular walls of the womb. The resultant extra tissue leads to a painful menstrual cycle and pelvic pain. This disease is also known as uterine endometriosis.
Adenomyosis is benign in nature, i.e. it is not cancerous. Adenomyosis results in swelling up of the uterus, sometimes to even two or three times its original size. It generally affects women over the age of 35. Adenomyosis is more common in women with high levels of estrogen. This condition disappears after menopause (a year after a woman’s final period), this is because estrogen levels drop after menopause.
The exact cause of Adenomyosis is not known, but research points out to the following factors:
The factors below enhance the risk of adenomyosis:
It is possible that one may not experience any symptoms at all, while on the other hand some women may experience mild to severe symptoms. Most of the symptoms are related to the menstrual cycle.
Symptoms during menstrual cycle:
Other symptoms affect the abdomen area:
Diagnosis of adenomyosis can be difficult, mainly due to the fact that there are some conditions (fibroids and endometriosis) which exhibit similar symptoms. Also, before the advent of MRI scans and Ultrasound imaging the only way to diagnose adenomyosis was hysterectomy.
Let’s discuss these procedures in detail:
Ultrasound: The ultrasound technique used to diagnose adenomyosis is known as transvaginal ultrasound scan. Here the doctor inserts the ultrasound device 2-3 inches into the vaginal opening in order to ascertain the disorder.
MRI: If the doctor is unable to determine adenomyosis with ultrasound he/she may order a MRI scan of the uterus. It should be noted that MRI is not an option pregnant women.
The method of treatment depends on factors such as:
Anti-inflammatory medicines :If the patient is nearing menopausal age then anti-inflammatory medicines can be used to subdue the pain till she reaches menopause. Anti-inflammatory drugs reduce the menstrual blood flow and help in controlling the pain. The medicines should be taken 2-3 days before the start of the menstrual cycle and should be continued in the cycle as well.
Hormone medications:Hormone medications include birth control pills containing combined estrogen-progestin, vaginal rings and hormone containing patches. They are used to lessen the severe bleeding & pain associated with adenomyosis. Progestin only birth control pills are known to cause absence of menstrual periods which may help in providing relief from symptoms.
Specific surgical treatment for women requiring conservation of uterus : Women experiencing symptoms due to adenomyomas – the focal region of adenomyosis resulting in a mass, may undergo laparoscopic resection or removal of these lesions. This procedure does not involve removal of uterus and thus preserves fertility and uterine function.
Hysterectomy :If your pain is extremely severe and menopause is years away then hysterectomy is considered. Hysterectomy is the only treatment to completely cure adenomyosis. Hysterectomy is a procedure wherein the womb/uterus is removed, therefore such an option should be only pursued to if the patient as no desire of childbirth. Your ovaries are not affected by adenomyosis and can be left in the body.