Adenomyosis is a condition in which endometrial tissue grows into the muscular walls of the uterus. The most commonly affects women aged 35-50.
Adenomyosis is not the same as endometriosis, a condition in which the endometrium is located outside the uterus, although women with adenomyosis often have endometriosis. The cause of adenomyosis is unknown, but the disease usually disappears after menopause. For women who have more severe difficulties there is treatment that can alleviate the symptoms, but hysterectomy is the only cure.
Although adenomyosis can be quite painful, condition is generally harmless.
In some women, adenomyosis causes no symptoms or a mild discomfort . However, some women may have:
• difficult periods
• severe cramping or sharp pelvic pain during menstruation (dysmenorrhea)
• menstrual cramps that worsen with age
• pain during sex
• bleeding between periods
• blood clots in menstrual blood
The uterus can be increased two or three times of its normal size. Although you might not know that the uterus increases, you may notice that the lower part of the abdomen is bigger or have a feeling of bloating.
Invasive tissue growth
Some experts believe that adenomyosis is due to direct invasion of endometrial cells from the surface of the uterus in the muscle wall of the uterus. The incisions in the uterus made during surgery, such as caesarean section, may cause direct invasion of endometrial cells in the wall of the uterus.
Other experts speculate that adenomyosis is due to endometrial tissue stored from the first formation of the uterus of female fetuses.
Inflammation of the uterus associated with childbirth
Another theory suggests a link between adenomyosis and childbirth. Inflammation of the uterus after childbirth can cause disruption of normal cells that line the edges of the uterus.
No matter how adenomyosis develops, its development depends on circulation of estrogen in the body. When production of estrogen in menopause is reduced, adenomyosis disappears.
Although not harmful, pain and bleeding associated with adenomyosis can have a negative impact on the daily lives. Painful periods can cause inability to perform duties. Recurring pain can lead to depression, irritability, anxiety and feelings of helplessness. That is why it is important to seek medical help if you suspect that you may have adenomyosis.
Tests and diagnosis
Your doctor can make a diagnosis based on:
• pelvic examination
• Magnetic resonance imaging (MRI ) of the uterus
In rare cases, the doctor may take a sample of endometrial tissue for a biopsy to check whether abnormal bleeding is associated with something else. However , a biopsy will help the doctor to confirm the diagnosis of adenomyosis. The only way to confirm a diagnosis is microscopic examination of tissue after removal of the uterus (hysterectomy).
Many women have uterine diseases that cause symptoms similar to adenomyosis, making it difficult to diagnose adenomyosis. These include fibroid tumors, endometriosis, and growths in the uterine lining. A doctor can diagnose adenomyosis after having checked that there are no other causes of the symptoms.
Treatments and drugs
Adenomyosis usually disappears after menopause, and treatment may depend on the stage of life.
If you are close to menopause, your doctor may try treatment with anti-inflammatory medications for pain control. You start therapy two to three days before menstruation and continue throughout the period.
Controlling menstrual cycle with combined oral contraceptives, contraceptive patches or vaginal ring can reduce heavy bleeding and pain.
If the pain is severe, and menopause onset is not close, the doctor may suggest removal of the uterus (hysterectomy). Ovary removal is not necessary.