Adenomyosis - What are the symptoms, causes, and treatment?

Obstetrics and Gynaecology | Posted on 12/06/2022 by Dr. Tripti Dadhich

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Are you experiencing heavy and painful periods? Did you know that it can be a sign of Adenomyosis? It is a less-known reproductive condition causing painful and heavy periods. Adenomyosis also leads to affecting the daily life of a woman specifically around pregnancy and having children.

Even though Adenomyosis is viewed as a common (not perilous) condition, the continuous agony and upsetting experience related to it can negatively affect a female. It is often found in 30-50-year-old women who have given birth.

About 15% of them have endometriosis, and about 50% of them have hysteromyoma. At present, the treatment of Adenomyosis is a global problem. Due to the unclear cause or origin of the disease, we should raise awareness of this disease for active treatment. Hence, in this write-up, you will find comprehensive information about Adenomyosis, make sure to read till the end.

What is Adenomyosis?

Adenomyosis is a reproductive condition among females wherein the inward coating of the uterus (the endometrium) gets through the muscle mass of the uterus (the myometrium). Endometriosis and Adenomyosis disorders occur simultaneously. So, when we talk about endometriosis then it causes menstrual spasms, lower stomach pressure, and swelling before menstrual periods and can bring out overwhelming period experience. The condition can be situated all through the whole uterus or restricted to one spot.

What are the Adenomyosis symptoms?

Some women experience Adenomyosis symptoms and some do not. However, the common symptoms of the condition are:

Progressive dysmenorrhea: 50% of Adenomyosis patients have dysmenorrhea, coital pain, pelvic pain, and other uncomfortable symptoms. Dysmenorrhea is a typical symptom of Adenomyosis, which is secondary and progressive. It usually appears one week before menstruation. When menstruation ends, dysmenorrhea patients find relief. Before menstruation or during the menstrual period, due to the bleeding of the focus, the blood stays in the dense muscle layer which causes the pressure to increase sharply and stimulates the peripheral smooth muscle causing spasmodic contraction, and abdominal pain.

Menstrual disorders: Dysmenorrhea is the primary symptom of Adenomyosis, which is mainly exhibited by increased menstrual volume and prolonged menstruation. On the one hand, the increase in menstrual volume is due to the expansion of the uterus and the consistent growth of the endometrial area. On the other hand, the infiltration of the endometrium and the proliferation of fibromuscular bundles interfere with the normal contraction and hemostasis of the myometrium.
Increased menstrual volume: About 40-50% of the experience increased menstrual volume symptoms, which shows that the menstrual volume increases in the menstrual cycle for several consecutive months.
Anemia: Female anemia is mostly due to excessive menstruation. Excessive menstruation means excessive blood loss, and the body's own hematopoiesis (the formation of blood cellular components) function cannot keep up with the speed of blood loss, which may lead to anemia symptoms. Menorrhagia is also a common symptom of Adenomyosis, so anemia is more common.
Infertility: Generally speaking, serious Adenomyosis, especially the patients with endometriosis experience infertility. Because this kind of patient with thickened uterus often has pelvic adhesion, which is not conducive to ovarian ovulation and embryo implantation, and the natural pregnancy rate declines.

What are the causes of Adenomyosis?

Inactive tissue growth - When there is a direct invasion of endometrial cells from the lining of the muscle that forms the uterus walls, there are increased chances of Adenomyosis. So, in case of a C-section, when there are any uterine incisions made, it might be one of the causes.
Another cause as per Gynae experts, Adenomyosis originates from the uterine muscle where the fetus first developed.
Inflammation of the uterine lining during the postpartum period causes a break in the normal boundary of the lining cells of the uterus. Surgical procedures can also have a similar effect and progress in such conditions.
The risk factors for Adenomyosis include prior uterine surgery, childbirth, and middle age. Most cases are found in women who are in their 40s and 50s. Recent studies have also claimed that it is quite possible in younger women.

What is the difference between Adenomyosis and endometriosis?

Adenomyosis and endometriosis are reproductive disorders among females involving the endometrial tissue. Both conditions are painful and in both disorders, females experience heavy menstrual bleeding. The only difference between these two conditions is the growth of endometrial tissue.

In Adenomyosis, endometrial tissues develop into the uterus muscles, and in endometriosis, tissue develops outside the uterus. However, endometriosis also involves other reproductive organs such as pelvic side walls, bowel, fallopian tubes, and ovaries.

How is Adenomyosis diagnosed?

The Adenomyosis diagnosis is initiated on the basis of symptoms experienced by an individual. So, here are the tests, your doctor might order for the appropriate diagnosis:

A pelvic exam is initiated in which the doctor will observe your uterus and see if it has become softer or larger, or painful when palpated.
Ultrasound is recommended as it will allow the doctor to view pelvic organs through images.
Imaging scans such as Magnetic resource imaging or MRI are also ordered to view the uterine expansion and thickening of uterus areas indicating Adenomyosis.
A biopsy is recommended to identify if there is a growing of tissue across the uterus walls.

What are the Adenomyosis treatment options?

Women with normal symptoms of Adenomyosis condition may not require medicinal treatment. Your primary care physician may suggest Adenomyosis treatment if your signs interfere with your daily life.

Medicines and treatment options for decreasing the side effects of Adenomyosis incorporate:

Medication: Ibuprofen is recommended as it helps in lessening the bloodstream during your period while additionally easing extreme issues. The medication is not recommended for women who are pregnant so always get in touch with your doctor before consuming it.
Hormonal medications: These incorporate oral contraceptives such as anti-conception medication pills, progesterone contraceptives (oral, infusion, or an intrauterine gadget), and GnRH-analogs, for example, Lupron (leuprolide). Hormonal medications can control expanded estrogen levels that might contribute to side effects.
Endometrial removal: This includes systems to expel or eliminate the endometrium It's an outpatient methodology with a short recovery time. Nonetheless, this method may not work for everyone, since Adenomyosis often attacks the muscle deeply.
Uterine embolization: Uterine embolization is normally used to treat another condition, called uterine fibroids. The strategy is performed in an emergency clinic. It typically includes remaining medium-term a short time later. However, it can be an alternative treatment option for Adenomyosis. Since it's insignificantly intrusive, it maintains a strategic distance from scar development in the uterus.
Hysterectomy: The best way to fix this condition is to have a hysterectomy. This includes the total careful removal of the uterus. It's viewed as a significant careful intervention and is used in life-threatening cases and for females who don't plan to have kids in the future.

Final thoughts

Adenomyosis is usually ignored when females seek pelvic pain treatment. In addition, endometriosis and Adenomyosis are disorders that frequently occur at the same time. So, chances are if you have endometriosis, you may also have Adenomyosis. The only difference is that the other condition is not well-known.

When the condition begins to disrupt your daily life, make sure to speak to your healthcare provider that will help in easing out the symptoms. The doctor will prescribe the right treatment and medications based on the symptoms.

FAQs

Is Adenomyosis dangerous?

Adenomyosis is a reproductive condition among women that is usually not harmful. However, some women might experience severe pain and too much bleeding during their periods causing disruption in their daily life.

How common is Adenomyosis?

Most women are not aware of Adenomyosis condition as it doesn’t cause noticeable symptoms and this is the main reason that the condition is uncommon. It affects around 20%-65% of females and most of them don’t even know.

Can I exercise if I have Adenomyosis?

It is not known what kind of impact exercise can cause among females having Adenomyosis condition. However, it will surely help in improving the symptoms and life quality. Also, exercise is recommended by the doctor to patients as part of their post-treatment plan.