Adenomyosis is a condition where endometrial tissue grows on the walls of the uterus, causing an enlarged and thickened uterus and significant pain. Symptoms include heavy periods, cramps, spotting, and pain during sex. Diagnosis is done through a pelvic exam, ultrasound, or MRI. Hysterectomy is a last resort treatment, and the condition resolves after menopause. The root cause is unknown, but it is more common in women who have had at least one child, especially via c-section.
Adenomyosis is a condition that affects the way the tissue lining the uterus, called endometrial tissue, grows. Instead of remaining as the uterine lining, endometrial tissue begins to grow on the walls of the uterus, leading to an enlarged and thickened uterus and significant pain. This should be thought of as distinct from endometriosis, where endometrial tissue can be found in other organs or other parts of the body. Adenomyosis affects only the uterus and almost always occurs in premenopausal women who have had at least one child.
The symptoms of this condition are often best noticed during menstruation. Periods can be very heavy, may contain blood clots, and may last longer than average. Cramps can be severe and instead of being limited to the first day or two of your period, they can last throughout your period. Women may also experience spotting or bleeding between periods, and many also report pain when having sex. Some also have a tender lower abdomen that may have a noticeable bulge or bump because the uterus is much larger than normal.
Women experiencing these symptoms should consult their doctors, as they can indicate more than one disease. Doctors usually diagnose adenomyosis by listening to the patient’s symptoms and doing a pelvic exam, which may indicate enlargement of the uterus. It is common for doctors to also order ultrasound scans (ultrasound of the pelvis) or magnetic resonance imaging (MRI). In rare cases, doctors may also want to take a sample of the uterine lining to rule out other conditions. There really isn’t a way to confirm the condition other than by ruling out other potential causes or by doing a hysterectomy and examining the uterus after removal.
One problem with attempting a diagnosis is that adenomyosis can be present alongside other conditions such as endometriosis. Confirming a second condition can be difficult. When doctors suspect that there are multiple conditions operating at the same time, they may recommend hysterectomy as it may be difficult to treat all of them.
While hysterectomy can be a treatment, it is usually a last resort choice. The condition resolves once menopause occurs, and many women can be helped by other measures that reduce pain and discomfort. These may include the use of anti-inflammatory pain medications before intercourse and during menstruation. Some women are helped by the use of birth control pills as these shorten periods.
Very little is known yet about the root causes of adenomyosis. People most at risk have had at least one child and may have had that child via cesarean section (c-section). There is strong evidence that estrogen plays a role in the development of this condition because it will improve once the body stops making estrogen and a woman is postmenopausal.
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