What is adenomyosis?
Adenomyosis is a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy periods. The condition can be located throughout the entire uterus or localized in one spot.
Though adenomyosis is considered a benign (not life-threatening) condition, the frequent pain and heavy bleeding associated with it can have a negative impact on a woman’s quality of life.
How common is adenomyosis?
Adenomyosis is most frequently seen in women in their early to middle 40s. Please discuss with your doctor for further information.
What are the symptoms of adenomyosis?
The common symptoms of adenomyosis are:
- Heavy or prolonged menstrual bleeding
- Severe cramping or sharp, knifelike pelvic pain during menstruation (dysmenorrhea)
- Menstrual cramps that last throughout your period and worsen as you get older
- Pain during intercourse
- Blood clots that pass during your period
- Your uterus may get bigger. Although you might not know if your uterus is enlarged, you may notice that your lower abdomen seems bigger or feels tender.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes adenomyosis?
The cause of adenomyosis isn’t known. Expert theories about a possible cause include:
- Invasive tissue growth. Some experts believe that adenomyosis results from the direct invasion of endometrial cells from the lining of the uterus into the muscle that forms the uterine walls. Uterine incisions made during an operation such as a cesarean section (C-section) may promote the direct invasion of the endometrial cells into the wall of the uterus.
- Developmental origins. Other experts speculate that adenomyosis originates within the uterine muscle from endometrial tissue deposited there when the uterus first formed in the fetus.
- Uterine inflammation related to childbirth. Another theory suggests a link between adenomyosis and childbirth. An inflammation of the uterine lining during the postpartum period might cause a break in the normal boundary of cells that line the uterus. Surgical procedures on the uterus may have a similar effect.
- Stem cell origins. A recent theory proposes that bone marrow stem cells may invade the uterine muscle, causing adenomyosis.
Regardless of how adenomyosis develops, its growth depends on the circulating estrogen in a woman’s body. When estrogen production decreases at menopause, adenomyosis eventually goes away.
What increases my risk for adenomyosis?
There are many risk factors for adenomyosis, such as:
- Prior uterine surgery, such as a C-section or fibroid removal
- Middle age
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is adenomyosis diagnosed?
Your doctor may suspect adenomyosis based on:
- Signs and symptoms
- A pelvic exam that reveals an enlarged, tender uterus
- Ultrasound imaging of the uterus
- Magnetic resonance imaging (MRI) of the uterus
In some instances, your doctor may collect a sample of uterine tissue for testing (endometrial biopsy) to verify that your abnormal uterine bleeding isn’t associated with any other serious condition. But, an endometrial biopsy won’t help your doctor confirm a diagnosis of adenomyosis. The only way to be certain of adenomyosis is to examine the uterus after surgery to remove it (hysterectomy).
Other uterine diseases can cause signs and symptoms similar to adenomyosis, making adenomyosis difficult to diagnose. Such conditions include fibroid tumors (leiomyomas), uterine cells growing outside the uterus (endometriosis) and growths in the uterine lining (endometrial polyps). Your doctor may conclude that you have adenomyosis only after determining there are no other possible causes for your signs and symptoms.
How is adenomyosis treated?
Treatment for adenomyosis depends in part on your symptoms, their severity, and whether you have completed childbearing. Mild symptoms may be treated with over-the-counter pain medications and the use of a heating pad to ease cramps.
- Anti-inflammatory medications. Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild pain associated with adenomyosis. NSAIDs are usually started one to two days before the beginning of your period and continued through the first few of days of your period.
- Hormone therapy. Symptoms such as heavy or painful periods can be controlled with hormonal therapies such as a levonorgestrel-releasing IUD (which is inserted into the uterus), aromatase inhibitors, and GnRH analogs.
- Uterine artery embolization. In this minimally invasive procedure, which is commonly used to help shrink fibroids, tiny particles are used to block the blood vessels that provide blood flow to the adenomyosis. The particles are guided through a tiny tube inserted into the vagina through the cervix. With blood supply cut off, the adenomyosis shrinks.
- Endometrial ablation. This minimally invasive procedure destroys the lining of the uterus. Endometrial ablation has been found to be effective in relieving symptoms in some patients when adenomyosis hasn’t penetrated deeply into the muscle wall of the uterus.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage adenomyosis?
The following lifestyles and home remedies might help you cope with adenomyosis:
- Soak in a warm bath.
- Use a heating pad on your abdomen.
- Take an over-the-counter anti-inflammatory medication, such as ibuprofen (Advil, Motrin IB, others).
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: September 12, 2017 | Last Modified: September 13, 2017
Adenomyosis. http://www.mayoclinic.org/diseases-conditions/adenomyosis/basics/definition/con-20024740. Accessed September 12, 2017.
What Is Adenomyosis? http://www.webmd.com/women/guide/adenomyosis-symptoms-causes-treatments#2. Accessed September 12, 2017.