Adenomyosis is a condition in which the endometrial tissue – the tissue that lines the uterus – grows into the muscular walls of the uterus. Endometrial tissue, whether it’s lining the uterus or embedding itself into the uterine walls, responds to your body’s hormones by thickening, breaking down, and bleeding with each menstrual cycle. As a result, women with adenomyosis can have heavier and more painful periods.
Symptoms of Adenomyosis
Luckily, adenomyosis is not a life-threatening condition. Some cases of adenomyosis have no symptoms at all, while others can seriously impact your quality of life. Symptoms may include:
- Heavy periods
- Long-lasting periods (longer than 5 days)
- Severe cramping
- Difficulty becoming pregnant
Adenomyosis is most commonly diagnosed in women who have been pregnant and women over the age of 35. It’s often misdiagnosed as uterine fibroids, a condition with similar symptoms but a very different course of treatment. It used to be quite difficult to diagnose adenomyosis, but today we have a few tests that can help detect the disease.
If you are experiencing some unusual menstrual symptoms, make an appointment with us. We can perform a pelvic exam and ultrasound to examine the uterine lining and the muscular walls more closely. In some cases, we will inject saline solution into the uterus and perform an ultrasound – this is called a sonohysterography.
If the ultrasound reveals conditions consistent with adenomyosis, we can perform an MRI to confirm the diagnosis.
Your OB-GYN can help you decide the best course of treatment for you, based on the severity of your symptoms and whether you’d like to become pregnant in the future.
If your symptoms are mild, over-the-counter pain relief drugs and heating pads can help you manage your discomfort.
Prescription pain relief
Your doctor may prescribe you stronger NSAIDs (nonsteroidal anti-inflammatory drugs). You can usually take these for 3-5 days during the most painful time of your period.
Many women have had success controlling their heavy and painful periods with an IUD, GnRH agonists, or aromatase inhibitors. There are many types of hormone therapies available, and some may act as contraception against pregnancy. Talk with your OB-GYN about your options and your family planning needs.
Uterine artery embolization.
This is a procedure in which tiny particles are inserted into the blood vessels to slow or stop blood flow to the uterus. This can shrink the adenomyosis and reduce your symptoms. It’s a minimally-invasive procedure that can be performed on an outpatient basis. It’s not yet well-known how having a UAE will affect a woman’s chances of becoming pregnant or carrying a pregnancy to term.
An endometrial ablation will destroy the uterine lining. It can treat adenomyosis if the endometrial tissue hasn’t grown too deeply into the muscular uterine wall. Ablation can significantly impact your future fertility, and is only recommended if you no longer wish to become pregnant.
This is the complete surgical removal of the uterus. Sometimes the ovaries are removed as well. Usually, a hysterectomy is only performed if your symptoms are very severe and they aren’t responding to other treatments. After a hysterectomy, you will no longer be able to become pregnant.