Adenomyosis – 8 Things You Need To Know
You may have heard of endometriosis but what about adenomyosis?
The two are similar however adenomyosis is strictly found in the uterus.
It’s a condition which causes cells that normally form a lining on the inside of the uterus to also grow in the muscle wall of the uterus damaging the uterine wall.
Endometriosis vs adenomyosis.
According to DrSeckin Endometriosis and adenomyosis are both metaplasia conditions, meaning that the diseased cells will change into the organs in which they invade. In the case of adenomyosis, this causes abnormal uterus cell growth.
It gets more complex, because women with adenomyosis often have endometriosis too, however they are different conditions.
Endometriosis is a condition in which fragments of lining of the uterus (endometrium) migrate into fallopian tubes, ovaries, vagina, and even the intestine where, still under influence of oestrogen and progesterone, they engorge with blood every month, irritating and scarring surrounding tissue. The same can happen with adenomyosis except the abnormal cells are found mostly within the muscle of the uterus. These can swell, blocking the fallopian tubes. (see diagram above)
Think of it as adenomyosis is more commonly internal of the uterus i.e the muscle and endometriosis is external.
However it is possible they can migrate.
Adenomyosis symptoms vary, whilst some experience symptoms that can impede their daily life, some women don’t experience symptoms at all.
Possible symptoms of adenomyosis include:
- Painful periods and cramps (dysmenorrhea)
- Heavy menstrual bleeding (menorrhagia), which can include clots
- Bleeding between periods
- Inflammation of the uterus
- Pain during bowel movements
- Bladder symptoms including uncomfortable urination (dysuria), burning urination or blood in the urine (hematuria)
- Peripheral nerve numbness or weakness (neuropathy), which can cause leg or bowel pain during periods
- Pain upon sexual intercourse (dyspareunia)
- Deficiency of blood cells or hemoglobin (anemia)
Who does it effect?
Studies have shown that adenomyosis occurs more often in women aged 40 to 50 and can worsen after each childbirth. Whilst endometriosis occurs more often in women who have not had children and between the ages 30s and 40s
It is possible (as in my case) to have it earlier or it could be that the endometriosis can then lead to adenomyosis and get progressively worse after each child.
What causes it?
There’s still a lot of research to be done to find out the specific cause of adenomyosis but they’re many theories.
According to DrSeckin, the first thing to note is that adenomyosis can form from endometriosis, by endometrial tissue extension from outside the uterus.
– Inflammation of the lining due to trauma or childbirth can cause cells to pass into the weakened muscle layer
– Cell migration in foetal life
– High levels of oestrogen cause stimulation of the migratory tissue into the myometrium
How is adenomyosis diagnosed?
There are a number of ways to diagnose the condition, but it can be difficult as other conditions have similar signs and symptoms. A doctor can base the diagnosis on the combination of increased bleeding and pain but a pelvic exam to help identify an enlarged and tender uterus can also help.
Ultrasound and magnetic resonance imaging (MRI) of the uterus are non-invasive ways to precisely identify where and how much adenomyosis is in the uterus.Though apparently not always effective.
Some Dr’s may offer a uterine biopsy which is an invasive way to diagnose adenomyosis.
So if you feel you are suffering with any of the symptoms who do you see?
First point of call is a GP, they will ask general questions and may do an examination, they’ll ofter some solutions or if they feel you require more attention they’ll refer you to a specialist. From here a Dr who specialises in gynaecology may do an internal examination, discuss the options and may recommend a scan, MRI or a biopsy if he/she feels it would pick up results.
Can it affect fertility?
Due to the nature and site of the condition it can affect fertility and decrease chances of conceiving. Although adenomyosis affects the uterus, the smooth tissue can swell and partially block the opening between the uterus and the Fallopian tubes thus limiting the chances of the egg being fertilised.
Another issue is that it is common for women with adenomyosis to also have endometriosis, so more areas of the reproductive system will be affected, decreasing fertility and in some cases, causing infertility.
How is adenomyosis treated?
Treatments vary depending on the individual, there’s no set procedure.
Anti-inflammatory drugs such as Mefenamic acid (a type of ibuprofen) are used to help with the pelvic pain and heavy menstrual bleeding. Hormone medication such as combined estrogen-progestin birth control pills, vaginal rings, or hormonal patches may help lessen the heavy bleeding and pain. Laparoscopic deep excision surgery in particular cases to remove adenomyoma or as an absolute last resort – hysterectomy.
During my research I found that Gabrielle Union has spoken publicly about being diagnosed with adenomyosis and has raised more awareness about the condition.
Despite having suffered 20 years with sever period pain resulting in numerous GP and hospital visits, this condition had never been mentioned to me before the end of last year, hence the research and this article.
I’m glad that adenomyosis is being highlighted and that there’s a diagnosis to put peoples minds at ease, especially those trying to conceive without success. It’s frustrating as it’s one of those conditions that isn’t easily identified or diagnosed but I hope this has been of some help.
I have a post coming which I share my experience of living with adenomyosis, when I first started having difficulties and what I changes I have made in my lifestyle to stop the pain and allow me to be discharged without any treatment. If you suffer with the above or endometriosis I recommend you check it out.
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