Uterine Adenomyosis

Uterine adenomyosis is a condition where tissue similar to the lining of your uterus (endometrium) grows into the muscular wall of the uterus (myometrium). This misplaced tissue responds to the hormonal changes of your menstrual cycle, just like the normal lining. However, since it’s located within the muscle wall, it can’t shed and is trapped. This can lead to a variety of symptoms, including heavy and painful periods, and a bulging or enlarged uterus.

Symptoms

Heavy menstrual bleeding with clotting
Pelvic pain, especially during menstruation
Pain during intercourse
Pressure or cramping in the lower abdomen
Pain in the lower back or legs
Irregular periods (less common)
Difficulty getting pregnant (less common)

Causes

The exact cause of adenomyosis is unknown. Some theories suggest that endometrial tissue implants itself in the muscle wall during menstruation, childbirth, or surgery. Others propose that stem cells within the uterus transform into endometrial tissue.

Diagnosis

Adenomyosis can be difficult to diagnose definitively. Doctors often rely on a combination of factors, including:

Pelvic exam: To check for an enlarged or tender uterus
Ultrasound: To visualize the thickness of the uterine wall
MRI scan: To provide a more detailed image of the uterus
Laparoscopy: A surgical procedure that allows a doctor to see inside the pelvis

Treatment

There is no cure for adenomyosis, but there are treatments that can help manage the symptoms. Treatment options depend on the severity of your symptoms and your desire for future pregnancy.

Pain medication: Over-the-counter pain relievers like ibuprofen or naproxen can help with cramps.
Hormonal therapy: Birth control pills, hormonal IUDs, or medications that suppress ovulation can help regulate periods and reduce cramping.
Gonadotropin-releasing hormone (GnRH) agonists: These medications put you into a temporary menopause-like state, which can shrink fibroids and adenomyosis. However, they have side effects like hot flashes and vaginal dryness.
Uterine artery embolization (UAE): This minimally invasive procedure involves blocking the blood supply to the uterus, which can reduce the size of adenomyosis and alleviate symptoms. It is a good option for women who want to preserve their fertility (Click here to read more on Uterine artery embolization for fibroids, adenomyosis)
Surgery: In severe cases, surgery such as myomectomy (removal of fibroids) or hysterectomy (removal of the uterus) may be an option.

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Uterine Adenomyosis