What is Adenomyosis
(the sister disease of Endometriosis)
Adenomyosis (ad-uh-no-my-O-sis) occurs when endometrial tissue, which normally lines the uterus, exists within and grows into the muscular wall of the uterus. The displaced endometrial tissue continues to act as it normally would — thickening, breaking down and bleeding — during each menstrual cycle. An enlarged uterus and painful, heavy periods can result.
Symptoms most often start late in the childbearing years after having children.
The cause of Adenomyosis remains unknown, but the disease typically disappears after menopause. For women who experience severe discomfort from Adenomyosis, certain treatments can help, but hysterectomy is the only cure.
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The severity of the signs and symptoms associated with Adenomyosis is often directly
proportional to the degree of involvement and penetration into the uterine muscle. The more the disease spreads, the greater the symptoms. Many patients with Adenomyosis can be without symptoms (asymptomatic) just like fibroids and Endometriosis, but most commonly women report the following symptoms associated with their enlarged uterus:
Symptoms
Sometimes, adenomyosis is silent — causing no signs or symptoms — or only mildly uncomfortable. In other cases, adenomyosis may cause:
- Heavy or prolonged menstrual bleeding - hypermenorrhea (heavy periods)
- Severe cramping or sharp, knifelike pelvic pain during menstruation (dysmenorrhea)
- Menstrual cramps that last throughout your period and worsen as you get older
- Blood clots that pass during your period and or large clots
- Unexplained bleeding between your periods
- Pain during sex, especially around the time of your period
- Swelling or tenderness in your lower belly
- Prolonged bleeding cycles
- Cramps
- Abdominal bloating
- Back pain
- Nausea and Vomiting
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.
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Statistics
- About 1 in 100 women will have Adenomyosis in their lifetime.
- Women in their 30s and 40s who have had one or more children are most at risk for adenomyosis and infertility.
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Testing
- A pelvic exam and ultrasound
- Magnetic resonance imaging (MRI) scans
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Adenomyosis Types
- The first type appears as solid tumors and are called Adenomyomas. This form of the disease is localized and is an encapsulated collection of endometrial cells with well defined borders. They appear much like fibroids and are often mistaken as such. Many can be safely removed from the uterus, but depending on size and location can the culprit of hysterectomy.
- The second, and more common type, is the diffuse disease that spreads out within the uterine myometrium. As the endometrial cells invade the organ, the uterus becomes enlarged and hardened, making pelvic exams and intercourse very painful. At the cellular level, the uterine muscle cells are being damaged as the disease spreads and eventually will lose their ability to stretch and contract. This is the main reason for the high rate of miscarriages during the 2nd and early 3rd trimester of pregnancy.
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Myths
- Only cure is by hysterectomy.
A skilled surgeon can do excision surgery, where they root out the disease inside the muscle wall of the uterus. This does depend on the severity of the disease and where it is located, as stated above in Adenomyosis's first type.
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