What is adenomyosis?
Adenomyosis or uterine adenomyosis is a benign (noncancerous) condition in which the inner lining of the uterus (endometrium) grows into the muscular layer of the uterus (myometrium). Adenomyosis is a benign condition. It is not generally life-threatening.
Adenomyosis or uterine adenomyosis is a benign (noncancerous) condition in which the inner lining of the uterus (endometrium) grows into the muscular layer of the uterus (myometrium). Since the endometrium at the abnormal site retains its ability to change (thicken, break down and bleed) during the menstrual cycle, adenomyosis results in heavy and painful menstrual periods. Adenomyosis generally affects women in the age group between 40 and 50 years old. About 80 percent of women with this condition have a history of childbirth. The exact cause of adenomyosis is not known, but some of the conditions that may increase the risk of adenomyosis are
- Middle age
- Childbirth
- Surgery on the uterus (such as cesarean delivery, dilatation and curettage and fibroid removal surgery)
- Early age of the onset of the menstrual cycle
- Short menstrual cycle
- Hormonal imbalance
- Inflammation of the uterus
What are the symptoms of adenomyosis?
The symptoms of adenomyosis include
- Pain and cramps during periods (dysmenorrhea)
- Heavy and prolonged menstrual bleeding
- Pain during sexual intercourse (dyspareunia)
- Chronic lower belly pain
- Swollen or bloated belly
- Pressure in the lower abdomen and pelvic region
Is adenomyosis serious?
Adenomyosis is a benign condition. It is not generally life-threatening. Nonetheless, prolonged and heavy bleeding can cause anemia, which can present with symptoms (such as fatigue, mood changes and dizziness). Other symptoms, such as severe pain during periods and sexual intercourse, may adversely affect the quality of life. Adenomyosis is also associated with several other problems, such as irritability, poor concentration, anxiety and depression. With adequate medical management, most of these problems can be controlled. The symptoms generally subside after menopause. The painful sexual intercourse may pose some problems in conceiving. However, adenomyosis is not associated with infertility or poor pregnancy outcomes.
How is adenomyosis treated?
The most definitive cure of adenomyosis is the surgical removal of the uterus (hysterectomy). Medications can control the symptoms in most women. The symptoms generally subside after menopause. Hence, the treatment of adenomyosis depends on factors, such as the severity of symptoms and how close the woman is to menopause.
The treatment options include
- Medications to control pain: These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.
- Hormonal medications: They include birth control pills, intrauterine devices (IUDs, especially the progesterone containing IUDs), hormone-containing patches and vaginal rings. The doctor may prescribe leuprolide, which is a medicine to stop ovaries from producing the hormones estrogen and progesterone.
- Uterine artery embolization: This is a surgical procedure in which particles are guided through a tiny tube inserted by the radiologist into the patient’s thigh to cut off blood supply to the adenomyosis. This shrinks the abnormal tissue and controls the symptoms.
- Endometrial ablation: This is a surgical procedure to destroy or scar the lining of the uterus.
- Hysterectomy: If none of the conservative options control the symptoms, a hysterectomy may be done.