Adenomyosis is a condition where endometrial tissue, similar to the endometrium, grows inside the uterine muscular wall. Adenomyosis doesn’t cause cancer. It’s currently unknown how many people have adenomyosis, and around one in three people with adenomyosis experiences no symptoms or very mild symptoms.
What causes adenomyosis?
The cause of adenomyosis is currently unknown, but a few explanations suggest that it is due to hormones, genetics, stem cells, or retrograde menstruation, when menstrual blood and uterine tissue flow backward through the fallopian tubes instead of out of the body. It might also be caused by pregnancy, such as if endometrial tissue is deposited in the uterus during fetal development or inflammation in the lining of the uterus after childbirth. The growth of the endometrial tissue is dependent on estrogen, and women who have had more estrogen exposure, like older women, may have a higher risk of developing adenomyosis.
What are the risk factors for adenomyosis?
A few risk factors for adenomyosis include childbirth, which can include complications discussed above, prior uterine surgery like a c-section, high estrogen exposure, and other uterine conditions like endometriosis and uterine fibroids. Middle-aged women, around age 35-50, are most likely to experience adenomyosis.
How do you diagnose adenomyosis?
Adenomyosis is typically first suspected from pelvic exams and symptom history, and is confirmed using a transvaginal ultrasound or a pelvic MRI to see if your uterine wall is thicker, a typical sign of adenomyosis. Since it is common for someone to have many uterine conditions at once, like endometriosis and uterine fibroids, it can be harder to diagnose.
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Most women who have adenomyosis are around the ages of 35-50. But is adenomyosis limited only to middle-aged women? Symptoms typically get worse over time, so it’s likely that when symptoms get bad enough to seek help, most patients are already middle-aged. Thus, mostly middle-aged women are the ones getting diagnosed, making it seem like adenomyosis is mostly prevalent in middle-aged women. In reality, there might be many younger or older women who are affected by adenomyosis but just aren’t officially diagnosed.
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What are the symptoms of adenomyosis?
The symptoms of adenomyosis tend to worsen over time. A few examples of symptoms that one might experience are unusual and painful periods(dysmenorrhea) with heavy or prolonged menstrual bleeding(menorrhagia) with clotting, abdominal or pelvic pain, painful sex(dyspareunia), and infertility. It’s also common to have a tender or enlarged uterus that’s caused by the endometrial tissue breaking down during menstruation. An enlarged uterus can also cause bloating or adenomyosis belly, which looks like a pregnant belly.
What can you do to manage adenomyosis?
While the only way to permanently treat adenomyosis is through a hysterectomy, removal of the uterus, there are many other ways to manage symptoms, including: medication like NSAIDS, hormonal treatments to reduce pain and bleeding, and surgery and procedures, like an adenomyomectomy, the removal of adenomyosis from the uterine muscle. Adenomyosis symptoms typically end at menopause.
What is the outlook for someone with adenomyosis?
It’s possible to have adenomyosis and experience little to no symptoms at all. But those who do can experience complications such as anemia(lack of healthy blood cells to transport oxygen throughout the body), problems during pregnancy, miscarriage, pre-term birth, and babies that are too small. These can cause lifestyle disruptions, increased anxiety, concern about a cycle, and missing activities.
How is it different from endometriosis?
If you’re familiar with endometriosis, you’ll know that endometriosis is when the endometrium grows outside of the uterus. Adenomyosis also involves the endometrium or endometrial tissue growing in the wrong place, but in the uterine muscular wall, instead of outside of the uterus, like in endometriosis.
Difficult Words:
C-section: Stands for “caesarean section.” Definition: A surgical procedure that allows a baby to be delivered through a cut made in the mother’s abdomen and uterus.
Endometriosis: Pronounced: “En-do-ME-TREE-o-sis.” Definition: A disease commonly found in women and girls of reproductive age, see article.
Endometrium: Pronounced: “en-dow-MEE-tree-umm.” The inner lining of the uterus that is regrown and then shed during the menstrual cycle to prepare for possible pregnancy.
Estrogen: Pronounced: “EH-struh-jin.” Definition: The sex hormone that develops and regulates the female reproductive system.
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Fibroids: Pronounced: “FAI-broydz” Definition: Non-cancerous growth of smooth muscle cells and connective tissue in the uterine wall.
Infertility: Pronounced: "in-fir-TI-luh-tee." Definition: The inability of someone to have a baby.
Inflammation: Pronounced: “IN-flam-ma-TION.” Definition: When a part of the body becomes reddened, swollen, hot, and painful. Caused by injuries or infection. Example: When you twist your ankle, it becomes swollen and painful. Your body is reacting to something being wrong.
Menopause: Pronounced: “Me-NO-pause.” Definition: The time during a woman’s life when menstruation stops permanently, and you can no longer get pregnant. This normally happens around 50.
Menstruation: Pronounced: “men-STUR-a-tion.” Definition: The process where a woman discharges blood and other materials lining the uterus. This happens about once a month from puberty until menopause. Menstruation stops during pregnancy.
MRI: Stands for “magnetic resonance imaging.” Definition: a medical examination using magnetic resonance imaging to produce an image.
NSAIDs: Stands for "non-steroidal anti-inflammatory drugs." Definition: a therapeutic drug that reduces pain; some can be found over the counter for fevers, inflammation, and pain.
Ultrasound: Pronounced: “UHL-tra-sound.” Definition: An imaging test that uses sound waves to take pictures of the inside of your body, like organs and tissue.
Sources:
https://my.clevelandclinic.org/health/diseases/14167-adenomyosi
https://www.mayoclinic.org/diseases-conditions/adenomyosis/symptoms-causes/syc-2036913
https://www.hopkinsmedicine.org/health/conditions-and-diseases/adenomyosis