Adenomyosis Vs Endometriosis: Differences Worth Knowing

Previously it was thought that endometriosis and adenomyosis, which are common hormonal diseases, were the same condition with the singular difference being that endometriosis develops outside the uterus and adenomyosis develops inside the uterus. However, further studies have revealed that these two conditions are very much different. A point to be noted here is that adenomyosis is sometimes referred to as internal endometriosis. Women can have both the conditions simultaneously or can have only one of these conditions.

Adenomyosis is a condition in which the lining of the uterus (endometrium) penetrates the muscular wall of the uterus (myometrium). Adenomyosis is completely limited to the inside of the uterus.

Adenomyosis is sometimes referred to as internal endometriosis. Adenomyosis develops when there is an imbalance in the levels of estrogen and progesterone in the body. This causes excessive growth of the inner surface of the uterus. If treatment is not started, then the endometrium infiltrates the muscle layer of the uterus.

Whereas, endometriosis develops when the endometrial cells start to develop outside the uterus. In endometriosis, there is increased production of estrogen or androgen due to which the mucous layer of the uterus grows into the peritoneum. Endometriosis can also develop when the menstrual blood gets thrown through the fallopian tubes and into the anterior region. All these factors cause the body of the uterus, the ovaries and other adjacent organs to function as endometrium. Endometriosis is considered very insidious, as the patient may not have any symptoms till this disease has reached its last stage.

As mentioned before, these 2 conditions are entirely different even though they do have some similarities. Adenomyosis is completely limited to being inside the uterus except in extremely rare cases. Whereas, endometriosis rarely develops inside the uterus; and instead can implant anywhere in the body. As a result of this, hysterectomy is considered a definite cure for adenomyosis, but not so for endometriosis. In endometriosis, an oophorectomy can be recommended, but not so in adenomyosis. Below we have drawn a parallel between these 2 conditions:

Adenomyosis: Adenomyosis occurs exclusively in the uterus only.

Endometriosis: Endometriosis commonly affects the fallopian tubes, the intestine, the outer shell of the uterus and other organs.

Adenomyosis: Adenomyosis affects only the inside of the uterus, which leads to enlargement of the uterus.

Endometriosis: The size of the uterus does not get affected with endometriosis; however, there can be development of adhesions, which joins the uterus to the surrounding organs and tissues.

Adenomyosis: Women with adenomyosis need not have other medical problems with adenomyosis.

Endometriosis: Women suffering from endometriosis are at an increased likelihood to develop other co-existing health conditions, such as chronic fatigue syndrome, auto-immune disorders, fibromyalgia, atopic diseases and endocrine diseases.

Adenomyosis: Adenomyosis symptoms are manifested sooner where the patient experiences prolonged monthly periods with pain.

Endometriosis: Endometriosis symptoms are gradual in developing and patient may not be aware of suffering from endometriosis, sometimes even till this disease has reached its last stage where there is presence of endometriomas (cysts).

Adenomyosis: Adenomyosis, in majority of the patients, can be diagnosed during tests such as ultrasound and hysteroscopy. An experienced gynecologist can diagnose Adenomyosis after internal exam of the patient.

Endometriosis: Endometriosis cannot be diagnosed with complete accuracy. The patient can be suspected to have endometriosis and tests, such as ultrasound scan also cannot reliably diagnose Endometriosis. Laparoscopy needs to be done for diagnosis of Endometriosis.

Adenomyosis: Medications are commonly used for treating Adenomyosis and these include hormonal drugs to suppress the production of hormones, such as estrogen and androgen. Progesterone may also be prescribed for treating Adenomyosis.

Endometriosis: Surgery for Endometriosis needs lot of care and the doctor has to remove or cauterize the origin or the focus of endometriosis. In endometriosis, conservative treatment is effective only in its initial stages.

Adenomyosis: Adenomyosis is also a dangerous disease; however, it does not affect the peritoneal organs and affects only the muscular layer of the uterus.

Endometriosis: If Endometriosis is not treated, then it can cause irreparable damage to the patient, such as thickening of fluid, adhesions, infertility and also fusion of the abdominal organs.

Both these conditions, i.e., Adenomyosis and Endometriosis do share some similarities such as:

• Both of these diseases are hormonal in nature with the cause being increased level of estrogen.
• Trauma to the uterus, such as a cesarean is thought to trigger both these conditions.
• Adenomyosis and Endometriosis affects women of child-bearing age and can cause infertility.
• Other common symptoms which both Adenomyosis and Endometriosis share include: Painful with urination, bowel movements and intercourse. Generalized pain in the pelvis, bloating, lower backaches and heavy menstruation.
• Even the initial treatment course for both Adenomyosis and Endometriosis is similar and can include birth control pills, progesterone/progestin treatment, an IUD, aromatase inhibitors, GnRH agonists, pain medications or anti-inflammatory drugs.
• There is a chance of relapse in both Adenomyosis and Endometriosis even after complete cure has been achieved.

So, we can safely say that these 2 diseases are completely different. Nevertheless in some cases even a specialist can find it difficult to get a correct diagnosis. So it is important to not ignore the symptoms and follow doctor’s advice and get timely checkups, tests and treatment to fight these 2 hormonal evils, which are Adenomyosis and Endometriosis.