What is Adenomyosis & How is it Treated|Symptoms, Causes, Prognosis of Adenomyosis

What is Adenomyosis?

Adenomyosis is a pathological condition in which the tissues that line the uterus encroach upon the muscles of the uterus. This results in abnormal thickening of the uterine walls causing longer than usual menstrual bleeding associated with severe abdominal pain. Adenomyosis may also result in painful sexual intercourse. There is no known cause for Adenomyosis, although it is noted to be present more in females with increased levels of estrogen. Adenomyosis usually goes away on its own after a woman reaches menopause, as this is the time when the estrogen levels start to decline. Some of the theories which are going around regarding the causes of Adenomyosis are presence of extra tissues around the uterine wall which may be present before birth and grow as the child grows, growth of abnormal tissues from endometrial cells encroaching the uterine muscles which can be due to an incision made in the uterus at the time of a Cesarean delivery of a baby.

What is Adenomyosis?

What are the Causes of Adenomyosis?

As stated, above, there is no known cause of Adenomyosis, although there are certain factors which put a female at a greater risk for having Adenomyosis. These factors are:

  • Women aged between 35 and 50 years are more prone to suffering from adenomyosis.
  • Women having children are also at risk of suffering from adenomyosis.
  • Having had a previous surgery of the uterus puts you at a risk of suffering from adenomyosis.
  • Having had a previous Cesarean delivery.

What are the Symptoms of Adenomyosis?

Some of the symptoms of Adenomyosis are:

  • Prolonged menstrual cramping can be a symptoms of adenomyosis
  • Spotting between menstrual cycles
  • Heavy menstrual bleeding
  • Longer than normal menstrual cycles
  • Clots during menstrual bleeding can also be a symptom of adenomyosis.
  • Painful sexual intercourse
  • Abdominal tenderness.

How is Adenomyosis Diagnosed?

In order to formulate the best treatment course for Adenomyosis, a complete and thorough physical examination needs to be conducted. The physician will first determine if the uterus is swollen or enlarged by doing a physical examination. A physical examination is good enough as it will show the size of the uterus to be abnormally high. The physician may also order an ultrasound for diagnosis of the condition and rule out other conditions that may be causing the symptoms. Imaging studies in the form of an MRI or CT scan will also be done to look at the uterus to see if there is presence of any tumors causing the symptoms or whether the uterus is swollen or enlarged. These above tests are good enough to confirm the diagnosis of Adenomyosis.

How is Adenomyosis Treated?

Mild forms of Adenomyosis do not generally require any treatment. Treatment will only be required in case if the condition of adenomyosis interferes with the daily routine of the patient. Some of the treatments for Adenomyosis are:

Antiinflammatory Medications to Treat Adenomyosis: Medications like Tylenol or Advil are given for controlling pain and calming down the inflammation. These medications also help in slowing down the blood flow during menstrual periods and also help with menstrual cramping.

Hormonal Treatments to Treat Adenomyosis: These treatments consist of oral birth control pills, placement of an intrauterine device), or medications like Lupron. These medications lead to decreased level of estrogen and thus control Adenomyosis.

Endometrial Ablation for Treating Adenomyosis: This is a procedure in which the entire endometrium is destroyed thus destroying Adenomyosis.

Uterine Artery Embolization: This is a procedure which prevents certain arteries to supply blood to the affected region and thus shrinking the Adenomyosis

Hysterectomy: This is by far the only way to completely cure Adenomyosis, as this surgery completely removes the uterus from the body and hence there is no chance of growth of Adenomyosis. This procedure is recommended only for those females who do not desire to have children as once the uterus is removed then the female will be unable to bear children anymore.

What are the Complications of Adenomyosis?

Adenomyosis is a potentially harmless condition but it may affect the lifestyle of an individual due to the painful symptoms. In some cases, females may be absolutely bedridden and unable to enjoy social life due to the severe bleeding and pelvic pain that they experience due to Adenomyosis.

What is the Prognosis of Adenomyosis?

As stated, Adenomyosis is harmless for the symptoms that it produces. There are many treatments available with hysterectomy being the only treatment which can definitively get rid of Adenomyosis, although once a female reaches menopause, the female can get rid of the painful symptoms of Adenomyosis forever.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:June 23, 2016

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