Uterine adenomyosis is a condition in which tissue from the inner lining of the uterus grows into the muscle wall of the uterus (myometrium) causing heavy, menstrual painful periods.
Adenomyosis is frequently seen along with other uterine problems such as endometriosis, a condition in which endometrial cells (the lining of the uterus) grow outside of the uterus. Both adenomyosis and endometriosis cause pain, but endometriosis does not usually result in heavy menstrual periods.
It is unclear if adenomyosis causes infertility for several reasons:
- There are not many studies on the impact of adenomyosis on fertility
- Many women who have adenomyosis also have endometriosis, uterine polys, or fibroids, which are conditions known to cause infertility
- Many women who have adenomyosis are older
What Are Symptoms of Adenomyosis?
Symptoms of adenomyosis include:
What Causes Adenomyosis?
The cause of adenomyosis is unknown but it may develop due to:
- Bone marrow stem cells enter the uterine muscle
- Inflammation of the uterus following childbirth
Risk factors for developing adenomyosis include:
How Is Adenomyosis Diagnosed?
If adenomyosis is suspected, a medical history and pelvic examination is performed. A pelvic exam may find an enlarged and soft uterus, and a uterus that moves around and is not fixed in place.
Imaging tests may include:
An ultrasound may indicate a suspected diagnosis of adenomyosis, but the only way to confirm a diagnosis of adenomyosis is based on pathology of the uterus which is evaluated after removal of the uterus (hysterectomy).
Blood tests may be used to rule out pregnancy, check for anemia, or exclude other conditions.
In some cases, an endometrial biopsy is performed in which a small piece of tissue from the lining of the uterus is removed and sent to a lab for examination. It is usually performed to rule out endometrial hyperplasia (thickening of the lining of the uterus) or cancer.
What Is the Treatment for Adenomyosis?
Treatment for adenomyosis is aimed at managing or relieving the symptoms.
Treatments that may reduce heavy bleeding due to adenomyosis include:
- Endometrial ablation, which surgery to scar the lining of the uterus to make periods lighter
- Intrauterine devices (IUDs) that release the hormone progestin
- Uterine artery embolization to block the blood supply to the uterus and help shrink uterine adenomyomas
Treatments for pain due to adenomyosis include:
- Over-the-counter pain medications, such as ibuprofen (Advil, Motrin)
- Birth control pills
- Leuprolide (Lupron, Eligard), which causes the ovaries to stop producing estrogen and progesterone
The only cure for adenomyosis is the surgical removal of the uterus (hysterectomy).
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