What you need to know about adenomyosis

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Many women have heard about endometriosis, but very few know about adenomyosis, which is pronounced: ad-uh-no-my-O-sis. So what is this disease which affects the uterus (womb) and what should you do if you suspect you may have it? Read on to find out more…


April is Adenomyosis Awareness Month which highlights a serious and debilitating disorder many Australians may not have heard of. Signs of adenomyosis include but are not limited to:

  • Heavy periods
  • Pain during your menstrual cycle or intercourse.

Adenomyosis is a condition of the uterus (womb) where cells similar to those lining the inside of the uterus are also present in the muscle wall of the uterus. One study estimated that about 1 in 5 women have the condition. The term comes from the words: adeno (gland), myo (muscle) and osis (condition).

Adenomyosis concentrated in one area can lead to a non-cancerous growth called an adenomyoma.

Often women with adenomyosis will also have endometriosis. Although they are different conditions, both involve ectopic (abnormal) placement of endometrial type tissue – adenomyosis into the uterine muscle layer and endometriosis outside of the uterus. With endometriosis, cells similar to those that line the uterus are found in other parts of the body such as the fallopian tubes, ovaries or the tissue lining the pelvis (peritoneum).

Fortunately, adenomyosis can be managed with the right health care team.


Causes and risk factors of adenomyosis

There is no known cause of adenomyosis. The research is ongoing, however there are a few theories, including:

  • After surgery (such as to remove fibroids) lining cells grow into the muscle layer
  • Lining tissue went into the uterine muscle early during development, before birth
  • Inflammation of the uterine lining after childbirth prompts cells to pass into the weakened muscle layer.


Adenomyosis symptoms

Symptoms can be mild to severe. Some women may not even experience any symptoms. Some of the most common symptoms women with adenomyosis report include:

  • Heavy menstrual bleeding
  • Painful periods
  • Prolonged menstrual cramps
  • Longer than normal menstrual cycles
  • Pain during sex (dyspareunia)
  • Abdominal tenderness
  • Chronic pelvic pain
  • Anaemia or iron deficiency (due to heave periods), leaving you feeling tired or dizzy.


Adenomyosis diagnosis

Unfortunately, adenomyosis may be difficult to diagnose, as there is no single set of agreed tests to confirm a diagnosis.  A definitive diagnosis is based on a histopathological assessment of the uterus after a hysterectomy.  However, a clinical diagnosis can be made based on history, physical examination and investigations – namely a transvaginal (internal) ultrasound scan or a pelvic MRI (magnetic resonance imaging) scan.


Adenomyosis and fertility

While a diagnosis of adenomyosis can impact fertility, just like endometriosis can, it is not a diagnosis of infertility. Your GP or gynaecologist can run through any risks regarding fertility and pregnancy depending on your stage of life and  what your symptoms are.


Adenomyosis treatment

Medical treatment isn’t usually required for mild symptoms, though if the condition interferes with your day-to-day life some treatment options include:

  • anti-inflammatory medications to reduce cramping or heavy bleeding
  • hormonal treatments (including combined oral contraceptive pills, progestin-only contraceptives and intrauterine devices)
  • Hysterectomy (removal of the uterus).

Your gynaecologist may also be able to recommend non-medical options such as meditation and exercise to help improve symptoms.

  • Endometriosis Australia features a story of a mother who was diagnosed with adenomyosis after two decades of searching for answers. She now steers a Facebook page dedicated to supporting adenomyosis sufferers.


Seeking help

If you are concerned you may have adenomyosis and it is impacting your health, your ability to live life normally or interfering in your relationship or sexual function, please do not hesitate to see your GP or gynaecologist.


Sources and sites for further reading about adenomyosis, as well as support groups:

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