The Truth About Uterine Adenomyosis
Uterine adenomyosis is a gynecological condition of the uterus that occurs when the innermost layer of the uterus or endometrium infiltrates the middle or muscular layer of the uterus. Normally, the walls of your uterus consist of three layers, the endometrium, myometrium, and perimetrium from inside out. While the myometrium is made up of muscles, the endometrium consists of specialized tissue that grows, sheds, and bleeds during the different phases of a woman’s menstrual cycle. Unfortunately, when the endometrium extends into the myometrium, it continues to undergo the same changes related to the menstrual cycle resulting in the symptoms of uterine adenomyosis.
Although, this disorder resembles endometriosis, they are both completely different from each other. Endometriosis involves the implantation of the endometrial tissue outside the uterus or on its outer surface. On the contrary, uterine adenomyosis is the infiltration of the endometrium into the uterine wall alone. However, about 10% women are likely to suffer from both of these diseases at the same time.
What Causes Adenomyosis?
The cause of uterine adenomyosis isn’t clearly known. However, any trauma to the uterine wall that breaks the barrier between the endometrium and myometrium is likely to increase the risk of this disease. Some of the possible risk factors include C-section, history of uterine surgery, pregnancy, surgical termination of pregnancy, tubal ligation, or middle age. The reason behind an increased incidence of adenomyosis in middle age is a possible elevation in the blood estrogen levels.
Symptoms of Adenomyosis
Uterine adenomyosis may or may not cause any symptoms. However, since the infiltrating endometrial tissue continues to undergo changes related to the menstrual cycle certain symptoms like increased pain or bleeding are quite common. Here’s a list of the symptoms that may occur with this disease.
- Severe pain that continues to increase during the menstrual period and around ovulation
- Intense pressure in the uterus and vagina as the extra endometrial tissue tries to shed during the menses
- A bearing down sensation
- Heavy and/or prolonged bleeding
- Blood clots along with menstrual bleeding
- Pain during sexual intercourse
Treatment of Adenomyosis
Most women with uterine adenomyosis to tend find some relief after menopause. Hence, the treatment also depends on the woman’s age and her proximity to menopause. Those nearing their menopause are likely to receive pain medications to reduce the pain alone, as the rest of the symptoms may disappear after menopause without any medical intervention. Oral contraceptive pills containing both estrogen and progesterone are also helpful in reducing the bleeding and pain associated with uterine adenomyosis. Additionally, progestin-only intrauterine contraceptive devices and birth-control pills may also help with this disorder by stopping the menses completely. All said and done, women with severe pain and bleeding and who are young with a lot of time before they attain menopause may require surgical removal of the uterus or hysterectomy. However, surgery is generally the last step when none of the other treatments seem to work.