The lining of the uterus, or womb, is made up of endometrial tissue. Adenomyosis occurs when the endometrial lining invades the muscle wall of the uterus.
The endometrial tissue can spread throughout the myometrium (uterine muscle) or nodules, called adenomyomas, can develop.
It’s not clear exactly why adenomyosis occurs, but the condition is commonly seen in women 40- to 50-years-old who have had children. Women with a history of uterine surgery may be at an increased risk for adenomyosis. It is believed hormones may play a role in the development of the condition.
Symptoms of Adenomyosis
Not all women with adenomyosis experience symptoms or symptoms may be so mild, they are unrecognized. Other women suffer from a variety of symptoms, including:
- Heavy or lengthy periods
- Severe menstrual cramps
- Painful intercourse
- Abdominal bloating
- Pelvic pressure
If adenomyosis is suspected, your OBGYN will likely perform a pelvic exam to check for uterine tenderness and enlargement. The uterus may also feel boggy or spongy on exam. Additional tests are needed to confirm a diagnosis of adenomyosis.
Additional diagnostic tests include:
- Ultrasound ( or transvaginal ultrasound) of the uterus
- Magnetic resonance imaging, MRI
- Endometrial biopsy to rule out other serious conditions
Treatment of Adenomyosis
Adenomyosis often resolves after menopause, so the decision of whether or not to treat the condition depends on the severity of symptoms and how soon menopause is expected to occur.
Treatment options include:
Hormone medications – birth control pills, hormone patches, intrauterine devices (IUDs), GnRH analogs and others can offer relief
Anti-inflammatory medications – Over-the-counter drugs containing ibuprofen can reduce pain and menstrual flow.
Hysterectomy – For women with severe symptoms who don’t want more children, removal of the uterus may be a solution.