Adenomyosis is a condition in which the lining of the womb/uterus (called the endometrium) is found within the muscles of the womb (called the myometrium). It can be in just one area or be found throughout the whole of the womb muscle. Although it involves the lining of the womb appearing where it shouldn’t, adenomyosis is not the same as endometriosis. Researchers have now concluded that the two conditions together are found in only 10% of cases although it has also been known to be misdiagnosed as fibroids.
As with endometriosis, the tissue thickens and is shed in accordance with the woman’s natural fertility cycle, however unlike normal periods the lining that has been removed cannot leave body via the vagina and cervix and consequently has nowhere to go. This results in more adenomyosis forming in the muscle.
Symptoms of adenoymosis
- Intense pain and menstrual cramps
- Pain during ovulation
- Very heavy bleeding and/or flooding
- Passing large blood clots
- Longer than normal menstruation
- A feeling of the womb contracting as in labour.
- Abdominal cramps
- Increased pressure on the bladder
- Dragging sensation in the upper legs and lower torso.
It most commonly occurs in women between the ages of 35 and 50, particularly those who have had children already. There is some evidence that abdominal surgery can also be a risk factor. It is also likely that imbalance between the various hormones, specifically oestrogen, progesterone and prolactin and FSH (follicle stimulating hormone) may be the cause of the problem. It is also possible that over production of oestrogen together with increasing amounts of environmental oestogens found in the water supply and manufacturing may be another cause.
Treatment of adenomyosis depends on the severity of symptoms and getting an accurate diagnosis. A diagnosis can now be given after an Ultrasound or MRI scan, however it can only be confirmed if the uterus is examined after it has been removed. Whether a woman has completed her family will also be a factor in determining appropriate treatment options. Mild symptoms can be treated with painkillers and non steroidal anti-inflammatory drugs like ibuprofen.
In some case use of a levonorgestrel-releasing IUD device (hormone replacement therapy) can be effective for heavy and painful periods.
Uterine artery embolisation can be used to block the blood vessels that are supplying the adenomysis. When the blood supply is removed the adenomyosis will shrink back, thus relieving symptoms.
Endometrial ablation can be used to remove the lining of the uterus and could be effective is the adenomyosis hasn’t penetrated too deeply into the muscle wall.
Hysterectomy and removing the womb is the only guaranteed way to cure adenomyosis.
Natural treatments may involve a change of lifestyle to avoid environmental oestrogens where possible and perhaps supplements or dietary changes that counter the effect of oestrogen dominance.
- Adenomyosis: the pathophysiology of an oestrogen-dependent disease