Adenomyosis is a condition in which tissue that normally lines the uterus also grows within the muscular walls of the uterus.
Adenomyosis is a common gynaecological disorder characterized by the abnormal growth of endometrium into the myometrium and myometrial hyperplasia. This is most likely to happen late in your childbearing years and after you've had children. The cause of adenomyosis remains unknown, but the disease typically disappears after menopause. For women who experience severe discomfort from adenomyosis, there are treatments that can help, but hysterectomy is the only cure. This condition results from the lining cells of the uterus growing directly into the muscle wall of the uterus. When the lining cells of the uterus bleed at the time of the menstrual period, these misplaced cells in the muscle bleed as well. And bleeding directly into the muscle causes pain.
Adenomyosis rarely occurs in women who have not carried a pregnancy to term. Although adenomyosis can be quite painful, the condition is generally harmless. Some form of adenomyosis affects 60% of women, but in most cases is does not cause symptoms. In more severe forms, it may lead to heavy bleeding and severe cramping during menstrual periods. As the blood accumulates, the surrounding muscle swells and forms fibrous tissue in response to the irritation. This swollen area within the uterine muscle wall, called an adenomyoma, feels very much like a fibroid on examination and is often confused with a fibroid on a sonogram. The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have painful and profuse menses. Adenomyosis may involve the uterus focally, creating an adenomyoma, or diffusely.
The diagnosis of adenomyosis is suspected if the uterus feels enlarged and tender to the touch during the pelvic examination. Adenomyosis is similar to Endometriosis, both are conditions in which the lining of the uterus grows where it shouldn't and both are progressive. However, the diagnosis of adenomyos is based on these findings is often inaccurate, and other causes-fibroids, endometriosis, or polyps-are often found as the cause for the bleeding or discomfort. Symptoms are different for every woman, but can include: irregular periods, longer than usual periods, heavy bleeding or clotting. Menstrual blood may start to have an unpleasant odor because the lining that is being shed is older than usual. Anemia can also become a concern in cases of heavy or prolonged periods.
Adenomyosis usually resolves after menopause. Treatment options range from use of NSAIDS & hormonal suppression for symptomatic relief, to endometrial ablation or hysterectomy for a more or less permanent cure. Pain medicine may be prescribe. A hysterectomy may be necessary in younger women with severe symptoms. Most treatment attempts using hormones have been unsuccessful. The medications Lupron or Synarel can cause cessation of the periods and associated menstrual cramping and even lead to shrinkage of the swelling associated with adenomyosis. However, the effect is temporary-when the medication is discontinued, the symptoms return. At the present time, the only treatment for adenomyosis is surgery. Only a small number of women with adenomyosis have been treated with uterine artery embolization (UAE), and the results so far have been disappointing.
