Just imagine an everyday, busy day-to-day life; suddenly, the old familiar pain of menstrual cramps becomes unbearable and even debilitating. The pain persists beyond the cycle, accompanied by heavy bleeding and fatigue. This is exactly what these women experience most who have Adenomyosis – a condition that for years may go undiagnosed.
What is the problem? The inside lining of the uterus starts growing into the wall of the uterine muscles, where it causes inflammation and leads to pain and excessive bleeding. Its cause is not well understood; however, hormonal imbalance and uterine trauma seem to be significant contributors. Let’s delve a little deeper into understanding this condition.
What is Adenomyosis?
The uterine tissue that lines the uterus turns into muscle in Adenomyosis. The vascular (blood vessels) and vaginal walls become bigger because of this condition. This can cause heavy periods, last a long time, and hurt. Some people with Adenomyosis also have pain during sexual activity and can’t have children.
When the lining of the uterus grows outside the body, that’s called endometriosis. Adenomyosis is not the same thing. Endometriosis can happen to or happen to people who already have Adenomyosis. It is thought that Adenomyosis depends on oestrogen or is sensitive to hormones. After 12 months have passed since the last period, which is called menopause, it generally goes away. During menopause, oestrogen levels also drop.
Adenomyosis Vs Endometriosis
When a woman has Adenomyosis or endometriosis, uterine tissue grows abnormally, but it grows in different places. When someone has Adenomyosis, the uterine tissue that lines the outside of the uterus grows into the myometrium, which is the uterus’s muscle wall. That causes the uterus to get bigger, which causes heavy periods, strong cramps, and long-lasting pelvic pain. A disease called Adenomyosis makes the uterus swell or hurt. It affects mostly women in their 30s and 40s, especially those who have already had children.
Endometriosis, on the other hand, occurs when tissue grows outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic parts nearby. Every month, this tissue swells, breaks down, and bleeds just like the tissue in the uterus. But because it’s not in the uterus, it causes a lot of pain, swelling, and scar tissue and sometimes makes it hard to get pregnant.
Patients with both diseases may have pain and heavy periods, but their sites and effects are usually different. With endometriosis, problems spread to other parts of the pelvis, but with Adenomyosis, they only happen in the uterus. Imaging or surgery is usually needed to make a diagnosis. Depending on how bad the problem is, medicine or surgery may be needed to treat it.
Symptoms of Adenomyosis
People with Adenomyosis have a wide range of complaints. About a third of women with this condition don’t have any symptoms at all, while for others, signs can make daily life difficult. Some signs of Adenomyosis could be:
- Having heavy monthly bleeding.
- Periods that hurt a lot, pain during sex, bleeding between periods, and cramps that get worse.
- A uterus that is big and painful, general pelvic pain, feeling like the bladder and rectum are under pressure, and pain while going to the toilet.
Adenomyosis causes
There are several ideas about what might cause Adenomyosis, but doctors aren’t sure:
- In a foetus, the uterus starts to form before birth, so a person may already have Adenomyosis.
- When someone has vaginal surgery, their uterus may become inflamed, which could also raise their risk of Adenomyosis.
- Adenomyosis can also be caused by damage to the uterus, like during a caesarean birth or other surgery. This is due to the tissue that looks like endometrium turning into muscle.
Diagnosing Adenomyosis
A doctor’s check and imaging tests are usually part of a diagnostic review. The doctor will want to check your body and pelvis to see if your uterus is swollen or painful to touch. The uterus of some people with Adenomyosis can be twice or three times as big as it should be.
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Ultrasound
A transvaginal ultrasound can help the doctor determine what’s wrong and rule out other possible reasons for your symptoms. Sound waves are used in ultrasound to make moving pictures of your organs, such as the uterus. For this process, the ultrasound tech (or sonographer) will put a condom over the ultrasound tool and then put a liquid electrical gel over the cover.
After that, the doctor will put the ultrasound tool inside your body. The probe will make moving pictures on the screen that will help the sonographer see what’s going on in your uterus and pelvis. It can be hard to tell if you have Adenomyosis with an ultrasound, so your doctor may suggest more advanced testing.
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MRI scan
MRI scans are the best way to find out if someone has Adenomyosis. An MRI uses a magnet and radio waves to make very clear pictures of the inside of the body. One way for a doctor to tell if someone has Adenomyosis is to look at an MRI and see certain changes in the uterus. One example is the area between the endometrium (the lining of the uterus) and the myometrium getting thicker.
You must lie still on a metal table that slides into the scanner for this process. If you think you might be pregnant and have an MRI, you should let the doctor know. You should also let the doctor and MRI tech know if you have any metal or electrical devices inside your body, like a pacemaker, tattoos, or metal pieces from a gun hit.
How to treat Adenomyosis?
It might worsen or stay the same if you don’t treat Adenomyosis. People don’t need to get treatment if they don’t have any signs, nor are they attempting to get pregnant or are getting close to menopause, a time when most people feel better. There are, however, a lot of different healing options:
- Medications that lower inflammation. Medicines like aspirin can ease pain and soreness.
- Injections (Depo-Provera), oral contraceptive pills, or progestin implantable devices can help ease the effects. Gonadotropin-releasing hormone agonists and inhibitors can also be prescribed by doctors, but generally only for a short time because they can cause a fake or brief menopause. If someone doesn’t get better with other medicines, doctors may sometimes give them for a long time.
- Uterine artery embolisation: A tube is put into a major artery in the groin, and small pieces are injected into the area that needs help. This keeps blood from getting to the area, making the Adenomyosis smaller, and the symptoms disappear.
- Hysterectomy: Taking out the whole uterus is the only permanent way to treat Adenomyosis. It might not be a good choice for someone who continues to desire to get pregnant unless all other treatments have been unsuccessful and they want to put pain relief ahead of pregnancy.
Conclusion
Adenomyosis usually doesn’t put you in danger of dying, but it can cause heavy bleeding. There are a lot of methods that can help ease your problems. A hysterectomy is the only surgery that can get rid of them for good. But after menopause, the problem usually goes away on its own.
