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Extremely Painful Periods: Adenomyosis Awareness Month

April is Adenomyosis Awareness Month

Adenomyosis is a painful and complex gynecological condition that is not well understood, can be difficult to detect, and can only be cured by hysterectomy. Its primary indication is painful periods.

What Is Adenomyosis?

Adenomyosis develops when cells from the endometrial lining of the uterus grow into the muscle of the uterus. These cells behave the same during a woman’s monthly menstrual cycle, but in this location, they become trapped. Inflammation leads to painful periods (sometimes debilitating), heavy bleeding, and enlargement of the uterus.

Adenomyosis is contained within the wall of the uterus. Endometriosis (cells similar to those found in the endometrial lining of the uterus) can exist throughout the pelvis, and in rare occasions, it may be found in the lungs and even in the brain. Both adenomyosis and endometriosis can be very painful, cause severe monthly bleeding, and can mimic other conditions, making them hard to diagnose.

Why Is Adenomyosis Hard To Diagnose & Treat?

An ultrasound is insufficient to detect the disease in the uterus. In many cases, an MRI can detect adenomyosis, but if it is small and diffuse, it may not appear on any imaging, and can only be diagnosed during surgery, and then confirmed in pathology tests.

There is little research on adenomyosis, as well as lack of definitive research on treatments other than surgical removal of the uterus. Limited knowledge in the medical community about how to diagnose and treat adenomyosis often leaves women suffering unnecessarily.

“After attempts at conservative management with medicine and minor temporizing procedures, if the symptoms continue and a woman has completed child bearing, then hysterectomy can be an option,” said Paul MacKoul, MD. “To date, hysterectomy is the only known cure for adenomyosis.”

Normalization of Painful Periods Creates Barriers to Diagnose and Treat Adenomyosis

“Women who have adenomyosis often feel trapped each month,” said Natalya Danilyants, MD. “Between heavy menstrual cycles, or debilitating pelvic pain, and severe anemia, this condition can be disruptive to their lives. I hear too often from my patients that they thought menstrual pain was to be expected, and had no idea anything was wrong.”

Adenomyosis Advice Association is a research group  with members on Facebook who have struggled with both the condition and even getting a diagnosis. This resource offers advice, support and information on adenomyosis.

Choosing a GYN Specialist and the Best Hysterectomy Option

“When it comes to lesser known GYN conditions like adenomyosis, women should seek a specialist for optimal care,” said Paul MacKoul, MD. “A minimally invasive hysterectomy should be performed by a skilled laparoscopic surgeon who is fellowship trained on advanced techniques to prevent damage to the delicate structures in the pelvic cavity.”

Learn more about treating adenomyosis and other complex GYN conditions.


The CIGC state-of-the-art specialists are available at three locations in the DC metro area. Virginia patients can visit the Reston, VA location, and Saturday appointments are available. Maryland offices are located in Rockville, MD and Annapolis, MD.

CIGC is dedicated to providing information and materials for women to help navigate the complicated healthcare system. The CIGC founders, minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD, developed their advanced GYN surgical techniques using only two small incisions with patients’ well-being in mind. Dr. Rupen Baxi, MD is a CIGC-trained minimally invasive GYN specialist with extensive fellowship training and a respected speaker and researcher.

Their personalized approach to care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD or Natalya Danilyants MD.

Dr. Paul MacKoul ReviewsVitals | RateMDs | Google | Wellness | UCompare

Dr. Natalya Danilyants Reviews: Vitals | RateMDs | Google | Wellness | UCompare

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