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Adenomyosis
Adenomyosis

Adenomyosis

Adenomyosis is a condition in which the cells that line the inside of the uterus (endometrium) are abnormally located in cells that make up the uterine wall (myometrium), often resulting in an enlarged uterus. This tissue thickens, breaks down and bleeds during periods and can cause heavy bleeding and severe pain.¹

Adenomyosis can be difficult to diagnose, and symptoms like heavy bleeding and pelvic pain are often dismissed by doctors that don’t specialize in GYN conditions. Physical signs of adenomyosis, such as an enlarged uterus or thickened uterine walls, can sometimes be detected with a Magnetic Resonance Imagining (MRI) scan or less likely with transvaginal ultrasound, but the condition can only be confirmed through pathology after a hysterectomy. To be cured of adenomyosis, a hysterectomy is necessary. Though for patients who wish to have fertility options in the future, nonsurgical management can sometimes help with symptoms.

The adenomyosis specialists at The Center for Innovative GYN Care® (CIGC®) are fellowship-trained and highly experienced in both diagnosing and treating adenomyosis. While hysterectomy is the primary surgical solution for adenomyosis, any course of treatment is discussed thoroughly by the specialists and is weighed against each patient’s goals for fertility.

Symptoms of Adenomyosis

Adenomyosis symptoms vary greatly between patients. For some, pain and abnormal bleeding may be debilitating, while others may have no symptoms at all. The most common symptoms include pelvic pain and heavy bleeding. Other symptoms may include pain in the legs and back, swelling of the abdomen, and more.

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Adenomyosis Causes, Risk Factors and Complications

The cause of adenomyosis is still being studied, but there are several theories that have been identified. Adenomyosis requires estrogen in order to grow, so women who are in their reproductive years are more likely to develop the condition.

There are factors that may put some patients at a higher risk than others, including cesarean section or myomectomy surgery, shorter menstrual cycles, a history of giving birth and starting your period at an early age.

When left untreated, the biggest concern with adenomyosis is chronic anemia and fatigue caused by the heavy bleeding experienced during periods. The disease can also severely impact your quality of life due to chronic pain and bleeding.

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Diagnosing Adenomyosis

Potential signs of adenomyosis, like a thickened uterine wall and misplaced endometrium, is best identified using imaging studies such as an MRI scan. Another method involves an ultrasound, which can be far less effective. However, the only way to definitively diagnose adenomyosis is by having a pathologist examine the uterus after a hysterectomy has been performed. Imaging studies can be used to suggest adenomyosis but are not completely accurate.

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Adenomyosis Treatment Options

The only definitive cure for adenomyosis is a hysterectomy. This surgery allows the tissue to be removed in its entirety along with the uterus, addressing the cause at its origin. Hormonal suppression is another option for women who are not yet finished with childbearing, although this method is not always effective and provides only short-term relief. 
Pain medication and other nonsurgical treatment methods can be used to manage pain and symptoms, but these methods don’t address the root of the problem and should be used as a complement to surgical treatment.

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Adenomyosis FAQ

Who does adenomyosis affect?

Although it is most commonly diagnosed in women over 35, it can occur even among teenagers. Current research suggests adenomyosis may be common in younger women as well

How common is adenomyosis?

Adenomyosis is an extremely common condition, but it is not always readily identified by many doctors. Initial imaging of the uterus is often conducted by an ultrasound, which is commonly used to detect fibroids, but has more difficulty detecting adenomyosis. An MRI scan is a better visual test to detect signs of adenomyosis.

What is the association between adenomyosis and infertility?

At this time, how adenomyosis affects fertility is unclear. Some studies show an association between adenomyosis and infertility and others show none. In general, it is thought that the severe inflammation caused by migration of the uterine lining into the uterine muscle may prevent implantation of an embryo into the uterine lining.3

Will menopause occur after hysterectomy?

Many women fear that removing the uterus will immediately send them into menopause and all the symptoms that may accompany it. This is not the case. The ovaries, not the uterus, produce the hormones that dictate menopause. If the ovaries are left in place, a woman will go through menopause naturally.

The only obvious change will be the lack of a monthly menstrual cycle. In many cases, unless there is a genetic risk of ovarian cancer or signs of existing cancer, the ovaries can be retained. Speak to your GYN specialist about your long-term goals and how hormone therapy can play a role in managing symptoms, especially in the transition and early stages of menopause.

Is adenomyosis the same as endometriosis?

No. Although they can occur together, endometriosis is when endometrial cells (the lining of the uterus) are in a location outside of the uterus. Adenomyosis is when these cells are embedded into the uterine wall. Although both can cause pain, endometriosis does not typically cause heavy bleeding.

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Adenomyosis Specialists at CIGC

The GYN specialists at The Center for Innovative GYN Care® (CIGC®) are fellowship-trained and highly experienced in both diagnosing and treating adenomyosis. The CIGC state-of-the-art laparoscopic techniques make it possible to treat complex GYN conditions like adenomyosis using just two small incisions with minimal recovery time.

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The CIGC Difference

Unlike a standard OBGYN, CIGC’s adenomyosis specialists perform laparoscopic surgeries every day. DualPortGYN was developed by the CIGC minimally invasive GYN specialists to improve the outcomes of hysterectomies. DualPortGYN takes advantage of advanced surgical techniques that enhance the safety and lower the complication rates of each procedure.

While hysterectomy is the primary surgical solution for adenomyosis, any course of treatment is discussed thoroughly with you by the specialists and is weighed against each patient’s goals for fertility.

Schedule a Consultation

If you think you have adenomyosis, our specialists are ready to provide an evaluation of your symptoms and conditions and recommend an appropriate solution.