Adenomyosis is a common gynaecological disorder that often causes severe menstrual pain and heavy periods. Not as well-known as it’s cousin endometriosis, adenomyosis is almost as problematic for many women.
Adenomyosis is pronounced A-DEN-OH-MY-O-SIS.
What is adenomyosis?
Adenomyosis describes a condition where the lining of the uterus (endometrium) grows within the thick muscular wall of the uterus. Over time the islands of endometrium enlarge, irritating the muscle fibres during the course of the cycle. In response, the muscle fibres enlarge (called hypertrophy) and thus, the uterus slowly swells over years to a larger size. On occasion, a benign tumour called an adenomyoma can form which may require surgery.
Why does adenomyosis cause bad period problems?
The islands of endometrium respond to your natural menstrual cycle in exactly the same way as the lining within the uterus. By the end of the month, just before your period is due, and in the early days of menstruation, the muscle fibres are irritated by the swelling and bleeding and contract more strongly than usual, leading to bad period pain (aka dysmenorrhoea).
Are periods heavier with adenomyosis?
Unfortunately, your period is often heavier with adenomyosis. Your uterus enlarges year by year and the cavity, and therefore the surface area to bleed from is larger. Adenomyosis is most common for women aged in their mid-30s and into their 40s. Other factors may also come into play by this time.
How is the adenomyosis diagnosed?
Adenomyosis is diagnosed with a combination of the above symptoms, a finding by the doctor on internal examination of a bulky enlarged uterus, and a pelvic ultrasound of the uterine muscle (a characteristic salt and pepper appearance) form the basis of the diagnosis. If you have worsening pain and heaviness with your period, consider making an appointment to have this investigated, we can then see what might be causing the problem.
What treatment can I choose from?
Treatment of adenomyosis includes a variety of options: – anti-inflammatory medication (capsules to help slow the blood flow) or hormonal contraception (the oral contraceptive pill) often helps. The most effective conservative treatment is the insertion of a Mirena IUD.
What if these methods fail?
Sometimes the symptoms are quite debilitating and attempts at conservative therapy fail in some individual women. In this case, hysterectomy (removal of the uterus) is the cure and can be considered by some women. Your age and desire for children will be an important decider in having a hysterectomy.
To discuss any gynaecology issues with Dr Peter England, please call the rooms and make an appointment.
This article has been written by Dr Peter England – Expert Obstetrician and Gynaecologist. Read more about Dr Peter England
Take a look through some of our other posts:
- What are the Reasons and Causes of Miscarriage
- Reasons for Bleeding in Early Pregnancy
- Medications to treat PCOS
- PCOS and Fertility
- PCOS: Polycystic Ovarian Syndrome
- March 2023
- October 2022
- July 2022
- May 2022
- December 2021
- November 2021
- October 2021
- August 2021
- May 2021
- April 2021
- March 2021
- December 2020
- November 2020
- October 2020
- September 2020
- August 2020
- July 2020
- June 2020
- May 2020
- April 2020
- March 2020
- February 2020
- January 2020
- December 2019
- November 2019
- October 2019