What is Adenomyosis?


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.

Author: Dr Peter England, Obstetrician and Gynaecologist.
Read more about Dr Peter England

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