 Adenomyosis - What Is It and How Can I Treat It? |
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My doctor mentioned my pain issues may be adenomyosis. What is this condition and how do I treat it?
Adenomyosis is a condition where the endometrium (lining of the uterus) grows into the myometrium or muscular wall of the uterus. As a result, the uterus can become enlarged and even boggy. It is completely contained within the uterus. Adenomyosis is not internal endometriosis as was once believed. Both conditions involve endometrial glands and stroma in abnormal areas, but the two conditions act and respond differently.
Though the cause of adenomyosis is unknown, there are some risk factors that may cause or contribute to the condition. These include hormonal issues, prior uterine surgeries including a myomectomy or C-section, childbirth, or other trauma to the uterus that could cause displaced endometrium. Typically, women diagnosed with adenomyosis will be in their 40s and 50s, but younger women may be diagnosed as well.
Adenomyosis can cause a variety of symptoms. Most frequently, women will experience intense menstrual cramps, heavy and prolonged menstrual bleeding, and abdominal bloating. Other symptoms may include lower back pain, abdominal pressure, and painful intercourse. Additionally, women can pass blood clots during their period, have breakthrough bleeding, and feel fatigued. Due to excessive bleeding, some women also experience anemia.
There are a wide variety of treatment options available depending on your symptoms and how close you are to menopause. These can include both pharmaceutical and surgical options.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs can be used to manage pain. These can include over-the-counter or prescription medications such as Ibuprofen, Naproxen, and Aspirin. If these are started a couple days before your period begins, they can relieve the pain during your cycle and decrease your menstrual flow. This option may help you manage your symptoms until menopause, which is when adenomyosis typically ceases to be an issue for some women.
Oral Contraceptives: These medications can control your menstrual cycle and hormone levels by providing a specific dose of hormones. They can also be taken continuously to prevent menstrual periods, thus alleviating symptoms related to bleeding.
Progestin/progesterone IUD: These IUDs can be used to try to minimize or stop menstrual bleeding. Because the hormone is released directly into the uterus, this option can be helpful for women who may not do well with oral hormones.
GnRH agonist (Lupron): A GnRH agonist will stop the ovaries from producing hormones causing a pseudo, or chemically-induced, menopause. With this treatment option, the adenomyosis may cease to be symptomatic during the induced menopausal period. Additionally, periods should stop which will relieve bleeding related issues.
Ablation: During an ablation, the endometrium is removed from the uterus which can eliminate menstrual bleeding and pain. Women with minimal adenomyosis can benefit from this option, but it is less likely to be effective for those with deep adenomyosis.
Uterine Artery Embolization: Tiny particles can be inserted in the blood vessels leading to the area of adenomyosis. These particles can then cut the blood flow to the adenomyosis causing it to shrink.
Osada Procedure: This lesser-known procedure involves opening the uterus and radically removing the adenomyotic tissues. The uterus is then reconstructed. This procedure can allow for the removal of adenomyosis while retaining fertility.
Hysterectomy: This surgery is the most invasive treatment option. It is also the only definite way to eliminate adenomyosis permanently. It may be a choice for women who have extreme symptoms and who are no longer interested in fertility.
To decide which choice is right for you, you need to keep a symptom diary that you share with your physician, decide if you wish to maintain your fertility, and determine how close you are to menopause. Weigh the pros and cons of each and seek a second opinion before making your final decision.
This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.
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Recommended for Hysterectomy Recovery
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Hysterectomy News May 18,2013
