Adenomyosis?
We understand that living with adenomyosis can be challenging. Our goal is to work with you to find a solution that improves your quality of life.
Adenomyosis is a common, non-cancerous condition where the tissue that normally lines the inside of your uterus (the endometrium) begins to grow into the muscular wall of the uterus (the myometrium).
When this tissue grows in the muscle, it continues to act as it normally would during your menstrual cycle—it thickens, breaks down, and bleeds. This process within the uterine wall can cause the uterus to become enlarged and lead to painful, heavy periods.
No, but they are related. In endometriosis, endometrial-like tissue grows outside the uterus. In adenomyosis, it grows inside the uterine muscle wall. It is possible to have both conditions at the same time.
What are the Symptoms?
While some women have no symptoms, others may experience:
Periods that are much heavier than normal or last longer than a week. You might pass large blood clots.
Sharp, knife-like pelvic pain (dysmenorrhea) during your period that often gets worse over time.
A general aching or pressure in your lower abdomen that can occur throughout the month.
Pain during or after sex (dyspareunia).
Your doctor may notice that your uterus feels larger or more tender during a pelvic exam. You may feel a sense of fullness or bloating in your lower abdomen.
How is Adenomyosis Diagnosed?
Diagnosing adenomyosis typically involves a combination of discussing your symptoms and performing an examination and imaging tests.
Your provider may feel that your uterus is enlarged, soft, or tender.
This is often the first imaging test used. A small ultrasound probe is placed in the vagina to get a detailed picture of your uterine lining and muscle.
An MRI can provide an even more detailed image of the uterine wall and can help confirm the diagnosis or rule out other conditions. Although, this often is not necessary for a diagnosis and treatment.
When to Call the Clinic
Please call us if you experience:
- Extremely heavy bleeding (soaking through a pad or tampon every hour for two or more hours).
- Pelvic pain that becomes severe or is not managed by your current treatment plan.
- Dizziness, lightheadedness, or shortness of breath, which could be signs of anemia from heavy blood loss.
- Any concerning side effects from your medication.
Treatment Options?
Treatment for adenomyosis depends on the severity of your symptoms, your age, and whether you plan to have children in the future. The goal is to manage your pain and heavy bleeding.
Anti-inflammatory Medications: Over-the-counter drugs like ibuprofen (Advil®, Motrin®) or naproxen (Aleve®) can help reduce menstrual blood flow and relieve mild pain.
Hormonal Therapies: These treatments can help control the hormones that contribute to the buildup of endometrial tissue.
- Hormonal IUDs (e.g., Mirena®, Liletta®): A small, T-shaped device placed in your uterus that releases a progestin hormone. This is a highly effective option for reducing heavy bleeding and pain.
- Birth Control Pills, Patch, or Ring: Can help make periods lighter and less painful.
- Other Progestin Medications: Can be given as a pill or injection.
Uterine Artery Embolization (UAE): A procedure where tiny particles are used to block the blood vessels that supply blood to the adenomyosis tissue, causing it to shrink.
Endometrial Ablation: A procedure that destroys the lining of the uterus. This is only an option for women who are certain they do not want to become pregnant in the future.
Hysterectomy: The surgical removal of the uterus. This is the only definitive cure for adenomyosis. It is typically reserved for women with severe symptoms who have not found relief with other treatments and are finished with childbearing.