Adenomyosis is a painful condition where the uterine lining starts to develop in the muscle wall of the uterus. It is common and gradually becoming more recognised. When you have your period, this condition will cause the uterus to swell as the lining in the muscle wall will also bleed. This can cause pressure on the bladder and bowel and painful muscle contractions.  

It is similar to endometriosis, although in endometriosis, the uterine lining is found in places outside of the uterus itself, eg fallopian tubes.

Symptoms of adenomyosis?

You may have heavy and painful periods or no symptoms at all, we’re all different. Sometimes it will be found in women with long term pelvic pain or those struggling with infertility 

What causes adenomyosis?

We do not know exactly why adenomyosis happens, but there are a number of theories.

One is that the healing process following a caesarean section may lead to deposits of uterine lining inside the muscle layer leading to adenomyosis. The truth is that women who haven’t had caesarean sections also suffer from this condition and those who have had caesarean sections do not necessarily have it. Other theories are family history and possible immune causes, as we don’t clearly know why it happens, at the moment we cannot prevent it.

How is adenomyosis diagnosed?

It often takes a long time for this condition to be diagnosed. Women often accept heavy or painful periods without seeking help. The symptoms of adenomyosis are also experienced in a lot of other conditions as well and you may also suffer from another, more easily recognised cause for your symptoms.

Helpful investigations include ultrasound scans and sometimes MRI scans.

How is adenomyosis treated?

Generally, we treat the symptoms rather than the cause of adenomyosis and the choice of treatment will be guided by factors such as individual preference and desire for children.

  • Pain relief and anti-inflammatories can be taken at the time you have symptoms to make pain more manageable
  • Tranexamic acid may be used to help. Control the flow of your bleed.
  • The Contraceptive pill can be taken without a break or the hormonal IUD can be used to reduce the number of periods you have.
  • Hormones can be given to trigger a ‘chemical’ and temporary menopause but they can't be used long-term.
  • A procedure can be used to reduce the blood supply to the area but this may only act as a temporary measure. It is known as uterine artery embolization and may retain your fertility.
  • A Hysterectomy (surgery to remove the uterus) may be an option for women who do not want to become pregnant.
  • Lifestyle – All of the management options will be helped by adopting a healthy diet and exercise regime

Integriti doctors can help you identify and manage this issue with relevant tests and will work with you to identify the best management plan for you, including onward referrals when needed.

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