Adenomyosis is a condition that occurs when endometrial tissue, which normally lines the uterus, grows into the outer muscular walls of the uterus. This condition differs from endometriosis, in which the tissue grows outside of the uterus. Adenomyosis commonly occurs in women older than 30 who have had at least one full-term pregnancy. Symptoms of adenomyosis can include severe menstrual cramps, and heavy or prolonged menstrual periods. Adenomyosis usually does not occur after menopause.
Causes of Adenomyosis
Although the exact cause of adenomyosis is unknown, it is believed to be caused by an invasion of endometrial cells into the uterine wall. Women who have had previous uterine surgery, as well as those who have given birth at least once, may be at a higher risk of developing adenomyosis. Research indicates that its development may be related to the production of estrogen in a woman's body, because as estrogen production decreases during menopause, adenomyosis eventually goes away.
Symptoms of Adenomyosis
Some women with adenomyosis do not experience any symptoms. Others may experience the following:
- Heavy menstrual bleeding
- Severe cramps and pelvic pain
- Pelvic pain during intercourse
- Bleeding between periods
- Passing of blood clots during period
The uterus can also become enlarged, resulting in tenderness or pressure in the lower abdomen.
Diagnosis of Adenomyosis
Adenomyosis is commonly diagnosed after a pelvic examination, and a review of symptoms, medical history and menstrual cycles. Additional diagnostic tests may include the following:
- Pelvic ultrasound
- MRI scan of the pelvis
A biopsy of endometrial tissue may also be taken to rule out any underlying conditions. Adenomyosis can be difficult to diagnose because several other uterine conditions cause similar symptoms.
Treatment of Adenomyosis
Treatment for adenomyosis depends on the severity of the condition, and often focuses on relieving symptoms. Anti-inflammatory medication and hormones may be prescribed. If pain is severe and does not respond to treatment, a hysterectomy, which removes the uterus, may be recommended. Most cases of adenomyosis resolve on their own, however, and symptoms dissipate as women go through menopause.