What is Adenomyosis? Causes, Symptoms, Diagnosis and Treatment

Introduction

The female body is gifted with the ability to nurture a new life by attaching to the uterus – the most important part of the reproductive system. The uterus is where the fertilized egg gets attached and grows into a foetus and then into a human baby.

Unfortunately, certain conditions associated with the uterus inhibit its functions, making a woman’s menstruation painful, and creating problems when conceiving.

One of these conditions is adenomyosis.

Adenomyosis is a condition of the uterine system that can potentially lead to problems in conceiving if left untreated.

Let’s understand this condition in detail.

What is Adenomyosis?

The uterus is a reproductive organ of the female body. Normally, there is a lining over the uterus called “Endometrium.”

Adenomyosis is a condition where the endometrial lining that covers the uterus grows and develops into a muscle. While this newly developed muscle functions completely normally, it isn’t normal for the endometrial lining to grow like this.

Adenomyosis is a painful condition as it causes the uterus to be inflamed and sore. The female suffering from this condition experiences one or more of the following symptoms:

• Painful menstruation
• Heavy bleeding
• Pelvic pain that is sharp, knife-like; this condition is also termed dysmenorrhea
• Prolonged, chronic pelvic pain
• Pain during intercourse – this condition is termed dyspareunia

Doctors aren’t currently certain about the exact causes of adenomyosis. However, the condition is usually resolved after the female hits menopause. The doctors may prescribe hormonal treatments if the female experiences excessive pain because of adenomyosis.

It is important to get adenomyosis treatment in time because if left untreated, the treatment may require a hysterectomy (surgery done in females to remove the uterus).

What are Adenomyosis Causes?

Doctors across the globe are still researching to pinpoint the exact adenomyosis causes. However, up until now, there hasn’t been a concrete explanation for this condition.

A few plausible theories exist that can explain why the endometrial lining would grow into a muscle; at this point, it is all hypotheses.

Let’s look at a few of these theories in a little more detail.

Invasive Growth of Tissue

It is believed that the tissue that lines the uterus – the endometrial tissue – invades the uterine muscle wall and begins to grow into muscle. This may happen because of the C-section surgeries performed for childbirth.

In simpler words, the incisions made on the organ for various operations could lead to this invasion.

Developmental Causes

A few experts believe that when the foetus is still developing inside a female’s body, it is likely that the endometrial tissue gets deposited in the uterine muscle wall.

This can cause the adenomyosis condition to trigger when the baby grows and hits menstrual age.

Inflammation of the uterus from childbirth

Childbirth is a delicate situation in the body of a female. A few experts believe that the uterus may get inflamed during the postpartum period, causing a break in the uterine walls.

This break in the cells could then be invaded by the endometrial tissue, causing adenomyosis.

Origin from stem cells

The most recent hypothesis suggests that adenomyosis cause may lie in the bone marrow. It says that the stem cells in the bone marrow may invade the muscle in the uterus, causing adenomyosis.

The causes of adenomyosis notwithstanding, whether or not this condition grows to become serious depends on how oestrogen (the female hormone) circulates in the body.

The most common risk factors for adenomyosis are middle age, prior surgery of the uterus and childbirth.

What are Adenomyosis Symptoms?

Some women who have been diagnosed with adenomyosis display absolutely no symptoms at all. On the more common scale, though, the following adenomyosis symptoms appear:

• Menstruation: During menstruation, the uterine lining disintegrates, sheds, and is discarded from the body as blood through the vaginal opening. Adenomyosis causes inflammation in the uterine lining, making menstruation extremely painful for a woman. Furthermore, the bleeding is heavier and the menstruation longer than usual. This condition, although not life-threatening for a woman, is detrimental to the quality of her life. Frequent, chronic pains and heavy bleeding are major discomforts of adenomyosis symptoms.
• Pressure in the abdomen: Another problematic symptom of adenomyosis is the feeling of heavy pressure in the abdomen. This happens because of the inflammation of the uterine lining. The lower abdomen (area directly exterior to the uterus) feels tight and pressured and may also feel bloated or blown up.
• Pain: Since adenomyosis involves inflammation of the uterine lining, the pains experienced during this condition are piercing and knife-like during menstrual cramping. It can be difficult to tolerate and manage these pains. Some women also experience chronic pelvic pains in this condition. Adenomyosis can be a localized problem or can cover the entire uterus.

Risk factors of Adenomyosis

Here are a few risks factors for adenomyosis:

• Middle age
• Childbirth
• Any reproductive tract surgery
• Myomectomy
• D&C- dilatation and curettage
• C-section delivery

Adenomyosis Diagnosis

Before ultrasound or non-invasive modern procedures were invented, it wasn’t easy to accurately diagnose a case of adenomyosis. The doctors only had the option to perform a hysterectomy and get a uterine tissue swab to examine under a microscope. This would then reveal if the patient had this condition.

Today, however, the advancement of medical technology has led to more accurate and painless procedures to diagnose adenomyosis causes in patients.

Imaging Technologies

Medical technologies like Magnetic Resonance Imaging (MRI) and Transvaginal Ultrasound have made it possible to view the characteristics of the disease inside the female body without having to perform any surgeries or incisions on the body. MRI is completely non-invasive and painless; however, it requires the patient to remain extremely still during the procedure.

Sono-hysterography

This procedure is a relatively newer technique. The only invasive part of this diagnostic procedure is an injection of a saline solution inserted in the uterus to make it more visible as the doctor performs an ultrasound procedure to view it.

Adenomyosis Treatment

There are quite a few treatments available for adenomyosis today. It depends on the severity of the condition and the type of procedure you would be prescribed:

• Anti-inflammatory medications (NSAIDs) are prescribed when the pain associated with the condition is mild; the medication is required to start two days before the period and throughout the period
• For more severely painful cases, doctors prescribe some hormone therapies
• Uterine artery embolization is a procedure where the arteries that provide blood to the adenomyosis tissue are blocked using tiny particles inserted by a radiologist (minimally invasive)
• In the cases where adenomyosis hasn’t penetrated much into the wall of the uterus, endometrial ablation is performed that destroys this lining of the uterus

It is important to approach doctors and get treatment for adenomyosis for a healthy life, so don’t hesitate to consult one.

Complications of Adenomyosis

There are a few complications that are associated with adenomyosis:

• Cervical incompetency
• Infertility
• Higher risk of anemia
• Body fatigue

Conclusion

Adenomyosis is a painful condition where the pelvic area can feel bloated, sore and painful. It causes uncomfortable, heavy menstruation and can severely impact a woman’s quality of life. In extreme cases, adenomyosis can even cause infertility in women. It is thus advised to visit Birla Fertility and IVF to know more about this condition, or book an appointment with Dr. Rashmika Gandhi at the earliest.

Frequently Asked Questions

1. Is adenomyosis a serious condition?

Adenomyosis is not a life-threatening condition. However, the bleeding and pain associated with the condition may result in a bad quality of life.

2. Does adenomyosis cause a big belly?

Bloating is one of the symptoms of adenomyosis. As a result of inflammation in the uterine lining, you may feel high pressure and bloating in your lower abdomen.

3. Does adenomyosis cause weight gain?

While the inflammatory condition is associated with bloating, adenomyosis isn’t associated with much weight gain.

4. Can adenomyosis affect my bowels?

Yes, the condition is associated with constipation and bowel movement changes.