Adenomyosis is a condition in which the tissue that normally lines the uterus (endometrium) grows into the muscle wall of the uterus (myometrium). In this blog post, we'll discuss how to prevent, recognize, and treat adenomyosis, which can cause the uterus to enlarge and become painful, especially during menstruation. Adenomyosis affects anyone who has a uterus, but it usually resolves after menopause.
Causes of Adenomyosis
There are several factors that may contribute to adenomyosis, including:
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Genetics: You may inherit genes that make you more susceptible to adenomyosis or affect how your uterus develops.
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Environment: You may be exposed to hormones or chemicals that affect your endometrial tissue or immune system.
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Surgery: You may have had a procedure on your uterus, such as a cesarean section or a dilation and curettage (D&C), that allows endometrial cells to invade the uterine wall.
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Inflammation: You may have had an infection or injury that causes inflammation in your uterus or endometrium.
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Stem cells: You may have stem cells from your bone marrow that migrate to your uterus and differentiate into endometrial cells.
Symptoms of Adenomyosis
Symptoms of adenomyosis depend on the extent and location of the endometrial tissue in the uterine wall.
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Bleeding during menstruation (menorrhagia).
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During menstruation, there is severe cramping or sharp pain (dysmenorrhea).
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Pain or pressure in the pelvis that persists over time.
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Dyspareunia (painful intercourse).
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An enlarged uterus or abdomen.
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Constipation or bloating.
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Fatigue or anemia.
There may be no symptoms or only mild discomfort in people with adenomyosis.
Diagnosis of Adenomyosis
You will be asked about your medical history, symptoms, and menstrual cycle to diagnose adenomyosis. You will also be examined physically and you will be checked for signs of enlargement, tenderness, or irregularity in your uterus. Some tests may be ordered to confirm the diagnosis or rule out other possible causes of your symptoms. Some of these tests include:
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An ultrasound is an imaging test that uses sound waves to create images of the uterus and other pelvic organs to determine if they are enlarged or have abnormal growths.
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An MRI uses magnets and radio waves to create detailed pictures of your uterus and other pelvic organs. It can determine the thickness and distribution of endometrial tissue in your uterus.
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These tests measure the levels of hormones, blood cells, or markers of inflammation in your blood. They can determine if you have an infection, anemia, or other conditions that may affect your uterus.
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During a biopsy, a small sample of tissue is removed from your uterus and examined under a microscope to determine if you have adenomyosis.
Treatment of Adenomyosis
Treatment options for adenomyosis vary depending on your age, symptoms, fertility plans, and personal preferences. The main goals of treatment are to reduce your bleeding, relieve your pain, and improve your quality of life.
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Medications can help control your symptoms by affecting your hormones, inflammation, or bleeding. Some common medications include:
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Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs reduce pain and inflammation in your body. In addition to inhibiting prostaglandins, which are substances that stimulate uterine contractions and blood flow, they can also decrease menstrual bleeding. The NSAIDs include ibuprofen (Advil®, Motrin®), naproxen (Aleve®), or aspirin.
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It suppresses ovulation and alters the hormonal balance in your body in order to prevent pregnancy. Hormonal contraceptives are also effective for reducing menstrual bleeding and pain by thinning the endometrium and preventing its growth. Birth control pills, patches, rings, injections, implants, or intrauterine devices (IUDs) are examples of hormonal contraceptives.
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By inhibiting the release of gonadotropins from your pituitary gland, gonadotropin-releasing hormone (GnRH) agonists block estrogen and progesterone in your body. By inducing a temporary menopause-like state, GnRH agonists can shrink endometrial tissue and reduce bleeding and pain during menstruation. Examples include leuprolide (Lupron®), goserelin (Zoladex®), or nafarelin (Synarel®).
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Inhibitors of aromatase: These drugs prevent the body from converting androgens into estrogens by inhibiting the aromatase enzyme. Aromatase inhibitors reduce estrogen levels in the body as well as endometrial tissue growth. They include anastrozole (Arimidex®), letrozole (Femara®), or exemestane (Aromasin®).
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It involves removing or destroying the endometrial tissue in the uterine wall during surgery. Some of the surgical options for adenomyosis include: It can relieve symptoms permanently or for a long time, but it can also affect fertility or require you to remove your uterus.
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A procedure known as endometrial ablation involves using heat, cold, electricity, or lasers to destroy the uterine lining. Most of the endometrial tissue is removed, which reduces menstrual bleeding and pain. When adenomyosis extends deep into the uterine wall, however, it may not be effective.
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This procedure involves injecting small particles into uterine artery vessels that supply blood to the uterus. In addition to reducing menstrual bleeding and pain, it can cause endometrial tissue to shrink by blocking blood flow. However, it may not be suitable for women who wish to become pregnant.
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An hysterectomy is a procedure in which your entire uterus or part of it is removed. It can cure adenomyosis by eliminating all endometrial tissue.
Prevention of Adenomyosis
As adenomyosis is often caused by factors outside your control, preventing it is impossible. However, you can take steps to reduce your risk of developing it or having complications from it.
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Smoking or being exposed to secondhand smoke can damage your uterus and increase your infection risk.
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Make sure you avoid toxins or chemicals that can harm your uterus or immune system, such as pesticides, solvents, or drugs.
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Be sure to maintain a healthy weight and avoid obesity and malnutrition, which can affect your hormone production and metabolism.
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Regularly check your uterus and immune system for infections, tumors, bleeding, and autoimmune diseases.
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If you have a condition that could affect your uterus or immune system, follow your doctor's advice and treatment plan.
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By thinning the endometrium and preventing its growth, hormonal contraceptives can reduce menstrual bleeding and pain.
There are several symptoms associated with adenomyosis, including heavy bleeding, severe pain, an enlarged uterus, and infertility, which occurs when the tissue that normally lines the uterus grows into the uterus' muscular wall. To protect yourself and others from adenomyosis' harmful effects, you must know its causes, symptoms, diagnosis, treatment, and prevention.
