Adenomyosis

Diagnosis of adenomyosis

If you suspect you have adenomyosis, it is important to see your doctor. There are two reasons for this. The first is that the symptoms of adenomyosis are similar to the symptoms of other, more serious conditions, such as:

  • Fibroid tumors
  • Endometriosis (when the endometrial cells grow outside of the uterus)
  • Endometrial polyps (growths in the lining of the uterus)

The other reason to see your doctor is that the treatment of adenomyosis can reduce symptoms and significantly increase your quality of life. It will address pain and heavy bleeding that may be preventing you from doing the things you love.

When you see your doctor, you will discuss your symptoms and medical history. Your doctor will also perform a pelvic exam to feel the size of the uterus. Other tests your doctor might request include:

  • An ultrasound to get an image of the uterus: This will help your doctor rule out other potential causes of your symptoms, such as uterine tumors and fibroids.
  • Magnetic resonance imaging (MRI): This will allow your doctor to get a more detailed high-resolution image of the uterus. It is often used if a diagnosis cannot be made via ultrasound.
  • An endometrial biopsy (sample of tissue): This test can be used to rule out something more serious, such as cancer.

All of these methods can tell your doctor if there is potential presence of adenomyosis. However, the only way to know for sure is to examine the uterus after a hysterectomy.

Treatment

Treatment and prevention options depend on the severity of your symptoms, the degree to which they affect your life, and your age. Because adenomyosis typically goes away with menopause, women with mild symptoms who are close to menopause may not need any treatment. For those who need adenomyosis treatment, options include:

  • Birth control pills: Birth control helps regulate hormone levels and decrease the pain and bleeding associated with adenomyosis.
  • Progesterone-containing IUDs: This treatment method may cause your periods to stop, providing relief from symptoms.
  • Endometrial ablation: This is a procedure that removes the endometrial cells from the uterine wall. However, it is only applicable when adenomyosis has not penetrated the uterine wall to a great depth.
  • Uterine artery embolization: This procedure cuts off the blood supply of the arteries that feed the adenomyosis, which will cause it to shrink.
  • MRI-guided focused ultrasound surgery (MRgFUS): This is a procedure that relies on the use of high-intensity waves that are focused on the adenomyosis. The resulting heat will destroy the adenomyosis tissue.
  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen: These medications not only decrease inflammation, they may also reduce blood flow and cramping during your period.
  • Hysterectomy: This is the only cure for adenomyosis and may be recommended if your symptoms are severe and interfering with your life, and other treatments have not provided satisfactory relief.

Your gynecologist will discuss your treatment options with you and help you select the most appropriate plan.

Preparation

To prepare for your appointment, you need to be sure to schedule it when you are not due to have your period. This is because the doctor will want to do a pelvic exam. In addition, you can do the following to prepare:

  • Compose a list of questions for your doctor
  • Be prepared to discuss your symptoms (severity, relation to menstrual cycle)
  • Be prepared to discuss your medical history (including childbirth and surgical history)
  • Bring a list of all medications you are currently taking

Your doctor may also ask whether you take birth control, whether you could be pregnant, and the date of your last period.

Recovery

Since adenomyosis is not life-threatening, the outlook for women with the condition is good. The available treatments are very effective at minimizing the symptoms so you can enjoy your regular lifestyle and activities. The only way to permanently be free of the condition is to have a hysterectomy or to wait it out, since it commonly goes away after menopause.

Complications

Since adenomyosis is typically accompanied by heavy periods with prolonged bleeding, one of the most common complications is the development of chronic anemia. This can result in fatigue and other associated health problems.

In addition, the pain, discomfort, and heavy bleeding associated with adenomyosis can impact your quality of life. For example, it can make it challenging to engage in activities you once enjoyed.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.