About Adenomyosis

Adenomyosis is a benign (non-cancerous) condition where the tissue that normally lines the uterus (endometrium) grows into the muscular wall of the uterus (myometrium).

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What Happens in Adenomyosis?

• During the menstrual cycle, this misplaced tissue responds to hormones just like regular endometrial tissue: it thickens, breaks down, and bleeds.

• But because it's trapped inside the muscle wall, it causes the uterus to become:

  • Enlarged

  • Thickened

  • Often tender or painful

Common Symptoms:

Symptoms can vary in severity—or be absent altogether—but commonly include:

• Heavy or prolonged menstrual bleeding (menorrhagia)

• Severe menstrual cramps (dysmenorrhea)

• Chronic pelvic pain

• Painful sex (dyspareunia)

• Enlarged, tender uterus (sometimes felt as abdominal bloating or heaviness)

• Fatigue or anemia (from blood loss)

Diagnosis:

Adenomyosis can be challenging to diagnose because it shares symptoms with other conditions like fibroids or endometriosis.

Diagnosis may include:

• Pelvic exam: Uterus may feel enlarged or tender

• Imaging:

  • MRI is the most accurate

  • Transvaginal ultrasound can show signs, but may miss subtle cases

• Definitive diagnosis: Only confirmed by examining uterine tissue after hysterectomy, though non-invasive diagnosis is improving

What Causes It?

The exact cause is unknown, but theories include:

• Invasive growth of endometrial tissue into the muscle

• Developmental origins (from when the uterus forms before birth)

• Post-childbirth trauma to the uterine lining

• Hormonal and immune system factors

It most commonly affects women in their 30s to 50s, especially those who have had multiple pregnancies.

Treatment Options:

Treatment depends on the severity of symptoms and whether the person wants to preserve fertility.

Non-surgical options:

• Anti-inflammatory meds (NSAIDs like ibuprofen)

• Hormonal treatments:

  • Birth control pills or IUDs (e.g., Mirena)

  • GnRH agonists to reduce hormone levels

• Tranexamic acid: Reduces heavy bleeding

Surgical options:

• Uterine artery embolization (UAE): Minimally invasive, cuts off blood supply to adenomyotic tissue

• Endometrial ablation: Can help in mild cases (not recommended if future fertility is desired)

• Hysterectomy: The only definitive cure, especially for severe or unresponsive cases