FAQs on Adenomyosis

Adenomyosis (uterine endometriosis) is a benign disease of the uterine muscle. This condition can be painful and cause loss of work time and disability. Endometrial cells form the lining of the uterus, and they can migrate from that region. When they go to the back wall of the uterus, adenomyosis occurs.

How common is adenomyosis?

Adenomyosis mostly affects women in their early to middle 40s, and it is associated with hormonal changes. Around 10% of women diagnosed with adenomyosis also have endometriosis, and 60% of women who have had a hysterectomy also have this condition.

What are the different types of adenomyosis?

Adenomyosis presents in two forms:

• Adenomyomas – This is solid tumors that involves encapsulated collections of endometrial cells with well-defined borders. These tumors appear as fibroids, and they are easily removed from the uterus.
• Diffuse adenomyosis – This is the most common form of adenomyosis, and it involves endometrial cells that invade the uterus. This causes enlargement and hardening of the uterus, and makes intercourse painful.

What causes adenomyosis?

Adenomyosis is often difficult to diagnose, and the exact cause is not known. Adenomyosis is associated with excess levels of hormones. In addition, this condition often runs in families. Adenomyosis is seen in people with tubal ligations, history of C-sections, and pregnancy terminations.

What are the symptoms of adenomyosis?

The signs and symptoms of adenomyosis are related to the severity of the disease and degree of penetration into the uterine muscle. The condition spreads, also, which causes more symptoms. These symptoms include:

• Cramps
• Prolonged bleeding
• Dysmenorrhea (painful menses)
• Hypermenorrhea (heavy periods)
• Abdominal bloating
• Large clots
• Painful intercourse
• Back pain
• Nausea and vomiting

How is adenomyosis diagnosed?

Many physicians diagnose adenomyosis based on the signs and symptoms. However, when you see a specialist, certain diagnostic tests are performed. These include ultrasounds, CT scans, and uterine scope. A medical history and physical examination is also performed. The conclusive test used to diagnose adenomyosis is a uterine muscle biopsy, which is done using a hysteroscope or laparoscope.

Does adenomyosis cause infertility?

Adenomyosis is associated with infertility but not in every case. Because it can lead to clots, bleeding, and pain with intercourse, many women are not able to get pregnant. Positive fertility outcomes are related to how much of the uterus is impacted by the disease.

How is adenomyosis treated?

Traditional medicine is used to treat adenomyosis. The doctor may combine treatment options. These options include:

• Pain medicines – Nonsteroidal anti-inflammatory drugs and tramadol are often used.
• Hormone therapy – This includes use of estrogen and progesterone to regulate menses. Progesterone helps balance the effects of excess estrogen, which often occurs with this condition.
• Dilation and curettage – A D&C and ablation is often used to reduce bleeding and clotting. Many patients respond to this treatment.
• Hysterectomy – This is the most common treatment for adenomyosis. This involves removal of the uterus, and possibly, the ovaries.

Does stem cell therapy help treat adenomyosis?

Stem cells have been used to treat problems with the endometrium (uterus lining). In a recent clinical study, stem cells were found to improve cyclic endometrial function. In the examination of these patients, researchers found that stem cells regenerated uterus cells.

Resources

Du H & Taylor HS (2007). Contribution of Bone Marrow-Derived Stem Cells to Endometrium and Endometriosis. Stem Cells, 25(8), 2082-2086.