Adenomyosis Symptoms, Causes & Treatment

Adenomy-what now? Bit of a tongue twister, but we think this little-known condition needs to be talked about more often. If you’ve never heard of it, we’re covering what it is, what symptoms to watch out for, what it’s like to live with the condition, how it affects fertility, treatment options, and more. Here we go… 

What is adenomyosis? 

Adenomyosis is a condition where the inner lining of the uterus breaks through the muscle wall of the uterus, known as the myometrium, in either one localised spot or throughout the whole of the uterus. 

This can cause a fair bit of bodily havoc for some, such as menstrual cramps, abdominal pressure, bloating, heavy periods, and more, although it is not life-threatening. That said, the pain it can cause, and symptoms like heavy bleeding, can negatively impact your life if you suffer from adenomyosis.

Who is most likely to get it? 

It’s quite common, and mostly found in middle age, or after having children. Studies suggest those who have had uterine surgery in the past could be at a higher risk. 

What causes it? 

The exact cause of adenomyosis is unknown, but studies suggest hormones such as estrogen, progesterone, prolactin, and follicle stimulating hormone, could be involved. It is believed that when the lining of the uterus attempts to heal after injury, re-growth may happen inwards rather than outwards, which could develop adenomyosis. 

Some factors that may increase the risk are being in your 40s or 50s (but premenopausal), having children, and having had surgery of the uterus, for example a C-section delivery or surgery to remove fibroids. There are many other risk factors, and unfortunately no known way to prevent this condition. It is thought to be simply down to genes, hormones, and the immune system. It’s not life-threatening, and may go away when you reach menopause.

What are the main adenomyosis symptoms? 

The most common symptoms of adenomyosis are:

• Heavy, painful or irregular periods
• Pre-menstrual pelvic pain
• A feeling of heaviness or discomfort in the pelvic area 

It’s also good to watch out for pain during sex and when having a bowel movement, but these symptoms are less common. In many cases, one third to be exact, sufferers will have no symptoms at all, and the condition is often found by chance during a routine scan. 

Is it similar to endometriosis?

Adenomyosis is different from endometriosis, which is when endometrial tissue is implanted outside of the uterus. People who suffer from adenomyosis could have endometriosis simultaneously, or develop it alongside at a later date. 

How does adenomyosis affect fertility? 

While there isn’t a lot of research in this area, and the research that does exist is conflicting, studies suggest that adenomyosis could affect fertility. Research has found that adenomyosis could potentially impair fertility by affecting the ‘uterotubal transport’ and altering endometrial function, but again, more studies must be done to determine whether the condition can directly affect fertility, and to what end. 

How is it diagnosed?

A doctor may diagnose you with adenomyosis after reviewing your medical history, and carrying out a pelvic exam to look for any enlargement. If they suspect adenomyosis, there may be tests such as an ultrasound (not always effective due to adenomyosis looking very similar to uterine fibroids on ultrasound), an MRI scan, or an endometrial biopsy to test a small sample of endometrial tissue. 

It’s important to know that none of these will help diagnose adenomyosis, but rather, rule out other causes for symptoms. The only way to properly diagnose adenomyosis is via hysterectomy, and having a pathologist examine the uterus. This would only be considered in extreme cases. 

Are there any treatments? 

With a difficulty in diagnosing adenomyosis, comes a difficulty in developing treatments, as many treatments simply address symptoms rather than the underlying cause. Still, if you suffer with intense pain or heavy bleeding due to the condition, available treatments could vastly improve your quality of life. 

Treatment options include non-hormonal medicines that ease pain and bleeding, hormonal medicines like the combined oral contraceptive pill or coil, hormone injections for a temporary and reversible menopause, a hysterectomy to remove the womb, or a uterine artery embolisation, where small particles are injected into your blood vessels to cut off the blood supply to the adenomyosis.

You can discuss possible treatment options with your doctor, and they will take into account factors that may influence your decision when it comes to treatments, for example your age and how close you are to menopause, whether you want to become pregnant in future, treatments you have already tried, your feelings about surgery, and more. In some cases, such as if symptoms are mild, you are nearing menopause, or you are trying for a baby, the best course of action may be to do nothing for the time being. 

Is it possible to live with the condition long-term?

Yes. Many people experience only mild symptoms of adenomyosis, and feel that they can manage it themselves until such time as they reach menopause age, or choose to have a baby and seek treatment afterwards. Studies have looked into the management of adenomyosis, and while there are no drugs currently available to manage the condition, there are a number of smaller procedures that could improve symptoms in the long run, and research is ongoing in this area. 

It is for this reason that you should speak to your doctor regularly about any symptoms you experience, so you can understand all treatment options, and they can continue to give you the most up-to-date advice. 

Have you been diagnosed with adenomyosis, or do you suspect you have the condition? Tell us about your symptoms and experience in our private Facebook group or drop us a note on Insta @itsyoppie. Don't forget that our personalised period box can get organic tampons, PMS supplements and more delivered easily and regularly through your letterbox, so that's one load off your mind about everything that might be going on down there.