Evertthing You Need to Know about Adenomyosis

Adenomyosis refers to the offsite growth of innermost uterine cells towards the middle layer of the uterus called the myometrium. This condition occurs only in women of reproductive age. The most plausible cause for this condition is the disrupted partition between two uterine layers. This condition is commonly evaluated through various laboratory tests involving biomarkers, and imaging tests like MRI, ultrasound, etc.

What is Adenomyosis

Adenomyosis is a reproductive-aged women’s condition in which endometrial tissues grow inside the myometrium (middle layer of the uterus). Endometrium refers to the innermost uterine layer. When the cells of the endometrium start growing in other places outside the endometrium, it will lead to various health issues and even cause infertility in women. When this ectopic growth of the endometrium occurs in the ovaries or outside the uterus, it leads to endometriosis. When this ectopic growth of the endometrium occurs in the myometrium, it leads to a condition called adenomyosis.

Causes 

The most plausible cause for this condition is the disrupted partition between two uterine layers. Other causes include, 

1. 1. Inflammation in uterus
2. 2. Endometrial cells invasion protrusion in the muscle layer of the uterus 
3. 3. Developmental defect- endometrial tissue may be deposited in the muscle layer of the uterus in the foetal stage.
4. 4. Bone marrow cells invading the uterus muscle layer
5.  

Symptoms

1. 1. Heavy flow in periods
2. 2. Extreme pain during sexual intercourse
3. 3. Swelling in the pelvic and abdominal region
4. 4. Urinary tract discomfort
5. 5. Extremely painful period cramps
6. 6. Irregular menstruation
7.  

Diagnosis

1. 1. Physical examination- for enlarged belly or swollen abdomen
2. 2. Abdominal scanning through:
   1. A. Vaginal ultrasound, 
   2. B. CT scan, 
   3. C. MRI of uterus
   4. D. Biopsy of uterine myometrium tissue
   5.  

Treatments

Medications to treat adenomyosis include:

Hormonal drugs or contraceptives

• 1. Oestrogen-progestin pills
• 2. Progestin contraception 
• 3. Intrauterine device
• 4. Vaginal rings
•  

Anti-inflammatory drugs- ibuprofen 

Surgical Treatments 

1. 1. Endomyometrial ablation- This surgical procedure is based on removing the extra tissues outside the uterus through heat.
2. 2. Hysterectomy- Surgical procedure to remove the uterus or ovaries is quite helpful in treating adenomyosis.
3.  

Risks 

1. 1. Problems during childbirth
2. 2. Middle age
3. 3. Post-C-section
4. 4. Post dilatation and curettage 
5. 5. Post fibroid removal
6.  

Complications

Heavy bleeding can lead to anaemia and other reproductive health issues.

If Left Untreated

Adenomyosis is a gynaecological condition that often gets worsens with time and must not be ignored because if it is left untreated, it can lead to various reproductive health issues, including 

1. 1. Pelvic organ prolapse- Slipping of one or more pelvic organs from the there original site towards the vagina 
2. 2. Infertility
3. 3. Miscarriages 
4. 4. Premature births
5.  

Frequently Asked Questions

Q1. What is adenomyosis?

Adenomyosis is a reproductive-aged women’s condition in which endometrial tissues grow inside the myometrium (middle layer of the uterus). Endometrium refers to the innermost uterine layer. When the cells of the endometrium start growing in other places outside the endometrium, it will lead to various health issues and even cause infertility in women. When this ectopic growth of the endometrium occurs in the ovaries or outside the uterus, it leads to endometriosis. When this ectopic growth of the endometrium occurs in the myometrium, it leads to a condition called adenomyosis.

Q2. What do you think are the possible causes for adenomyosis?

The most plausible cause for this condition is the disrupted partition between two uterine layers. Other causes include, 

1. 1. Inflammation in uterus
2. 2. Endometrial cells invasion protrusion in the muscle layer of the uterus 
3. 3. Developmental defect- endometrial tissue may be deposited in the muscle layer of the uterus in the fetal stage.
4. 4. Bone marrow cells invading the uterus muscle layer
5.  

Q3. Can you list out the symptoms for adenomyosis?

Adenomyosis occurs in adolescent girls and women in their reproductive age. If a woman is experience some or all of the following symptoms she must go to a gynaecologists for adenomyosis diagnosis:

1. 1. Heavy flow in periods
2. 2. Extreme pain during sexual intercourse
3. 3. Swelling in the pelvic and abdominal region
4. 4. Urinary tract discomfort
5. 5. Extremely painful period cramps
6. 6. Irregular menstruation
7.  

Q4. What are the diagnostic tests for adenomyosis?

Physical examination of the pelvic region

1. 1. Feeling of tenderness in vagina
2. 2. Enlarged belly or swollen abdomen
3. 3. Immobile uterus
4. 4. Palpable nodules in posterior fornix
5.  

Biopsy of uterine myometrium tissue

MRI of uterus- transvaginal ultrasound with high resolution can help in exploring intramuscular tissues of the uterus.

Q5. Are there any  non-invasive diagnostic methods for adenomyosis? 

To diagnose adenomyosis, there are various non invasive diagnostic tools, which include,

1. 1. Magnetic resonance imaging
2. 2. Transvaginal ultrasound
3. 3. Biomarker tests 
4.  

Q6. What are the treatment options available for adenomyosis?

Medications to treat adenomyosis include:

Hormonal drugs or contraceptives

• 1. Oestrogen-progestin pills
• 2. Progestin contraception 
• 3. Intrauterine device
• 4. Vaginal rings
•  

Anti-inflammatory drugs- ibuprofen 

Surgical Treatments

1. Endomyometrial ablation- This surgical procedure is based on removing the extra tissues outside the uterus through heat.
2. Hysterectomy- Surgical procedure to remove the uterus or ovaries is quite helpful in treating adenomyosis.

Q7. Are there any surgical procedures to treat adenomyosis?

Surgical Methods

1. 1. laparoscopic surgery
2. 2. Endomyometrial ablation- This surgical procedure is based on removing the extra tissues outside the uterus through heat.
3. 3. Hysterectomy- Surgical procedure to remove the uterus or ovaries is quite helpful in treating adenomyosis.
4. 4. Cystectomy
5.  

Q8. What are the risk factors associated with adenomyosis?

Some of the risk factors associated with adenomyosis are as follows:

1. 1. Problems during childbirth
2. 2. Middle age
3. 3. Post-C-section
4. 4. Post dilatation and curettage 
5. 5. Post fibroid removal
6.  

Q9. What will be the consequences if I don’t take treatment for adenomyosis?

Adenomyosis is a gynaecological condition that often gets worsens with time and must not be ignored because if it is left untreated, it can lead to various reproductive health issues, including 

1. 1. Pelvic organ prolapse- Slipping of one or more pelvic organs from the there original site towards the vagina 
2. 2. Infertility
3. 3. Miscarriages 
4. 4. Premature births
5.  

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