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Uterine Adenomyosis - Causes, Symptoms, Risk Factors, Treatment

Menstrual cramps that won't go away? Heavy bleeding? Sometimes your body tells you something is wrong. And when it does, it's important to listen to it. Severe pain during that time of the month that doesn't even respond to painkillers can be a sign of uterine adenomyosis.

But what does adenomyosis mean? Why does it hurt so much and, most importantly, what can you do when you hear this diagnosis? You've come to the right place, because in this article we explain exactly what adenomyosis is, how to recognize it and what treatment methods exist.

What is uterine adenomyosis (enlarged uterus)?

Uterine adenomyosis is a gynecological condition that occurs when the uterine lining (the endometrial tissue that normally lines the inside of the uterus) grows into the muscular wall of the uterus. This can also cause the uterus to enlarge, which is why adenomyosis is also called an β€œenlarged uterus.”

Women suffering from this condition may have increased sensitivity in the uterus and may notice heavy, long-lasting menstrual bleeding accompanied by intense menstrual pain.

Adenomyosis - Causes

Doctors and researchers have not yet identified the causes of uterine adenomyosis. It is not known for sure why it occurs in some women, nor what causes the endometrium to grow into the uterine wall.

Instead, they were able to identify a series of factors that may favor the infiltration of endometrial tissue into the uterine wall. These include:

  • Hormonal imbalances : Due to the favorable role that estrogen plays in the growth of endometrial tissue, too high a level of estrogen compared to progesterone has been associated with the growth of tissue in the uterine wall and the development of adenomyosis.
  • Childbirth: It has been observed that there is a higher risk of endometrial tissue infiltrating the uterine wall after childbirth , in women who have gone through one or more pregnancies, as a result of stretching and weakening of the uterine walls.
  • Previous uterine surgeries: especially cesarean sections, curettage, fibroid removal, or other uterine surgeries that may affect the normal structure of the uterine walls.
  • Inflammation: If there is chronic inflammation inside the uterus, it can lead to the weakening and rupture of the barrier between the endometrium and myometrium, facilitating the development of adenomyosis.

    What is uterine adenomyosis ➜ Adenomyosis symptoms & Treatment

Uterine adenomyosis - Risk factors

Most cases of adenomyosis are found in women over the age of 30, but any woman who menstruates can be affected. Also, in most patients, the symptoms of adenomyosis disappear completely after menopause due to the strong impact of decreased estrogen levels.

So, in addition to the possible causes discussed above, there are other factors that may contribute to an increased risk of an enlarged uterus:

  • Age: Most diagnoses of uterine adenomyosis have been identified in women between the ages of 40 and 50.
  • Family history: Women with a family history of adenomyosis are at higher risk of receiving the same diagnosis themselves, which may indicate a possible genetic influence.
  • Menstrual history: Factors related to the menstrual cycle , such as early onset of menstruation and heavy flow, are also associated with a higher risk of adenomyosis.

Adenomyosis - Symptoms

If we look at the statistics, 1 in 3 women affected by adenomyosis do not know they have this problem because they do not show symptoms. However, for the other 2 in 3 women, uterine adenomyosis can manifest itself through discomfort, menstrual cycle disorders and severe pain:

  • Heavy or prolonged menstrual bleeding: also known as menorrhagia , characterized by long-lasting bleeding or a heavy menstrual flow, requiring changing pads and tampons even hourly.
  • Pelvic pain: It can be constant or intermittent abdominal pain , with an intensity that can vary from mild pain to unbearable pain, which becomes stronger during menstruation or during sexual intercourse.
  • Severe menstrual cramps: Severe menstrual pain, which intensifies from one month to the next and can no longer be relieved with painkillers or natural methods such as Enroush heat patches , is among the most common signs of uterine adenomyosis.
  • Pelvic pressure or discomfort: a feeling of pressure, discomfort, or pain in the lower part of the pelvis.
  • Urinary symptoms: frequent urination, discomfort when urinating (dysuria), or the inability to empty the bladder can also be symptoms of adenomyosis.
  • Digestive disorders: Bloating, constipation, or diarrhea can be symptoms of an enlarged uterus, especially if it puts pressure on nearby organs.

    What is uterine adenomyosis ➜ Adenomyosis symptoms & Treatment ➜ The difference between adenomyosis and endometriosis ➜ Learn more!

Adenomyosis vs. Endometriosis - What is the difference between them?

The truth is that adenomyosis and endometriosis not only have similar names, but sometimes they just feel the same. Both are associated with menstrual irregularities and severe menstrual pain, which is why they are easy to confuse. However, they affect the body in different ways.

Endometriosis occurs when endometrial tissue, which should normally line the inside of the uterus, grows outside the uterus: on the ovaries, fallopian tubes, bladder, and other places where it shouldn't be.

Adenomyosis, on the other hand, occurs when the same endometrial tissue grows, this time, into the uterine wall, causing the uterus to enlarge and causing pain from within.

Uterine adenomyosis - How is it diagnosed?

The gynecologist is the one who diagnoses uterine adenomyosis, based on the patient's history and the results of the investigations.

Your doctor will first take your medical history. They will ask you questions about your menstrual cycle, your surgical history, and any symptoms you are experiencing. They may then perform a pelvic exam to see if your uterus is tender or enlarged, its size and shape, or if there are any other signs of gynecological problems.

Because simply correlating the medical history with a physical examination is not enough to diagnose adenomyosis, the doctor may also request other tests and investigations:

  • Transvaginal ultrasound, to obtain detailed images of the pelvic organs and to observe whether the uterine wall is thickened, whether there are cystic spaces or other irregularities in the uterine lining.
  • MRI, recommended when ultrasound results are not sufficient, to analyze the uterus in more detail, to assess the severity of the condition, but also to differentiate an enlarged uterus from fibroids, polyps, or other gynecological problems.
  • Endometrial biopsy, which is not always necessary nor is it normally performed, but only in situations where confirmation of the diagnosis is needed to exclude other possible conditions.

Treatment for uterine adenomyosis

Due to the strong impact that estrogen levels in the body have on the growth of endometrial tissue, symptoms of uterine adenomyosis often disappear on their own after menopause, when estrogen levels decrease.

But for women who suffer from severe discomfort due to this condition, there are several effective treatment options. These aim to relieve pain, reduce menstrual bleeding, and overall improve quality of life.

Factors such as the severity of symptoms, the stage of the condition, your overall health, and your position regarding the possibility of becoming pregnant in the future will be considered by the doctor before recommending treatment.

Anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs can help reduce menstrual cramps and the feeling of pressure or discomfort in the pelvic area. If these are ineffective, painkillers may also be recommended.

Hormone-based medications

Estrogen and progesterone medications may be prescribed in the treatment of adenomyosis to reduce heavy bleeding and painful cramps.

Hormonal intrauterine device

Another hormonal treatment method is the IUD. Like estrogen and progesterone-based birth control pills, the intrauterine device can help relieve pain and abnormal menstrual bleeding.

Uterine artery embolization

The intervention consists of injecting small particles into the arteries that supply blood to the uterus. These particles have the role of blocking blood flow to the affected areas. The procedure is minimally invasive and is performed by a radiologist.

Endometrial ablation

Endometrial ablation is another intervention whose goal is to reduce menstrual bleeding and pelvic pain. This time, the procedure consists of destroying the endometrium through freezing, heat, or other methods.

In general, the intervention is not recommended for women who still want to get pregnant.

HIFU

Known as High Intensity Focused Ultrasound, this procedure uses intensely focused high-frequency ultrasound to destroy certain parts of the uterus, with the aim of reducing its volume and improving the symptoms of adenomyosis.

Hysterectomy

Hysterectomy is universally considered the definitive treatment for adenomyosis. It is a surgical procedure that involves removing the uterus to completely eliminate symptoms.

Due to its implications, the procedure is only recommended for women who no longer wish to become pregnant, or for whom other treatment options have not worked.

The difference between adenomyosis and endometriosis ➜ Learn more! A

Uterine adenomyosis - Possible complications

If left untreated, uterine adenomyosis can cause chronic pain and infertility. The prolonged and heavy bleeding caused by adenomyosis can also lead to chronic anemia, fatigue, and other health problems over time. Here are the most possible complications of an enlarged uterus if you ignore the symptoms:

  • Chronic pelvic pain, so severe that it prevents you from carrying out your daily activities
  • Heavy menstrual bleeding, which can lead to anemia, fatigue, feeling weak, and difficulty breathing
  • Dysmenorrhea, or unbearable menstrual cramps, on which analgesic medications no longer have an effect
  • Infertility or miscarriage, because it can prevent the embryo from implanting in the uterus and cause inflammation or scarring of the ovaries and fallopian tubes.
  • Emotional stress, anxiety, and depression, because life with chronic pain and constant discomfort can be difficult to manage.
  • Sexual dysfunction, because pelvic pain and associated discomfort can have negative effects on libido and sex life, causing problems in couple life.

Uterine adenomyosis - Prevention

There are currently no known ways to prevent adenomyosis, but there are methods that can reduce the risk of developing the condition and improve symptoms:

  • Maintaining a healthy body weight, through an active lifestyle and a nutritious and balanced diet, to avoid hormonal imbalances associated with under- and overweight.
  • Limiting exposure to estrogen-like substances, such as hormone disruptors in plastics, pesticides, and other toxic chemicals that may be present in cosmetics and personal care products; choosing instead organic foods and personal care products, made with pure ingredients that are gentle on the body.
  • Managing hormonal imbalances to reduce the risk or severity of the condition.
  • Minimizing unnecessary uterine trauma by avoiding unnecessary surgeries such as curettage or fibroid removal surgery.
  • Regular medical check-ups, to detect any gynecological condition early and receive appropriate treatment before complications arise.

Recommended diet and lifestyle for patients with adenomyosis

Unless you're going through menopause or having a hysteroscopy, adenomyosis won't go away overnight. But your everyday choices can make a real difference in how you feel and how intensely you experience the symptoms of an enlarged uterus.

Thus, patients suffering from adenomyosis are recommended to follow an anti-inflammatory diet, rich in vegetables, fruits, nuts and sources of omega-3 fatty acids, which can help reduce inflammation and pain. It is also recommended to avoid ultra-processed foods and excessive consumption of sugar and alcohol.

Also, stress management techniques, an active lifestyle, and sufficient rest nightly are key factors that ensure hormonal balance, essential in managing adenomyosis.

Frequently asked questions about adenomyosis

We know, the most specific questions sometimes arise right after you finish reading. That's why we've gathered the most frequently asked questions about uterine adenomyosis and the answers to each one. So that you're not left with any questions, but only with more confidence in yourself and your body.

Can adenomyosis affect fertility?

Yes, adenomyosis can make it harder for an embryo to implant in the uterus. When endometrial tissue grows into the uterine wall, constant inflammation can prevent implantation. However, β€œharder” does not mean β€œimpossible.” Many women with adenomyosis are able to get pregnant.

Can uterine adenomyosis be treated without surgery?

Yes, there are many non-surgical treatment options to relieve the symptoms of adenomyosis. Mild pain can be reduced with anti-inflammatory and analgesic medications. Heavy bleeding and pain can be managed with hormonal treatments such as an intrauterine device or the estrogen-progesterone birth control pill.

Also, lifestyle changes and opting for natural intimate care products, without endocrine disruptors, can have a positive impact.

Are there natural remedies that can improve the symptoms of adenomyosis?

Some women use anti-inflammatory ginger, turmeric, and raspberry leaf teas, or magnesium supplements to relieve symptoms caused by adenomyosis. However, these are not a substitute for professional advice and proper treatment.

Don't ignore the signs by trying to use only natural remedies, as severe cramps and heavy bleeding can lead to complications such as chronic pain, anemia, infertility, and more.

Can adenomyosis be confused with other gynecological conditions?

Yes, adenomyosis can be easily confused with endometriosis, both of which manifest themselves through menstrual cycle disorders and severe menstrual pain. For this reason, before establishing a diagnosis, thorough investigations recommended by a gynecologist are necessary.

When is surgery necessary for adenomyosis?

Surgery is usually only recommended in chronic cases, when the patient has unbearable pain, heavy bleeding, or does not respond to other treatments. If the patient does not plan to become pregnant again, endometrial ablation or hysterectomy may be recommended.

Can exercise help relieve the symptoms of adenomyosis?

Yes, regular and moderate exercise (walking, swimming, pilates, yoga, etc.) supports hormonal balance, can reduce inflammation and improve blood circulation, helping to reduce menstrual pain and relieve symptoms of adenomyosis.

Photo source: Pexels.com

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