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.
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 βenlarged uterus.β
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.
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:
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.
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:
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:
Digestive disorders: Bloating, constipation, or diarrhea can be symptoms of an enlarged uterus, especially if it puts pressure on nearby organs.
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.
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:
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.
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.
Estrogen and progesterone medications may be prescribed in the treatment of adenomyosis to reduce heavy bleeding and painful cramps.
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.
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 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.
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 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.
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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:
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:
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.
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.
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, βharderβ does not mean βimpossible.β Many women with adenomyosis are able to get pregnant.
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.
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.
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.
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.
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.
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