What is adenomyosis?

Adenomyosis is a condition of the uterus. Where the inner lining of the uterus breaks through the muscle wall.

Basically, the uterus has several layers. The innermost layer lines the uterine cavity. This is the endometrium. This is the part that will shed each month when a woman has a period. The next layer – going outwards is the myometrium. The outermost layer is a thin covering called the serosa.

Adenomyosis occurs when tissue that lines the uterus grows into the muscular wall. This tissue then continues to act as normal. Breaking down and bleeding as it would during each menstrual cycle. It is a long-term condition that can affect your daily routine. The symptoms will stop when the menopause starts.

It can be local, restricted to one area of the uterus or can affect the uterus as a whole. It is not contagious and is not cancerous.

Adenomyosis symptoms
Around a third of women show no symptoms at all and the condition quite often goes unnoticed. Those that suffer symptoms feel them at different times during the menstrual cycle. Before your period you may experience discomfort or a ‘heavy’ feeling in the pelvis. Quite often accompanied by bloating and abdominal pressure.

During periods it can cause heavy menstrual bleeding. This can last longer than it has before. You may also suffer from severe menstrual cramps. Less common, pain during sex or when going to the toilet.

What causes it?
We do not know the exact cause for why Adenomyosis occurs. One current theory is that the womb lining tries to heal itself after injury. The re-growth happens inward instead of outward. It is likely that hormones, immune system and your genetic make up may also play a part.

Other studies suggest hormones can trigger the condition. Such as estrogen, progesterone and prolactin. At the moment, there is no known way to prevent it. It is not down to anything you have done in the past, so you should not worry that you have done anything to cause it.

Imaging technology have made it possible to recognise Adenomyosis without surgery. Using MRI and ultrasound doctors can now see the characteristics in the uterus.

An initial pelvic examination can reveal a tender and enlarged uterus. A transvaginal ultrasound shows the muscular wall and the lining of the uterus. Although not definitive, these tests help rule out other conditions with similar symptoms. An MRI is often used for diagnosis when the symptoms include heavy bleeding.

The treatment will depend on several factors. The symptoms you show and how severe they are. How old you are and how close to the menopause you are. Whether you are actively trying to become pregnant.

Often over the counter pain medication is enough to manage the symptoms. If symptoms are mild, or if you are trying for a baby. The same goes if you are close to menopause where the symptoms will go away on their own.

For heavy or painful periods, you can use non-hormone and hormone treatments. If you want to preserve your fertility, uterine artery embolisation is an option. Tiny particles are injected into your blood vessels through a catheter in the groin. The particles cut off the supply of blood to the adenomyosis. This is less invasive but symptoms can recur in the future.

How does adenomyosis affect fertility?
It is difficult to tell what part it plays in fertility issues. It does not seem to decrease the chance of getting pregnant. But, it’s thought to increase the risk of miscarriage or premature delivery. Many women also suffer from endometriosis at the same time. This is a well-known cause of infertility. This makes it difficult to determine which condition is as fault.

Adenomyosis and IVF
It can have an effect on a successful IVF implantation. The condition it’s thought to interfere with the IVF process. It can disrupt the embryo implanting in the cells of the endometrium.

To find out more about Adenomyosis and the testing and treatment options available to you, get in touch and arrange a consultation.

Further reading:
Adenomyosis Advice Association

Adenomyosis and IVF