In adenomyosis, tissue from glands in the lining of the uterus (endometrium) grows into the muscular wall of the uterus. The uterus becomes enlarged, sometimes doubling or tripling in size.
Adenomyosis can cause heavy, painful menstrual periods and pelvic pain.
Doctors suspect adenomyosis when they do a pelvic examination, and they often do ultrasonography or magnetic resonance imaging to support the diagnosis.
How many women have adenomyosis is unclear, partly because it is hard to diagnose.
Adenomyosis causes symptoms in only some women, usually those aged 35 to 50. Some women with adenomyosis also have endometriosis or fibroids.
The cause of adenomyosis is unknown. Adenomyosis may be more common among women who have had more than one pregnancy.
Symptoms of Uterine Adenomyosis
Symptoms of adenomyosis include heavy and painful periods (dysmenorrhea), vague pain in the pelvic area, and a feeling of pressure on the bladder and rectum. The heavy bleeding may lead to anemia. Sometimes sexual activity is painful.
Symptoms usually disappear or lessen after menopause.
Diagnosis of Uterine Adenomyosis
A pelvic examination
Ultrasonography or magnetic resonance imaging
Doctors may suspect adenomyosis when they do a pelvic examination and discover that the uterus is enlarged, round, and softer than normal.
Doctors often diagnose adenomyosis based on the results of pelvic ultrasonography or magnetic resonance imaging (MRI). Ultrasonography is often done with a handheld ultrasound device inserted into the vagina (called transvaginal ultrasonography).
However, for a definitive diagnosis of adenomyosis, doctors must examine tissues taken from the uterus. The only way to obtain these tissues is to remove the uterus (hysterectomy).
Treatment of Uterine Adenomyosis
A levonorgestrel intrauterine device
Birth control pills
For severe symptoms, hysterectomy
Using an intrauterine device
Analgesics may be taken for pain.
If symptoms are severe, a hysterectomy is done. A hysterectomy completely relieves symptoms.
