Adenomyosis Causes, Symptoms And Treatment

Adenomyosis is a condition in which endometrial tissue grows into the muscular wall of the uterus (myometrium). Endometrium is the layer of tissue that normally covers the inside of the women’s uterus. It is the inner layer of the uterus. Hormonal changes during a woman's menstrual cycle causes the endometrium to change. Estrogen causes the endometrium to thicken, breaks down and bleeds with each woman’s menstrual cycle. During pregnancy, it helps in the nourishment of embryos. Myometrium is the middle layer of the uterine wall that induces uterine contractions. The displaced endometrial tissue acts normally such as it thickens, breaks down and bleeds with each woman’s menstrual cycle. But this displacement causes your uterus to grow double or triple in size. This uterine enlargement causes heavy menstrual bleeding and severe menstrual cramps. The exact cause of adenomyosis is still unknown. It is believed to be caused by increased levels of estrogen in your body. That’s why it is relieved on its own after menopause because of decreased production of estrogen. It is more common in women between the ages of 40-50 years because of childbirth, C-section, dilatation and curettage.

Causes

The exact cause of adenomyosis is still unknown. There are several theories regarding the causes of adenomyosis. Any condition that causes the endometrial tissue to grow into the muscular wall of the uterus (myometrium) can cause adenomyosis. During childbirth, the inflammation of the uterus occurs that causes breakage in the cell lining of the uterus. Bone marrow stem cells also play an important role in causing adenomyosis by invading the uterine muscles. It is also believed to be caused by increased levels of estrogen in your body. Some other hormones such as progesterone, prolactin, and follicle stimulating hormone are also involved in causing adenomyosis. It can also develop in the fetus before birth.

Symptoms

The symptoms of adenomyosis vary from women to women depending upon the extent and severity of condition. Some women do not have any symptoms (asymptomatic). However, the most common symptoms reported in adenomyosis are discussed below,

• Heavy menstrual bleeding
• Severe menstrual pain and cramps
• Painful sexual intercourse
• Feeling of pain and pressure in the pelvic area (bladder and rectum)
• Uterine enlargement
• Dysmenorrhea
• Bleeding or spotting between periods
• Prolonged duration of menstrual cycle

Treatment

There are two treatment approaches used in adenomyosis, medical and surgical treatment. Your doctor may prescribe over the counter painkillers for the treatment of pain.Painkillers may include non-steroidal anti-inflammatory drugs (NSAIDs). They are used for the reduction of pain and swelling. The NSAIDs used are aceclofenac, acemetacin, azapropazone, dexibuprofen, dexketoprofen, diclofenac, etodolac, fenbufen, flurbiprofen, ibuprofen, indomethacin, naproxen and piroxicam.Your gynecologist can prescribe supplemental hormonal therapy for the treatment of pain or unusual heavy bleeding during adenomyosis. Hormonal contraceptives in the form of birth control pills, patches and vaginal rings can also be prescribed in less severe adenomyosis.Your doctor can also prescribe progestin-only contraception in the form of intrauterine devices (IUDs) for the treatment of adenomyosis. This method is very effective for birth control. It is a T shaped device which is placed in your uterus during a small surgical procedure. It is very effective in treating heavy bleeding due to adenomyosis. Another effective procedure used for the treatment of adenomyosis is endometrial ablation. A specialized instrument is inserted into your uterus. It uses heat, hot water, microwave energy or electric current for the destruction of the uterine's lining. It is very effective in stopping your heavy menstrual bleeding by causing artificial menopause. Uterine artery embolization is very effective for the treatment of adenomyosis. It is a minimally invasive procedure in which small particles are injected into the uterine arteries. This will cut off the blood supply to the affected area and cause them to die. If there is no improvement with any treatment in adenomyosis, then hysterectomy is recommended. It involves the removal of the uterus, ovaries and cervix. These organs are involved in the production of estrogen which plays a vital role in causing adenomyosis.