Spread Of Endometrial Lining Into Uterus – Symptoms and Remedies of Adenomyosis
Do you experience sharp knife like pain in the pelvis during menstrual periods? Do you feel severe abdominal pressure with heavy menstrual bleeding? Then you can be a victim of a common condition in many women known as adenomyosis. Let’s break it down.
Adenomyosis is referred to a condition that occurs in the uterus. A uterus in woman is buildup of smooth muscle that is lined by special mucous membrane known as endometrium. This membrane as a response to hormones, sheds during menstruation cycle.
Naturally, the endometrium is separated from muscular layer of the uterus. But in women with adenomyosis, the endometrial lining encroaches or spread into the muscles of the uterus. This causes uterine wall to become thicker and as a result, a woman would feel pain and heavy bleeding during menstruation.
How common is Adenomyosis?
The condition typically occurs in women aged above 30 while the diagnosis is usually done in women in their 40s. Adenomyosis can also affect teenage girls; however, the frequency is relatively very less. This condition normally goes away after menopause.
What causes Adenomyosis?
What exactly causes adenomyosis is still an undecided topic among the medical fraternity. But whatever the reason is, it is certainly related to changes in levels of estrogen. There are some theories regarding this condition. These include:
- Higher levels of estrogen hormone
- Direct invasion of endometrial cells into the muscles of uterus (adenomyoma), especially after incision made during c-section
- Presence of extra tissue in uterine wall from birth
- Inflammation of the uterus that occurs after childbirth
- Presence of bone marrow stem cells that might spread into the uterine muscle
Who are at the risk of getting Adenomyosis?
Regardless of the exact cause which is still debatable, there are some factors that can increase the odds of getting adenomyosis. These are:
- Being in the middle age of 40-50
- Injury or disruption in the lining of the uterus
- History of c-section surgery
- Suffering from endometriosis
Signs and Symptoms of Adenomyosis
Often adenomyosis is asymptomatic, means no signs or symptoms. However, with those experiencing symptoms might complain about:
- Spotting between periods
- Heavy and prolonged menstrual bleeding
- Longer than normal menstrual cycle
- Pain during sexual intercourse
- Appearance of blood clots during menstrual bleeding
- Severe cramping or sharp shooting pain during menstruation
- Tenderness in the abdomen
If your doctor suspects of adenomyosis, he or she will first like to examine you physically if the uterus is swollen. Most often, this condition can turn the uterus double or even triple than the normal size. The doctor may conduct following tests to exactly diagnose the condition:
- Ultrasound to check the characteristics of the uterus, its lining and the muscular wall
- MRI (magnetic resonance imaging) of the uterus
- Sonohysterography which involves injecting a saline solution through a small tube into the uterus during ultrasound
- Endometrial biopsy to rule out any serious condition
Since the symptoms of adenomyosis are similar to that of uterine fibroids, it is often misdiagnosed. But the two conditions aren’t the same. Where fibroids are benign non-cancerous growing in the walls of the uterus, adenomyosis on the other hand, is a well-defined mass of cells within the uterine wall.
How adenomyosis is treated?
There are various treatment options the doctor can suggest for adenomyosis. The treatment will also depend on severity of the symptoms, age, health factors and if you have plans to become pregnant in future. A mild form of adenomyosis would hardly require any treatment. However, if the symptoms affect your daily life, following medications and surgeries can be recommended:
Non-steroid anti-inflammatory medication such as ibuprofen will help in reducing blood flow and give respite from severe cramps. You would have to take this medication 2-3 days before your period starts. This medicine will not be recommended to pregnant women.
Second option is to give hormonal treatment. These include birth control pills, oral injection, progestine-containing intrauterine device and GnRH (Gonadotropin Releasing Hormone Agonists). Thesemedications suppress ovulation by stopping the production of progesterone and estrogen. Progestin-containing intrauterine device can be placed for up to 5 years.
- Endometrial ablation –Through this procedure, the endometrium is removed. This method is not for severe cases of adenomyosis as in these cases, the endometrium may invade deeper into the uterine muscles. This surgery can compromise fertility, so if you don’t want children in future, talk to your doctor in detail.
- Uterine artery embolization–Although this procedure is typically used to treat uterine fibroids, it also works for adenomyosis. This method prevents blood supply to certain arteries in the uterus. With shortage of blood, the adenomyosis shrinks.
- Hysterectomy –In severe cases where the pain is unbearable and you are years away from the menopause, the doctor may recommend removing the entire uterus. This is the most decisive treatment for adenomyosis. After this surgery, you will not be able to become pregnant again.So, completely make up your mind before going for this surgery.
Adenomyosis usually goes away on its own after menopause and isn’t a life threatening condition. There are several treatments that can provide respite from symptoms. Routine examination is the key to prevent such conditions from turning into serious disorders.