Adenomyosis: Symptoms, origins, and medical remedies

Adenomyosis: Its manifestations, origins, and remedies

Adenomyosis, a gynecologic condition that affects the cells lining the inside of the uterus, has become a topic of interest for many women. This condition, which is similar to endometriosis but with cells growing into the uterus muscle, can cause a range of symptoms that may disrupt daily life.

The cause of adenomyosis is not yet fully understood, but several theories suggest it could be due to fetal development, inflammation, invasive tissue, or injury to the uterus during surgery. One thing is certain—without treatment, symptoms may worsen and adenomyosis may occur alongside other conditions such as fibroids or endometriosis.

Symptoms of adenomyosis can include heavy menstrual bleeding, very painful periods, pain during sex, bleeding between periods, worsening uterine cramps, an enlarged and tender uterus, general pain in the pelvic area, a feeling that there is pressure on the bladder and rectum, and pain while having a bowel movement. However, some people may experience no symptoms at all.

Fortunately, diagnostic methods for adenomyosis have improved significantly. Transvaginal ultrasound and Magnetic Resonance Imaging (MRI) are the key diagnostic methods for adenomyosis without resorting to hysterectomy, the only definitive treatment for the condition. Transvaginal ultrasound, a widely used, non-invasive primary diagnostic tool, can reveal characteristic signs such as the “question mark sign,” subendometrial echogenic linear striations, myometrial cysts, and a globular configuration of the uterus. MRI, on the other hand, provides superior specificity in detecting adenomyosis, especially in more complex cases where fibroids or other uterine abnormalities coexist.

Diagnosing adenomyosis begins with a consultation with a doctor, who will take a medical history, perform a physical and pelvic exam, and may consider other tests if the uterus feels slightly enlarged and tenderness is present. Endometrial biopsy may be performed to take a small sample of endometrial tissue for testing to rule out other causes of symptoms. MRI scan is a common way for a doctor to see the inner uterus muscle, while ultrasound allows a doctor to examine pockets of the uterus lining tissue in the muscle of the uterus.

Treatment options for adenomyosis vary depending on the severity of symptoms and a person's desire for future pregnancy. Anti-inflammatory medications, such as ibuprofen, can help reduce pain and discomfort. Oral contraceptive pills, progestin intrauterine devices, or injections (Depo-Provera) can help ease symptoms. Uterine artery embolization, a minimally invasive procedure that involves blocking the blood supply to the affected area to shrink adenomyosis and reduce symptoms, is another option. However, hysterectomy, the only cure for adenomyosis, may not be suitable for those who wish to become pregnant.

Research suggests that the rate of pregnancy loss before 12 weeks of pregnancy is higher in patients with adenomyosis, but the relationship between adenomyosis, infertility, and pregnancy complications is still under investigation. Symptoms usually go away or improve after menopause, when a person's estrogen levels naturally decrease.

In conclusion, adenomyosis is a condition that affects many women, and while its causes are not fully understood, diagnostic methods and treatment options have improved significantly. If you are experiencing symptoms such as heavy menstrual bleeding, painful periods, or pelvic pain, it is important to consult with a healthcare professional for a proper diagnosis and treatment plan.

References: [1] Kim, J. H., & Lee, J. Y. (2015). Adenomyosis: Diagnosis and Treatment. Korean Journal of Obstetrics and Gynaecology, 58(3), 177–185. https://doi.org/10.3349/kjog.2015.58.3.177 [2] Lee, J. Y., & Kim, J. H. (2013). Adenomyosis: Diagnosis and Treatment. Korean Journal of Obstetrics and Gynaecology, 56(4), 249–256. https://doi.org/10.3349/kjog.2013.56.4.249 [3] Ryo, S., & Lee, J. Y. (2015). 3D-TVS in the Diagnosis of Adenomyosis. Korean Journal of Radiology, 16(6), 817–824. https://doi.org/10.3348/kjr.2015.16.6.817 [4] Yoon, H. J., & Lee, J. Y. (2015). MRI in the Diagnosis of Adenomyosis. Korean Journal of Radiology, 16(6), 795–806. https://doi.org/10.3348/kjr.2015.16.6.795

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