Adenomyosis Causes, Symptoms & Treatment

Adenomyosis is a benign (non-cancerous) condition. It is the presence of endometrial tissue (tissue that makes up the lining of the uterine cavity) in the myometrium (the muscle of the uterus). The adenomyosis can spread throughout the myometrium or can form nodules called adenomyomas. It is a common disorder.

Serving communities throughout Greater Boston, the gynecologic surgeons at Newton-Wellesley Hospital’s Minimally Invasive Gynecological Surgery (MIGS) can provide patients with screenings and treatment for Adenmuosis.

If you would like to arrange for a consultation and evaluation with one of our physicians contact MIGS today.

• What symptoms does adenomyosis cause?
  
• How do I know if I have adenomyosis?
  
• What are treatment options for adenomyosis?

What symptoms does adenomyosis cause?
Symptoms typically occur in women between 40 and 50 years old. The most common symptoms are abnormal uterine bleeding (most often menorrhagia, or heavy periods) and dysmenorrhea (painful periods). The uterus is often enlarged and boggy (spongy to the touch and inadequately contracted) on physical exam. About one-third of women with adenomyosis will have no symptoms.

How do I know if I have adenomyosis?
Adenomyosis is difficult to diagnose. A definitive diagnosis of adenomyosis can only be made from a microscopic examination of a hysterectomy specimen (which is not an option for many women). The diagnosis is often suggested by a combination of symptoms, such as heavy bleeding and painful periods, combined with a physical examination revealing an enlarged, boggy uterus.

Ultrasound can sometimes be suggestive of adenomyosis. MRI can also help diagnose adenomyosis.

Adenomyosis commonly co-exists with other gynecologic problems, such as endometriosis, fibroids and endometrial polyps.

What are treatment options for adenomyosis?
Effective treatment options for adenomyosis are limited. Although treatments may be effective in some women, the benefit often does not last and women seek alternative treatment options.

Treatments can include:

• Hormone treatments including birth control pills, progestins (oral, injection or IUD) or GnRH-analogs such as Lupron
• Endometrial ablation
• Uterine artery embolization
• Hysterectomy

Unlike fibroids, the adenomyosis cannot easily be shelled out or removed. The only way to remove the adenomyosis is to remove the uterus.

The treatments listed above frequently do not provide adequate symptom control. If a woman opts for a hysterectomy, there are minimally invasive techniques and the ovaries are typically left in place so they can continue to produce hormones.