Adenomyosis

Adenomyosis is the presence of uterine lining cells growing within the muscle wall of the uterus. It is a benign condition that is often mistaken for fibroids, but is much less common than fibroids. Adenomyosis occurs in about 20% of women.

Symptoms
Symptoms of severe adenomyosis are heavy menstrual bleeding and very painful cramping during your period. The uterus feels enlarged and tender to the touch during a pelvic exam. Unfortunately, these signs and symptoms are also characteristic of other conditions, and there is no definitive way to diagnose adenomyosis short of analyzing tissue from the uterine muscle wall under a microscope.

Treatment Options
Hormonal medications are available that can be used to prolong or stop your period, and these may provide temporary relief from the heavy bleeding and severe menstrual cramping. However, when medication is discontinued, your periods will resume and so will the symptoms of adenomyosis.

If the problem occurs in just a few well-defined areas of the uterine muscle wall, surgery can remove these affected areas and the rest of the uterus can be repaired. However, if adenomyosis is widespread, then for complete relief the only choice may be a hysterectomy. Other options that tend to be less effective for long-term relief, such as endometrial ablation and uterine artery embolization, may be discussed with your doctor.

References

American Society for Reproductive Medicine. Pelvic Pain: A Guide for Patients. Patient Information Series 1997. www.asrm.org/patients/patientbooklets/pelvicpain.pdf.
Parker WH. A Gynecologist’s Second Opinion. (c)2003; A Plume Book; Published by the Penguin Group, New York, NY.