Understanding Adenomyosis | Causes, Symptoms, and Treatments

Adenomyosis is a gynecological condition that affects the uterus. It occurs when tissue similar to the lining of the uterus (endometrium) grows abnormally within the muscular wall of the uterus (myometrium). This misplaced tissue responds to hormonal changes just like the normal lining, thickening and breaking down each menstrual cycle. However, due to its location, it can’t be shed during menstruation, leading to a variety of symptoms.

While the exact cause of adenomyosis remains unknown, some factors may increase one’s risk of developing it. Our blog discusses adenomyosis in detail, including its causes, symptoms, treatment options and how one can get pregnant with it.

Adenomyosis Symptoms

Adenomyosis can cause a range of symptoms, with the severity varying from woman to woman. Some women may experience no noticeable symptoms at all. However, there are some common signs to be aware of:

• Heavy and prolonged menstrual bleeding: This is the most common symptom of adenomyosis. The displaced endometrial tissue bleeds along with the normal lining, leading to heavier and longer periods.
• Pelvic pain: Pain in the lower abdomen or pelvis can occur before, during, and after your period. This pain can range from a dull ache to sharp cramps.
• Painful intercourse: Intercourse may be painful due to the enlarged and tender uterus pressing on surrounding structures.
• Painful urination or bowel movements: In some cases, the growth of the uterus can put pressure on the bladder or bowel, causing discomfort during urination or bowel movements.
• Bloating and cramping: Adenomyosis can cause bloating and cramping in the lower abdomen, similar to premenstrual symptoms.
• Urinary frequency or urgency: The enlarged uterus can sometimes press on the bladder, leading to a frequent urge to urinate.

If you experience any of these symptoms, particularly heavy or painful periods, it’s important to schedule an appointment with your doctor to discuss your concerns and explore potential causes.

Diagnostic Methods for Adenomyosis

There’s no single definitive test for adenomyosis. However, your doctor may use a combination of approaches to reach a diagnosis. Here are some common methods:

• Pelvic exam: During a pelvic exam, your doctor will feel your uterus to check for any enlargement or tenderness.
• Ultrasound: An ultrasound can sometimes show a thickened uterine wall, which may be indicative of adenomyosis. However, an ultrasound alone isn’t always conclusive.
• MRI scan: An MRI scan can provide a more detailed view of the uterus and surrounding tissues, helping to identify endometrial tissue within the muscle wall.
• Laparoscopy: In some cases, a laparoscopy may be necessary. This minimally invasive surgical procedure involves inserting a small camera through a tiny incision in the abdomen to directly visualize the uterus and surrounding organs.

It’s important to note that these tests can sometimes be inconclusive, and a definitive diagnosis may only be possible after examining tissue samples during surgery (hysterectomy).

Treatment Options For Adenomyosis

Treatment for adenomyosis depends on the severity of your symptoms and your desire for future pregnancy. Here are some common approaches:

• Pain management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain associated with adenomyosis.
• Hormonal therapy: Medications like birth control pills, progestin-only pills, or hormonal IUDs can help regulate your menstrual cycle, reduce bleeding, and ease cramping.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Prescription NSAIDs may be prescribed to manage pain during menstruation.
• Gonadotropin-releasing hormone (GnRH) agonists: These medications suppress ovulation and hormone production, leading to lighter periods and pain relief. However, they have side effects like hot flashes and vaginal dryness and are typically not used for long-term management.
• Surgery: In severe cases where other treatments are ineffective, surgery may be an option. This could involve a myomectomy (removal of fibroids), endometrial ablation (destruction of the uterine lining), or hysterectomy (removal of the uterus).

Adenomyosis And Fertility

While adenomyosis can pose some challenges for conception, it doesn’t have to be a roadblock to parenthood. If you want to get pregnant with adenomyosis, it’s key to discuss treatment options with your doctor. They can explore strategies to manage the condition, like hormonal therapies or minimally invasive procedures, which may improve your chances of a successful pregnancy. Remember, many women with adenomyosis conceive naturally, so don’t hesitate to talk to your doctor about your specific situation and create a personalized plan.

Schedule An Appointment with V-Fertility Center

If you suspect you might have adenomyosis and are experiencing symptoms like heavy or painful periods, consider scheduling an appointment with V-Fertility Center at Vejthani Hospital in Bangkok.

At V-Fertility Center, we understand the unique challenges adenomyosis can present. Our team of experienced fertility specialists, equipped with the latest technology, can work with you to develop a personalized plan for your infertility treatment in Thailand. We offer a variety of options, from managing adenomyosis symptoms to exploring assisted reproductive techniques like IVF. As a JCI-accredited hospital, we offer our international patients personalized support through our International Patient Advocates, ensuring a seamless experience from inquiry to post-treatment follow-up.

Choosing our clinic means placing your trust in a team devoted to bringing you the most innovative, comprehensive, and compassionate infertility diagnosis and treatment. We always strive to provide our patients with access to cutting-edge treatments and a holistic approach that addresses the physical, emotional, and psychological challenges of infertility.

Contact us today for a consultation.

Article by Dr.Sorramon Songveeratham