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Adenomyosis – The Evil Twin Of Endometriosis

Endometriosis affects roughly 10% globally of reproductive women and yet gets very little press and not everyone realises that their heavy bleed is not a normal symptom with every month.

However, even less is know of her evil twin sister Adenomyosis which affects over double the amount of women and is just as difficult to diagnose due to not all will experience symptoms.

WHO COULD SUFFER WITH ADENOMYOSIS?

Adenomyosis is a condition that primarily affects individuals assigned female at birth and is most commonly diagnosed between the ages of 30 and 50, although it can occur at any age after puberty.

It is important to note that it is possible for transgender men who have not undergone a hysterectomy to also develop adenomyosis if they still have their uterus.

Despite being a relatively common condition, Adenomyosis remains largely under diagnosed and therefore misunderstood but it does not cause cancer or lead to cancer.

WHAT IS ADENOMYOSIS?

Adenomyosis is a medical condition in which the tissue that normally lines the inside of the uterus (endometrium) starts to grow within the muscular wall of the uterus. This abnormal growth of endometrial tissue can cause the uterus to become enlarged, thickened and tender.

In a healthy uterus, the endometrium thickens and sheds during the menstrual cycle, resulting in menstruation. However, in adenomyosis, the endometrial tissue becomes embedded within the muscular wall of the uterus. As a result, during each menstrual cycle, the trapped tissue bleeds internally, leading to inflammation, pain and the characteristic symptoms of the condition.

The exact cause of adenomyosis is not fully understood, but several theories have been proposed. One theory suggests that the invasion of the endometrial tissue into the uterine wall may occur due to uterine incisions from surgeries like cesarean sections or fibroid removal. Another theory suggests that it may result from a process called retrograde menstruation, where menstrual blood flows backward into the uterus and embeds in the uterine wall instead of leaving the body.

The symptoms of adenomyosis can vary from mild to severe and may include:

  1. Menstrual cramps (dysmenorrhea) that worsen over time
  2. Heavy or prolonged menstrual bleeding (menorrhagia)
  3. Pelvic pain or pressure, often worsening during menstruation
  4. Painful intercourse (dyspareunia)
  5. Enlarged and tender uterus
  6. Irregular bleeding between periods

WHEN IS IT MOST LIKELY TO AFFECT YOU?

Adenomyosis is most commonly diagnosed in women between the ages of 30 and 50. However, it’s important to note that adenomyosis can occur at any age after puberty.

The exact timing of when adenomyosis may affect you can vary. Some women may develop adenomyosis earlier in their reproductive years, while others may experience symptoms later in life. It’s worth mentioning that not all individuals with adenomyosis experience symptoms, and the severity of symptoms can also vary.

Several factors can increase the risk of developing adenomyosis or influence the likelihood of experiencing symptoms, including:

Age:

The risk of adenomyosis tends to increase as women get older, particularly between the ages of 30 and 50.

History of childbirth:

Women who have had multiple pregnancies may have a higher risk of developing adenomyosis.

Uterine surgery:

Prior surgical procedures involving the uterus, such as cesarean sections or fibroid removal, may increase the risk.

Hormonal imbalances:

Adenomyosis is thought to be influenced by hormonal imbalances, particularly estrogen dominance. Women with higher levels of estrogen relative to progesterone may be at a greater risk.

Endometriosis:

There is an association between adenomyosis and endometriosis, another condition where the tissue lining the uterus grows outside the uterus. If you have endometriosis, you may have a slightly higher risk of developing adenomyosis.

If you have concerns about adenomyosis or are experiencing symptoms such as pelvic pain, heavy menstrual bleeding, or other menstrual irregularities, it’s advisable to consult with a healthcare professional.

WHERE DOES IT AFFECT YOU PHYSICALLY & MENTALLY?

Adenomyosis can have both physical and emotional effects on the body and mind.

Physical Effects:

Pelvic pain:

Adenomyosis can cause chronic pelvic pain, which may vary in intensity and duration. The pain is often associated with menstrual cycles but can also occur throughout the month.

Menstrual abnormalities:

Heavy and prolonged menstrual bleeding (menorrhagia) is a common symptom of adenomyosis. This can lead to fatigue, anaemia (low red blood cell count), and other physical discomforts associated with heavy bleeding.

Enlarged uterus:

Adenomyosis can cause the uterus to become enlarged, leading to a feeling of pelvic fullness or pressure.

Painful intercourse:

Some individuals with adenomyosis may experience pain or discomfort during sexual intercourse (dyspareunia) due to the inflammation and sensitivity of the uterus.

Gastrointestinal symptoms:

In some cases, adenomyosis may be associated with gastrointestinal symptoms such as bloating, constipation, or diarrhea.

Emotional and Psychological Effects:

Chronic pain and discomfort:

Dealing with chronic pelvic pain and other symptoms of adenomyosis can be physically and emotionally draining. It may impact a person’s quality of life, daily activities, and overall well-being.

Emotional distress:

Coping with the physical symptoms and the challenges adenomyosis brings can lead to emotional distress, including feelings of frustration, sadness, anxiety or depression.

Impact on relationships:

The pain and limitations caused by adenomyosis can affect intimate relationships and sexual activity, potentially causing strain or stress within partnerships.

Fertility concerns:

Adenomyosis may pose challenges for individuals trying to conceive. The condition can affect fertility, and the associated difficulties in becoming pregnant or managing pregnancy loss can have emotional implications.

It’s important to address both the physical and emotional aspects of adenomyosis.

WHY DOES IT MATTER TO DEAL WITH IT?

Dealing with adenomyosis is important for several reasons:

Alleviating symptoms:

Adenomyosis can cause significant pain, discomfort, and other symptoms that can interfere with daily life, work, and relationships. By addressing the condition, you can seek appropriate treatment options to alleviate or manage these symptoms, improving your overall quality of life.

Preventing complications:

Although adenomyosis is not considered a life-threatening condition, it can lead to complications. Heavy and prolonged menstrual bleeding may result in anaemia (low red blood cell count), which can cause fatigue and other health issues.

Preserving fertility options:

For individuals who desire to conceive or preserve fertility options, managing adenomyosis is crucial. The condition can affect fertility by impacting the structure and function of the uterus. By working with healthcare professionals, you can explore fertility-sparing treatments or interventions that may increase the chances of successful conception or assist with family planning decisions.

Emotional well-being:

Adenomyosis can have a significant impact on emotional well-being. Coping with chronic pain, fertility concerns, or the challenges associated with the condition can lead to emotional distress, anxiety, or depression. Seeking appropriate support, counseling, or therapy can help you navigate and manage these emotional aspects effectively.

Early detection of other conditions:

Adenomyosis is often associated with other conditions such as endometriosis. Identifying and managing adenomyosis can prompt healthcare professionals to evaluate for concurrent conditions or complications, ensuring comprehensive care.

Remember, everyone’s experience with adenomyosis is unique, and the importance of dealing with it may vary based on individual circumstances, symptoms, and personal goals. It’s recommended to consult with a healthcare professional who can provide personalized guidance, discuss treatment options, and help you make informed decisions about managing adenomyosis effectively.

Adenomyosis is typically diagnosed through a combination of medical history assessment, physical examination, imaging techniques, and, in some cases, a biopsy. Here are the main steps involved in diagnosing adenomyosis:

Medical history assessment:

Your healthcare provider will discuss your symptoms, menstrual history, and any relevant medical or surgical history. It’s important to provide detailed information about your symptoms, such as pelvic pain, heavy menstrual bleeding, or any other concerns you may have.

Physical examination:

During a pelvic examination, your healthcare provider may feel for an enlarged or tender uterus. However, it’s important to note that a physical examination alone cannot definitively diagnose adenomyosis.

Imaging techniques:

  • Transvaginal ultrasound: This is often the initial imaging test used to evaluate adenomyosis. It involves inserting a small ultrasound probe into the vagina to obtain detailed images of the uterus. Adenomyosis may appear as thickened areas or heterogenous areas within the uterine wall.
  • Magnetic resonance imaging (MRI): In cases where ultrasound results are inconclusive or further detail is needed, an MRI may be recommended. MRI can provide more precise imaging of the uterus and can help distinguish adenomyosis from other conditions.

Biopsy:

In some cases, a biopsy may be performed to confirm the diagnosis. A biopsy involves removing a small sample of the uterine tissue for examination under a microscope. It is usually done through a minimally invasive procedure called hysteroscopy, where a thin tube with a camera is inserted through the cervix into the uterus.

It’s important to note that adenomyosis can be challenging to diagnose definitively, as it shares some symptoms with other conditions such as endometriosis and fibroids. Your healthcare provider will use a combination of these diagnostic methods to reach a diagnosis and rule out other potential causes of your symptoms.

If you suspect you may have adenomyosis or are experiencing symptoms, it’s advisable to consult with a healthcare professional. They can evaluate your specific situation, order appropriate tests if necessary, and provide an accurate diagnosis.

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