Adenomyosis is a common benign condition of the uterus that is defined by the presence of islands of endometrial tissue (inner lining of uterus) within the myometrium (outer muscle of the uterus). Adenomyosis can cause menstrual cramps, lower abdominal pressure, bloating before menstrual periods, and can result in heavy and painful periods. The condition can be located throughout the entire uterus or localized in one spot.
Though adenomyosis is considered a benign condition, the frequent pain and heavy bleeding associated with it can have a negative impact on a woman’s quality of life.
It is most often diagnosed in middle-aged women and women who have had children. Some studies also suggest that women who have had prior uterine surgery may be at risk for adenomyosis.
Adenomyosis isn’t necessarily harmful. However, the symptoms can negatively affect your lifestyle. Some women have excessive bleeding and pelvic pain that may prevent them from enjoying normal activities such as sexual intercourse.
Women with adenomyosis are also at an increased risk of anemia due to the excessive loss of blood, which leads to iron deficiency. Without enough iron, the body can’t make enough red blood cells to carry oxygen to the body’s tissues. This can cause fatigue, dizziness, and moodiness.
The condition has also been linked with anxiety, depression, and irritability.
A transvaginal pelvic ultrasound is the first line of investigation. Other tests may include a blood test (to check for other causes of abnormal bleeding and to look for anaemia), and a biopsy of the lining of the womb (to rule out other causes of abnormal bleeding such as endometrial hyperplasia or cancer).
If a woman is asymptomatic no treatment is indicated. If symptoms are present, there are several potential treatment options, medical (hormonal) or surgical treatment. A treatment will be chosen based on the patient’s symptomatology and whether she is interested in future child bearing.
The only way to completely cure this condition is to have a hysterectomy. This involves complete surgical removal of the uterus. A hysterectomy is considered a major surgical intervention and is only used in severe cases and in women who don’t plan to have any more children. Your ovaries don’t usually affect adenomyosis after hysterectomy and may be left in your body.
Dr Farrell will organize the appropriate investigations and discuss your individual options for management of adenomyosis if it is found.