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This is another topic that was presented when I polled you all on Instagram about issues you wanted me to discuss for Wellness Wednesdays. This is definitely a women's health problem that deserves more awareness and education. I didn't learn about adenomyosis until I became a Midwife because I never heard other women talking about it. So let's dive in, define what it is, discuss the symptoms, and look at treatment options, specifically alternatives to surgery.
What is it?
Adenomyosis is when endometrial tissues (the endometrium is the lining of your uterus) grows into the uterine wall. This is different than endometriosis, where endometrial tissue exists OUTSIDE of the uterus. The cause of adenomyosis is still unknown, but risk factors include having a prior uterine surgery, such as a C-section, D&C, or fibroid removal; history of childbirth; and being middle aged. Women in their 40s and 50s are more likely to be diagnosed, but it usually resolves after menopause.
With adenomyosis, you may experience the following symptoms:
Severe menstrual cramps/pelvic pain
Pain during intercourse
Heavy or prolonged bleeding during your period
Chronic pelvic pain
It's also possible to experience no symptoms at all. The symptoms are also similar to those with uterine fibroids, endometriosis, and endometrial polyps, which can make it difficult to diagnose. However, your provider can perform a pelvic exam, pelvic ultrasound, MRI, and/or biopsy to rule out other issues as needed.
As I mentioned earlier, adenomyosis tends to go away on its own after menopause, so if you are close to that phase in your life (average age is 51), then you could always wait if the symptoms aren't severe. However, the following treatments can be utilized to manage the condition:
Anti-inflammatory drugs - These over the counter medications, such as ibuprofen, can be used to decrease blood flow during your period and help with your pain. Best results are seen when you start taking it one to two days before your period.
Comfort measures - You can try soaking in a warm bath or using a heating pad to help relieve pain.
Hormone medications -Various methods of birth control can be tried to decrease pain, blood flow, and the duration of your period. For an in-depth discussion on birth control, check out this blog post.
Hysterectomy - This is a surgical procedure that removes your uterus and is only recommended if you are done having children and have not found relief from other treatment options.
Unfortunately, because we still don't fully understand what causes it, we are also not sure of the best way to prevent adenomyosis. This can make it frustrating to deal with the symptoms, but if you are experiencing severe discomfort with your periods or abnormal periods in general, always follow up with your healthcare provider.
xoxo, Global Midwife
Disclaimer: This is not medical advice, only education. Always check with your healthcare provider.