Displaced endometrial tissue from adenomyosis can cause an enlarged uterus and painful, heavy periods.
Adenomyosis (ad-uh-no-my-O-sis) occurs when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus. The displaced tissue continues to act normally — thickening, breaking down and bleeding — during each menstrual cycle. An enlarged uterus and painful, heavy periods can result.
Doctors aren't sure what causes adenomyosis, but the disease usually resolves after menopause. For women who have severe discomfort from adenomyosis, hormonal treatments can help. Removal of the uterus (hysterectomy) cures adenomyosis
With adenomyosis, the same tissue that lines the uterus (endometrial tissue) is present within and grows into the muscular walls of your uterus.
Sometimes, adenomyosis causes no signs or symptoms or only mild discomfort. However, adenomyosis can cause:
Your uterus might get bigger. Although you might not know if your uterus is bigger, you may notice tenderness or pressure in your lower abdomen.
If you have prolonged, heavy bleeding or severe cramping during your periods that interferes with your regular activities, make an appointment to see your doctor.
The cause of adenomyosis isn't known. There have been many theories, including:
Regardless of how adenomyosis develops, its growth depends on the body's circulating estrogen.
Risk factors for adenomyosis include:
Most cases of adenomyosis — which depends on estrogen — are found in women in their 40s and 50s. Adenomyosis in these women could relate to longer exposure to estrogen compared with that of younger women. However, current research suggests that the condition might also be common in younger women.
If you often have prolonged, heavy bleeding during your periods, you can develop chronic anemia, which causes fatigue and other health problems.
Although not harmful, the pain and excessive bleeding associated with adenomyosis can disrupt your lifestyle. You might avoid activities you've enjoyed in the past because you're in pain or you worry that you might start bleeding.
Some other uterine conditions can cause signs and symptoms similar to those of adenomyosis, making adenomyosis difficult to diagnose. These conditions include fibroid tumors (leiomyomas), uterine cells growing outside the uterus (endometriosis) and growths in the uterine lining (endometrial polyps).
Your doctor might conclude that you have adenomyosis only after ruling out other possible causes for your signs and symptoms.
Your doctor may suspect adenomyosis based on:
In some instances, your doctor might collect a sample of uterine tissue for testing (endometrial biopsy) to make sure you don't have a more serious condition. But an endometrial biopsy won't help your doctor confirm a diagnosis of adenomyosis.
Pelvic imaging such as ultrasound and MRI can detect signs of adenomyosis, but the only way to confirm it is to examine the uterus after hysterectomy.
Adenomyosis often goes away after menopause, so treatment might depend on how close you are to that stage of life.
Treatment options for adenomyosis include:
To ease pelvic pain and cramping related to adenomyosis, try these tips:
Your first appointment will be with either your primary care provider or your gynecologist.
Make a list of:
For adenomyosis, basic questions to ask your doctor include:
Don't hesitate to ask other questions.
Your doctor might ask you: