What Is Adenomyosis?
Adenomyosis is a benign condition that occurs when the endometrium (tissue lining the uterus) grows into the muscles of the uterine wall. Normally, the endometrium thickens, sheds blood and is then discharged during each menstrual cycle. In adenomyosis, the overgrown endometrium is trapped in the muscle wall, leading to heavy, prolonged and painful periods.
The exact causes of adenomyosis are unknown. The condition is associated with several risk factors, including:
- Childbirth-related inflammation, which may cause the dividing line between the endometrium and uterine wall to break down.
- Longer exposure to hormones, due to periods starting at an early age or having more frequent menstrual cycles.
- Previous surgery on the uterus, such as removal of fibroids or caesarean section, which may result in the healing tissue to grow inward.
Symptoms vary from one woman to another and can range in severity from mild to debilitating. Primary symptoms include:
- Heavy menstrual bleeding — Menstrual flow may be much heavier than usual and last for 2 weeks or more.
- Infertility — While the exact reasons are unclear, the thickened endometrium caused by adenomyosis may prevent implantation of a fertilized egg or cause miscarriage.
- Severe pelvic pain — Cramps may be extremely painful, and abdominal pain, pressure or bloating may occur between cycles.
- Unusual discharge — Large blood clots may form during periods or spotting may occur between periods.
When adenomyosis becomes severe or affects fertility, treatment can help. Options include:
- Hormonal therapy — Oral contraceptives or an intrauterine device (IUD) can help reduce bleeding.
- Medications — Anti-inflammatory medications, such as ibuprofen, help relieve painful cramps and reduce menstrual flow.
- Surgery — Minimally invasive techniques to remove some of the damaged uterine wall or reduce blood supply to the affected area can provide relief of symptoms. Severe cases may require a hysterectomy (surgical removal of the uterus) to cure the condition.
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