By Dr. Ashwini Talpe, Gynaecology,
Adenomyosis is a condition in which the endometrium, which usually lines the inside of the uterus, projects and grows into the muscular tissue of the uterus. The endometrium keeps acting normally – becoming thick, breaking down and bleeding during every menstrual cycle. This leads to heavy bleeding during periods, bloating and abdominal pain and cramps. Adenomyosis can occur either throughout the entire uterus or in one spot.
Symptoms often start in middle aged women and after childbearing.
- Focal adenomyosis – The endometrium projects into the muscular wall of the uterus only in one site.
- Focal adenomyoma – It is more extensive than focal adenomyosis as it results in the formation of a tumour which is quite similar to a uterine fibroma.
- Diffuse adenomyosis – The endometrium projects into the muscular wall throughout the uterus.
Treatment options: Symptoms of adenomyosis usually go away after menopause, however in severe cases some of the treatment options which could be pursued are –
Doctors usually prescribe non-steroidal anti-inflammatory drugs (NSAID) to ease abdominal pain and cramps associated with adenomyosis. NSAIDs should be taken two to three days before your period starts and continue taking it through the first few days. Hormonal treatments
Often, adenomyosis is caused by high estrogen levels. This can be controlled with the use of oral contraceptives such as combined estrogen-progesterone birth control pills or progestin-only contraceptives such as IUDs (Intrauterine devices). Through the use of such treatments, heavy bleeding and pain during menstruation can be lessened.
Uterine artery embolization
This is a surgical process that is usually used to treat uterine fibroids in which blood flow to the certain areas with adenomyosis is prevented by using very small particles blocking the arteries that provide blood to these areas. Since it is a very minimally invasive procedure, it prevents scarring in the uterus.
In this minimally invasive surgery, the lining of the uterus (the endometrium) is removed. This often stops a woman’s period completely or at least causes it to be very light. This procedure may not work for women in whom the endometrium has invaded very deep into the muscle wall of the uterus.
Although adenomyosis is not a life-threatening disease, it can have very negative impacts on a womans life. The above treatments can help to ease the symptoms of adenomyosis and help women lead pain-free, normal lives. Another, more extreme option available to women suffering from adenomyosis is hysterectomy in which the uterus is removed. But that is more of a last-resort option which doctors usually do not recommend.