Dr. Arockia Virgin Fernando MBBS, DGO, Fellowship in Reproductive Medicine Infertility Specialist, Reproductive Endocrinologist (Infertility)
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Causes and Treatment for Adenomyosis

Adenomyosis is a disease in which the cells that line the inside of the uterus abnormally locate themselves in the uterine muculature. This is the reason for an enlarged uterus, causing excruciating pain and heavy bleeding during periods.

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Symptoms

Adenomyosis is also called the evil sister of Endometriosis. Its symptoms include:

  • Abdominal pressure and bloating
  • Peripheral nerve numbness or weakness, which can cause leg or bowel pain during periods
  • Pain upon sexual intercourse
  • Inflammation of the uterus
  • Painful bowel movement
  • Painful periods and cramps and pelvic pain
  • Bladder symptoms including uncomfortable urination, burning urination or blood in the urine
  • Heavy menstrual bleeding
  • Passing of blood clots during menstruation

Causes of Adenomyosis

The actual cause of Adenomyosis is uncertain, a lot more studies in the field is needed..

However, there are some theories which conclude the cause behind Adenomyosis, these are:

  • Abnormal Uterine Development
  • Invasive Growth of Foreign Tissues
  • Uterine Inflammation and Childbirth

Diagnosis of  Adenomyosis

When the symptoms of Adenomyosis occur, a strict evaluation needs to be done.

Procedure diagnosis include:

  • Pelvic ultrasound
  • Pelvic exam revealing a large, soft or tender uterus
  • Hysteroscopy

Treatment of Adenomyosis

  • Anti-inflammatory medications

An example for such a medicine is Ibuprofen. Such medications can help to reduce blood flow during your period while also relieving severe pain. Medication should not be used if the person is pregnant and without consulting a doctor.

  • Hormonal treatments

Hormonal treatments consist of oral contraceptives or birth control pills, injections, intrauterine device, and GnRH-analogs such as Lupron (leuprolide)

This involves techniques to remove or destroy the endometrium. Although, this procedure might not be helpful for all cases as adenomyosis invades muscle more deeply.

This is a procedure in which high-intensity waves are employed to create heat and focus directly on the targeted tissues and destroy them. The heat is monitored using MRI images. However, more studies are needed to test its overall success.

  • Hysterectomy

This is the only way to completely cure this condition is to have a hysterectomy. This is a surgical procedure that involves complete removal of the uterus. This however is only used in severe cases.

Adenomyosis and Infertility

The relationship between Adenomyosis and infertility is and hence much studies in this in needed. However, women suffering from this condition suffer from Endometriosis which might cause infertility.

Whichever treatment is taken, that should be done under the proper supervision of a specialist doctor. Since we already understand, doctors know the best!

Adenomyosis alters the endometrial receptivity and gene expression and thus reduces the implantation chances i.e. pregnancy chances in a natural or ART cycle.

The old blood collected in the musculature of the uterus acts as toxin and prevents pregnancy.

There is progesterone hormone resistance in this condition ,so miscarriages are common.

They need higher doses of progesterone hormone after embryo transfer in IVF and also throughout pregnancy. It is also associated with pregnancy complications.

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