Adenomyosis: Symptoms, Treatment, and Fertility

What is Adenomyosis?

Often referred to as “endometriosis’ cousin,” adenomyosis shares many characteristics of endometriosis. While endometriosis will have endometrial tissue growing outside of the womb, adenomyosis will have cells growing within the muscular wall of the uterus.

While one in ten women may be diagnosed with endometriosis, only one in five hundred women receive an adenomyosis diagnosis. This may be because the condition is less common or because it is overshadowed by other similar conditions like endometriosis, but also may be because it has historically been more difficult to diagnose. 

It is important to note that adenomyosis is a condition with unknown causes, but is not contagious and is not a form of cancer.

Symptoms of Adenomyosis

Until recently, the only way to confirm adenomyosis was after a hysterectomy. This meant that most symptoms caused by adenomyosis were misdiagnosed or went untreated completely. Now, adenomyosis can be diagnosed with a pelvic exam, making treatment more readily available. 

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Symptoms of adenomyosis can include:

  • An enlarged uterus
  • Painful menstruation
  • Heavy menstrual bleeding
  • Extended periods
  • Painful intercourse
  • Bloating and stomach pressure
  • Possible fertility issues

Pregnancy & Adenomyosis

Because of the difficulty surrounding obtaining a diagnosis, the fertility issues caused by adenomyosis have often been widely untreated. It’s unknown for sure how adenomyosis may impact fertility, but it is recognized that it can be far more detrimental than endometriosis alone.

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It is understood that adenomyosis can affect how well embryos attach to the uterine wall, how embryos grow in the womb, and how the placenta develops. When a successful pregnancy occurs, adenomyosis has been correlated with a higher rate of miscarriage, an increased risk of miscarriage, and more likelihood of prenatal complications such as premature birth, placenta previa, pregnancy-induced hypertension, and postpartum hemorrhage. 

What is Next for Adenomyosis?

Events like adenomyosis awareness month in March and other efforts to share information can bring understanding and urgency for additional knowledge and treatment options. Additional research can raise the standard of care for those diagnosed with adenomyosis and other reproductive health issues. 

Current treatment options consist of anti-inflammatory painkillers, hormone therapy (such as birth control), and in severe cases, hysterectomies. Newer treatments include non-surgical uterine artery embolization (UAE) and an adenomyomectomy. Understanding your treatment options can ensure you make the right choice for you. 

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