Adenomyosis: everything you need to know about endometriosis’ hidden ‘sister’

Adenomyosis is a gynaecological condition which is thought to affect up to 1 in 10 women, but it doesn’t even have its own fact page on the NHS website. So, what do you need to know about this common yet often-forgotten condition?

What is adenomyosis?

Like endometriosis, adenomyosis is a condition where endometrial tissue (womb lining) is found in other places in the body, and it is possible to have both conditions together. However, unlike endometriosis, adenomyosis only causes this tissue to grow in one place: through the muscle wall of the womb (myometrium). It is more common in women aged 40-50 and those who have already had children, but it can also occur in younger and/or childless women. Many women are unaware they have this condition, simply attributing their symptoms to ‘naturally’ heavy periods, but sometimes the pain caused by adenomyosis can become constant and debilitating.

Symptoms

– Heavy, painful and/or irregular periods
– Severe pre-menstrual pelvic pain including a feeling of pressure or ‘heaviness’ in the pelvic area
– Pain during or after sexual intercourse
– Painful bowel movements (most commonly before or during menstruation)

Diagnosis

Adenomyosis can take a long time to diagnose because of the variety in symptoms and other conditions with similar symptoms, like pelvic inflammatory disease or irritable bowel syndrome. It is usually diagnosed via an internal ultrasound scan or MRI, or sometimes via hysteroscopy.

Treatment

Although adenomyosis does not usually require laparoscopic resection treatment like endometriosis, other treatments can help alleviate the symptoms if they become problematic. Like endometriosis, adenomyosis can respond well to hormonal treatment, such as certain types of birth control, especially the Mirena IUS.

However, over time, the pain caused by adenomyosis can mean the best course of treatment is a hysterectomy. Because adenomyosis only occurs in the womb itself, this can be a very effective treatment if hormonal interventions are not working, and if you do not have endometriosis, it is usually not necessary to remove the ovaries.

If you are concerned you might have adenomyosis or endometriosis, contact Mr Chilcott for a specialist consultation.