When endometrial implants are found outside the uterus, the condition is called Endometriosis. Sometimes the endometrial implants stay inside the uterus, attach themselves onto the wall of the uterus, and start moving inward. The result of these migrating endometrial growths is a thickening of the uterine wall, and when this happens it called Adenomyosis. Although the two conditions sound similar, Adenomyosis can be more complex and more difficult to treat.
Symptoms of Adenomyosis can vary and can be mild, moderate, or severe. In many cases, a women will have long, heavy menstrual cycles oftentimes with blood clots during menstruation and spotting in between cycles. Menstrual cramps tend to be severe, along with abdominal tenderness and pain with intercourse. Less common symptoms are lower back pain, pain in the hips/thighs, and fatigue. If Adenomyosis is present on only one side of the uterus, that side might be severely painful while the other is only mildly so.
In order to diagnose Adenomyosis, a physical exam is needed. The doctor will check your abdomen for tender or swollen parts by pushing gently in specific areas. Then, the doctor will insert a probe into your vagina and take an ultrasound of your pelvic area. Although some cases of Adenomyosis will not be present in an ultrasound, sometimes we will be able to see evidence of a swollen uterus or a thickening of the uterine wall.
Treatment will depend on the results of the ultrasound and location of swelling , your quality of life, desire to have children, age, etc. Typical treatments include over the counter pain relievers, prescription pain relievers, oral contraceptives, or hormones and/or an IUD called Mirena. The goal of these less aggressive forms of treatment is to minimize the growth and spread of Adenomyosis and help relieve pain allowing you to have a better quality of life. If the disease progresses and these lesser forms or therapy stop working, we will likely recommend a hysterectomy. This is the only way to completely and permanently remove Adenomyosis from the body.