Adenomyosis is a condition where there is an abnormal presence of endometrial tissue in the myometrium. This means that there is uterine lining located in the muscular layer of the uterus. Adenomyosis is similar to endometriosis where the endometrial tissue is located outside the uterus.
It is a common and poorly understood condition observed to affect women of all ages. It has been associated with multiparity, middle age, and a history of gynecologic surgery. The definitive diagnosis for adenomyosis requires a histologic exam of a surgical specimen during a hysterectomy. This condition has been estimated to affect between 20 to 30 percent of the general population. Patient education is important to help patients understand the prognosis and treatment.
Those with mild adenomyosis may not require any treatment. The aim of treatment is to reduce the symptoms of adenomyosis using options such as anti-inflammatory medications, hormonal treatments, endometrial ablation, uterine artery embolization, magnetic resonance imaging, guided focused ultrasound surgery, and hysterectomy.
Symptom #1: Dysmenorrhea
Dysmenorrhea, or menstrual cramps, refers to pain that occurs during menstruation. Dysmenorrhea usually begins during menstruation and resolves once menstruation is over. The pain is usually felt in the lower abdomen and can include other symptoms such as diarrhea, back pain, and nausea.
Dysmenorrhea commonly occurs in younger women without any underlying issues. However, among older women, dysmenorrhea is usually caused by underlying issues such as adenomyosis, endometriosis, and uterine fibroids. Medications that may be helpful include paracetamol (acetaminophen) and non-steroidal anti-inflammatory drugs (NSAIDs).