If you’ve never heard of adenomyosis (a-den-oh-my-osis), you aren’t alone. Despite affecting 1 in 10 women, and as common as diabetes in the US, this disease of the uterus is lesser known than it’s big sister, endometriosis. Whilst the two diseases share some commonalities, there are distinct differences and treatment pathways.
Navigating the complexities of adenomyosis can be overwhelming, especially for those who have recently received a diagnosis. This condition, characterised by the invasion of endometrial tissue into the muscular wall of the uterus, often presents challenges that impact various aspects of life. Let’s take a look at some common questions that many of you have had about adenomyosis:
Q: “I’ve been experiencing heavy menstrual bleeding and severe pelvic pain, and I’m concerned about these symptoms and that it’s adeno. What steps should I take to seek help?”
A: If you’re experiencing symptoms such as heavy menstrual bleeding and severe pelvic pain, it’s important to seek medical evaluation promptly to determine the underlying cause and explore treatment options. Start by scheduling an appointment with your gynaecologist or primary care physician to discuss your symptoms and concerns. During your appointment, your healthcare provider may perform a physical examination and recommend further tests, such as pelvic ultrasound or magnetic resonance imaging (MRI), to assess the health of your uterus and identify any potential abnormalities, including adenomyosis.
If adenomyosis is diagnosed, treatment options may vary depending on the severity of your symptoms and your personal preferences. In milder cases, medication such as non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal therapies, such as oral contraceptives or progestin-only treatments, may be prescribed to alleviate pain and regulate menstrual cycles. For individuals with more severe symptoms or those who do not respond to medication, surgical interventions such as uterine artery embolisation (UAE), endometrial ablation, or hysterectomy may be considered to remove or alleviate affected tissue.
Q: “I’ve recently been diagnosed with adenomyosis, and I’m unsure about what steps to take next. Can I do anything to avoid it worsening?”
A: Unfortunately, there is no known cure for adenomyosis apart from surgery – usually to remove the uterus. Considering factors to minimize symptoms and reduce the frequency of flare ups, there are some lifestyle considerations that might help. Firstly, refrain from smoking and excessive alcohol consumption, as these habits can aggravate inflammation and hormonal imbalances associated with adenomyosis. Additionally, consider moderating high-impact activities that strain the pelvic region, such as heavy lifting or intense exercise, to alleviate discomfort. Lastly, be mindful of dietary choices, avoiding foods known to trigger inflammation, such as processed foods, caffeine, spicy foods and excessive sugar.
Reading experiences from women with adenomyosis can help you feel less alone, and there are many communities now on social media and beyond supporting women with adenomyosis with women sharing tips that have helped them manage their condition.
Q: “I have this disease and have heavy periods and cramping with it and find it hard to concentrate through the pain in flare ups. What other complexities should I expect?”
A: Adenomyosis can manifest in a variety of ways, causing a range of symptoms that can significantly impact daily life. Common symptoms include heavy or prolonged menstrual bleeding, pelvic pain or pressure, bloating, and discomfort during intercourse. In some cases, adenomyosis may lead to anemia due to excessive blood loss during menstruation. Moreover, the chronic pain associated with adenomyosis can affect daily activities, work productivity, and overall quality of life. It’s important to address these symptoms proactively to manage the condition effectively.
To manage heavy periods, consider leak-proof underwear such as Nixi Body for added protection. Wuka also offer period pants for heavy flow, and Wear ‘Em Out are super absorbent reusable liners that are easy to wash.
Q: “I’ve noticed that my adenomyosis symptoms seem to flare up at certain times. What might be causing these flare-ups, and how can I manage them?”
A: Understanding the triggers for adenomyosis flare-ups is key to effectively managing the condition. Flare-ups often coincide with hormonal fluctuations, particularly during the menstrual cycle. The surge in estrogen levels, which stimulates the growth of endometrial tissue, can exacerbate symptoms of adenomyosis. Additionally, factors such as stress, inadequate sleep, and poor dietary choices may contribute to flare-ups. By identifying and addressing these triggers, individuals can take steps to minimize the impact of adenomyosis on their daily lives.
To manage a flare up, it’s important to rest, to take NSAIDs (if you can – speak to your doctor) to ease inflammation. You can use heat pads, or TENS machines. Modern TENS machines, such as Myoovi, stick onto the body and are easily worn throughout the day.
Q: “I’ve heard about different stages of adenomyosis. Can you explain what these stages are and how they may affect treatment options?”
A: Unlike endometriosis, adenomyosis does not have standardised staging criteria. However, healthcare providers may assess the severity of adenomyosis based on factors such as the extent of tissue invasion and the presence of associated symptoms. Treatment options may vary depending on the severity of the condition and the individual’s specific needs. These options may include medication to manage symptoms, hormonal therapies to regulate menstrual cycles, or surgical interventions to remove affected tissue.
Q: “I’m curious about the connection between adeno and fertility. How might this condition impact my ability to conceive or carry a pregnancy?”
A: Adenomyosis can affect fertility in various ways, making it important to discuss concerns with a healthcare provider. While some individuals with adenomyosis may conceive and carry a pregnancy to term without difficulty, others may experience challenges. Adenomyosis can lead to structural changes in the uterus, which may interfere with embryo implantation or increase the risk of miscarriage. Additionally, the chronic inflammation associated with adenomyosis may affect reproductive function. Consulting with a fertility specialist can provide personalised guidance and support for individuals seeking to conceive with adenomyosis.
Q: “Are there any lesser-known symptoms of adeno that I should be aware of?”
A: In addition to the more common symptoms of adenomyosis, such as heavy menstrual bleeding and pelvic pain, there are several lesser-known signs that individuals should watch for. These may include gastrointestinal symptoms such as diarrhoea, constipation, or bloating, which can occur due to the proximity of the uterus to the intestines. Some individuals may also experience urinary symptoms, such as increased frequency or urgency, as a result of pressure on the bladder. By recognising these lesser-known symptoms, individuals can seek appropriate medical evaluation and treatment to manage their adenomyosis effectively.
Q: “I’ve been diagnosed with adenomyosis, and I’m exploring treatment options. Can you explain the available treatments for adenomyosis, and what are the considerations regarding surgery, particularly hysterectomy?”
A: When it comes to treating adenomyosis, there are various options available, ranging from conservative management to surgical interventions. Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies, including oral contraceptives, progestin-only treatments, or gonadotropin-releasing hormone (GnRH) agonists, are often prescribed to alleviate symptoms such as pelvic pain and heavy menstrual bleeding. These medications work by suppressing estrogen production and regulating menstrual cycles, thereby reducing the growth and proliferation of endometrial tissue within the uterus.
In cases where medication alone is insufficient to control symptoms or when individuals desire a more definitive solution, surgical interventions may be considered. One such option is uterine artery embolisation (UAE), a minimally invasive procedure that involves blocking the blood supply to the uterus to shrink adenomyosis lesions and alleviate associated symptoms. Another surgical approach is endometrial ablation, which aims to destroy the uterine lining to reduce menstrual bleeding and pain.
However, it’s important to note that for individuals seeking a permanent resolution to adenomyosis, hysterectomy may be recommended. Hysterectomy involves the surgical removal of the uterus and is considered the most effective treatment for eliminating adenomyosis completely. While hysterectomy can provide long-term relief from symptoms and improve overall quality of life, it is a major surgical procedure that requires careful consideration and discussion with your healthcare provider.
It’s also crucial to be aware that for some individuals, adenomyosis may coexist with endometriosis, another condition involving the abnormal growth of endometrial tissue outside the uterus. In such cases, undergoing hysterectomy without addressing endometriosis may lead to persistent symptoms or exacerbation of the condition post-surgery. Therefore, individuals considering hysterectomy for adenomyosis should undergo thorough evaluation and, if necessary, excision of endometriosis lesions to ensure comprehensive treatment and optimal outcomes.
It’s important to always seek medical advice if you believe you are experiencing symptoms of adenomyosis.