Adenomyosis is the endometriosis of the uterus. In other words, the endometrial tissue that should be placed within the uterus, that is to say, in the uterine inner layer is found in the uterine muscle and creates a mass causing irregular thickening of the uterus.
The signs of adenomyosis disease may be mild or severe. Some women can be detected by chance during gynecological examination, there may be no symptoms. The most common symptoms of adenomyosis disease are:
• Severe menstrual pain
• Intermittent bleedings between menstrual periods
• Severe and/or long menstrual bleeding
• Pain during sexual intercourse
• Constant pain or discomfort in the abdominal area
• Fatigue, depressed mood
The uterus is irregular, two or three times larger than the normal size during gynecological examination and ultrasound. Adenomyosis can be detected or suspected during transvaginal ultrasound. If it can not be diagnosed by ultrasound, MRI may be required to obtain high resolution images of the uterus.
HOW IS ADENOMYOSIS TREATED?
Treatment may not be necessary in women who have no complaints but suspected of having adenomyosis on ultrasound. However, if you have complaints affecting your daily life, your doctor will give you one of the different treatment options. It depends on which treatment option is right for you, whether you are married or not and whether you have children.
Treatment options that can be applied to reduce adenomyosis complaints include:
These medications help to reduce blood flow during menstrual periods, while also relieving severe cramps. It will be wise to start medicines 1-2 days before menstrual period and continue all through the menses.
These include oral contraceptives, contraceptives containing only progestin (tablet, injection or intrauterine device forms) and hormone-containing monthly or 3-monthly depot injections.
The only way to completely cure an adenomyosis disease is hysterectomy which is uterine removal. It is a surgical procedure that is the last step and may be preferred only in severe cases that do not respond to other treatment options or in women who do not consider to have more children.
In summary, adenomyosis is not a life-threatening disease. There are many treatment options available to relieve the complaints. Hysterectomy is the only treatment option that can completely cure the disease as it is the removal of uterus. Suppression of estrogen hormone which is a contributing factor for the development of adenomyosis might alleviate the complaints. Therefore, complaints of adenomyosis mostly disappear following menopause.
Banu Kumbak Aygun, M.D., Professor
Gynecology & Obtetrics