Adenomyosis is as condition where the endometrial glands grow into the myometrium(muscle of the uterus). These glands are stimulated by hormones in the body. Patients with adenomyosis often experience heavy monthly cycles and their cycles can be very painful.
How do I know If I have Adenomyosis?
Your doctor my suspect adenomyosis based on your history and physical examination. Ultrasound can often detect areas in the uterus that are suspicious for adenomyosis. An MRI is very good at detecting MRI but is not commonly used outside research studies. The only way to definitively determine if you have adenomyosis is by having a pathologist examine the muscle cells of the uterus under a microscope. This can only done after a patient has undergone a hysterectomy.
What are the treatment options for Adenomyosis?
Treatment options for adenomyosis often depends on the symptoms of the patient and what treatments have already been used. Treatment is usually medical or surgical. An endometrial biopsy may be needed to look for cancer of the endometrium (lining of the womb). Medical treatment is often used first and the goal is to suppress the growth of the glands that have invaded the muscle of the uterus. Suppression of these glands are usually hormonal forms of birth control including pills, shots, or an intrauterine device.
If medical treatments have failed then surgery is considered. An endometrial ablation may be considered if the main symptom is heavy bleeding. However, an endometrial ablation does not treat endometrial glands that have invaded deep into the muscle. An endometrial ablation might not relieve the severe menstrual pain associated with adenomyosis. Surgical treatment is often in the form of hysterectomy. By removing the muscle of the uterus adenomyoisis is often cured. A hysterectomy can be performed without removing the ovaries. There have been case reports of resection of areas of adenomyosis in the patients who desire to have children in the future however this is not the typical treatment and should only be considered in select patients.