April 17, 2025 | Adenomyosis has been called “the silent disease” as many women dealing with the disorder are unaware they have it because it doesn’t always cause obvious symptoms. For this reason, it’s unknown exactly how many women have the gynecologic condition, although research has shown that it’s more common in people who have had a procedure on their uterus and those over the age of 40. The tissue that lines the uterus is a special type of glandular tissue that responds to hormones. Each month, it prepares for a pregnancy by getting thicker. If pregnancy doesn’t occur, the endometrial tissue sloughs off during your menstrual period. But in adenomyosis, some of this tissue grows into the myometrium, which is the muscular inner wall of the uterus. The tissue still behaves as it would if it lined the uterus, so it thickens and bleeds with a woman’s monthly hormone cycle. It can cause the uterus to enlarge up to double or triple its usual size.

April 17, 2025 | Medical experts are unsure what causes the gynecologic condition known as adenomyosis although research has shown that hormones, genetics, inflammation or trauma may be contributing factors. It most commonly occurs in women who are between the ages of 40 and 50, who have given birth at least once or have had prior uterine surgeries such as uterine fibroid removal or dilation and curettage, the procedure better known as D and C. Adenomyosis is difficult to diagnose since one in three women show no signs of the condition. The symptoms can range from painful menstrual cramps and heavy menstrual bleeding to chronic pelvic pain and painful intercourse. Adenomyosis may cause your uterus to get bigger and although you might not notice the growth, you may notice tenderness and pressure in your lower abdomen. Fortunately, the major symptoms of adenomyosis go away after a woman goes through menopause.

April 17, 2025 | Adenomyosis, endometriosis and uterine fibroids are all disorders of the female reproductive tract. Because they cause very similar symptoms, it can be easy to confuse them. Dr. Nirvana Manning, chair of the UAMS Department of Obstetrics and Gynecology, says that even though these conditions share some symptoms, they are very different and require different forms of treatment. Adenomyosis occurs when diffuse endometrial tissue grows into the wall of the uterus. Endometriosis, meanwhile, is a condition in which cells like the lining of the uterus grow outside the uterus throughout the pelvis. It might grow on the fallopian tubes, ovaries, vagina or intestines. Uterine fibroids are caused by benign tumors, solid masses of cells that aren’t cancerous, that grow on different parts of the uterus. Dr. Manning says women who have prolonged bleeding or severe cramping during their periods should make an appointment to see their physician.

April 17, 2025 | Before a physician can properly determine whether you have adenomyosis, they will have to rule out any other gynecologic problems. A physical exam is the first step. During a pelvic exam, the physician may notice that your uterus has gotten larger, softer or is painful to the touch. The next step is an ultrasound. Ultrasounds are quick and easy tests that can usually be performed in the doctor’s office. While an ultrasound might not provide a very high-resolution image of the myometrium, it can help rule out other conditions, such as endometriosis or uterine fibroids. An MRI may be needed to help distinguish this condition from other uterine tumors. It is often used when an ultrasound exam does not provide sufficient information to make a diagnosis. Your doctor may rule out more serious conditions with a biopsy of the inside of the uterus. During a biopsy, your doctor collects tissue and tests it for signs of more serious diseases.

April 17, 2025 | Adenomyosis is not a condition a woman has to live with. Left untreated, it can most often lead to chronic pelvic pain and irregular bleeding. Because adenomyosis often goes away after menopause, choosing how to treat the condition usually depends on how close the patient is to that stage of life. Anti-inflammatory medications such as ibuprofen are usually recommended to control the pain. Combined estrogen-progestin birth control pills or hormone-containing patches or vaginal rings might lessen heavy bleeding and pain associated with adenomyosis. Progestin-only contraception, such as an intrauterine device, or continuous-use birth control pills often cause amenorrhea, the absence of menstrual periods, which might provide some relief. A hysterectomy may be performed if a woman’s symptoms are severe. The hysterectomy may remove only the uterus or the uterus and the cervix, depending on the patient’s preference.