Adenomyosis

Adenomyosis is a disease that occurs when the cells that normally line the uterus grow into the muscular tissue of the uterine wall. This can cause painful, heavy periods and chronic pelvic pain.

Sometimes adenomyosis does not cause any symptoms. But when symptoms are present, they can include:

• Heavy or prolonged menstrual periods (menorrhagia).
• Painful menstruation (dysmenorrhea).
• Chronic pelvic pain.

When symptoms occur, the evaluation of suspected adenomyosis may include:

• History of symptoms, menstrual periods, and family history.
• Pelvic exam, which may reveal a large, soft, or tender uterus.
• A sample of the tissue of the wall of the uterus (endometrial biopsy).
• Pelvic ultrasound, which may help tell adenomyosis from other pelvic tumors.
• Hysteroscopy. This test allows the doctor to examine and take samples of the lining of the uterus.
• MRI of the pelvis.

But adenomyosis can only for sure be diagnosed when a pathologist examines the uterus after a hysterectomy.

Pelvic pain and heavy menstrual bleeding from adenomyosis can be relieved with nonsteroidal anti-inflammatory drugs (NSAIDs) and hormone therapy. A hysterectomy may be needed if you have severe symptoms but are not approaching menopause. Symptoms often go away after menopause is complete or after hysterectomy.

Other procedures may be tried to help relieve symptoms if medicine doesn't work and you don't want a hysterectomy. During these procedures, the doctor removes or shrinks adenomyosis in the uterus without removing the whole uterus.