Despite adenomyosis affecting around 20 to 35 per cent of women, little is known about this sometimes painful condition.
While the cause of adenomyosis remains unknown, Sydney-based GP and female health specialist Dr Jill Forer fills us in on the condition and how it’s treated.
What is it?
“Uterine adenomyosis is a disorder in which the endometrial lining (inside the ueterus) appears ectopically outside the muscular tissue of the uterus or womb and causes enlargement of the surrounding muscle wall,” Jill explains. “This results in an enlarged uterus.”
Women who are aged between 15 and 50 are usually affected and this condition is estimated to be present in 20 to 35 per cent of women, she reveals.
While many women don’t show any symptoms, adenomyosis is sometimes discovered incidentally during a pelvic ultrasound.
“However, around 60 per cent of symptomatic women experience heavy menstrual bleeding and 25 per cent of affected women experience dysmenorrhea (painful periods),” Jill says. Chronic pelvic pain may also occur since the uterus is generally enlarged.
While adenomyosis can be difficult to diagnose, Jill says it can be detected by ultrasound and pelvic examination.
“Ultrasound should be performed by a specialist womens ultrasound centre,” she adds. “Transvaginal ultrasound is the first-line imaging choice for evaluation of an enlarged uterus, pelvic pain, and/or abnormal bleeding, and focal adenomyosis.”
For most people, Jill explains that no treatment is required and the condition may also settle around menopause when the lining of the uterus shrinks because of hormonal influences.
“For those that require treatment, there are medical and surgical interventions, but every patient has different requirements and should be assessed on a case by case basis because no one size fits all,” she tells.
Jill says that medical treatments can include:
- Pain medications
- Medications to decrease the flow and quantity of menstrual blood
- Oral contraceptive pill
- Progesterone containing IUD (intra uterine device)
- Surgical. These are complex and carry complications but include endometrial ablation (removing endometrial lining ) and uterine artery embolisation (this blocks blood supply to the uterus)
- Hysterectomy, which involves removing the uterus
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