Fact: pelvic health is one of the most misunderstood areas of health care. That’s because health care providers have historically lumped all symptoms of pelvic pain together and brushed them off as something people just have to live with. All too often, patients are told there’s no reason for their symptoms or that they don’t fall into a proper diagnosis. In reality, so little is understood about so many pelvic pain conditions, like adenomyosis, that many doctors would prefer not to deal with them at all.
At Pelvic Pain Doc, we’re in a crusade against all that. We believe pelvic pain is not only diagnosable and treatable, but an important topic that deserves attention, sensitivity and compassion. It doesn’t matter if someone has a common condition or something we rarely see at our New York pelvic pain offices — we’ll do whatever we can to get to the root cause of our patients’ pain.
Adenomyosis is just one of those rare conditions that many people haven’t heard of. Characterized by severe menstrual cramps, bloating and abdominal pressure, most sufferers go years without a proper diagnosis, if they ever get one at all. In this post, Dr. Sonia Bahlani will share:
- What adenomyosis is
- What causes adenomyosis
- The side effects of untreated adenomyosis
- Treatment options for adenomyosis
What Is Adenomyosis?
Adenomyosis is a pelvic pain disease that occurs when the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). The displaced tissue continues to function as though it were still within the uterus, thickening, breaking down and shedding with each menstrual cycle. As the tissue grows outside the uterus, adenomyosis can lead to an enlargement of the uterus. While the patient will likely not notice this change in size, they may experience tenderness or pressure in the lower abdomen.
This condition can cause severe pelvic pain, particularly during menstruation, and can greatly interfere with a person’s quality of life. The symptoms of adenomyosis include:
- Heavy or prolonged menstrual bleeding
- Severe menstrual cramping
- Lower abdominal pressure
- Chronic pelvic pain
- Painful intercourse
What Causes Adenomyosis?
The unfortunate reality with many pelvic pain conditions is that the cause is largely unknown. The same is true for adenomyosis, however, experts believe that certain hormones (including estrogen, progesterone, prolactin and follicle stimulating hormone) play a role in triggering the condition. There are also many theories for what causes adenomyosis, including:
- Invasive tissue growth: Uterine surgery, such as cesarean section, can cause the direct invasion of the endometrial cells into the wall of the uterus.
- Developmental causes: Some experts believe that endometrial tissue may become displaced when the uterus is first formed in utero.
- Postpartum uterine inflammation: Some theories suggest that adenomyosis is linked to childbirth and the inflammation of the uterine lining during the postpartum period.
- Stem cell origins: Other experts believe that bone marrow stem cells may invade the myometrium which ultimately causes adenomyosis.
While the causes of adenomyosis are in the theoretical stage, there are certain risk factors that may increase a person’s chances of developing the condition. This includes prior uterine surgery (c-section, D&C, fibroid removal), middle age and childbirth.
What Happens If You Don’t Treat Adenomyosis?
If you think you might have adenomyosis or you’ve recently been diagnosed, you might be wondering how having this condition will affect your life. Of course, you’ve already experienced the pain and discomfort that adenomyosis causes, but what happens if you don’t treat it?
It is commonly believed that adenomyosis is correlated with infertility. Unfortunately, it is difficult to say whether or not this is true. Many patients with adenomyosis also have endometriosis, which can indeed cause infertility, but this makes it challenging to determine the role that adenomyosis plays.
Since adenomyosis and endometriosis often cause similar symptoms, the two pelvic health conditions are often confused with one another. The difference between adenomyosis and endometriosis is where the displaced endometrial-like tissue grows. With endometriosis, this endometrial -like tissue grows outside the uterus and may include the ovaries, fallopian tubes, pelvic walls or bowel. With adenomyosis, the tissue grows into the muscular wall of the uterus.
Additionally, adenomyosis is a progressive disease. This means that, without proper management, it gets worse over time. While not life-threatening, adenomyosis can lead to more serious problems if left untreated, such as pelvic organ prolapse.
How to Treat Adenomyosis
If you’re dealing with this painful and disruptive disease, it’s time for you to get the support you need to regain control of your life. You deserve to feel good in your body. With the right combination of treatments, therapies and medications, you can overcome your pain symptoms and get back to the things you love.
Here are some of the possible treatment options for adenomyosis:
- Anti-inflammatory medications: For mild cases of adenomyosis, taking medications like ibuprofen can help reduce cramping, inflammation and blood flow during menstruation. Your doctor can advise you on how to take these medications to best combat your pain, but starting to take ibuprofen two to three days before your period can be highly effective.
- Hormonal treatments: Since estrogen is a significant part of adenomyosis, treatments that help control the hormone can alleviate ongoing symptoms. This could involve taking contraceptive pills, getting an intrauterine device (IUD) or contraceptive options that stop your menstrual cycle altogether.
- Endometrial ablation: This minimally invasive procedure is used to destroy the endometrium (the lining of the uterus). Endometrial ablation is only effective if the adenomyosis has not progressed too deeply into the uterine muscle. Since it can cause scarring to the uterine wall, this procedure is only recommended for those who are finished with childbearing or are not interested in getting pregnant.
- Uterine artery embolization: This procedure uses tiny particles to block the blood vessels that supply blood flow to the adenomyosis, shrinking the adenomyosis as a result. Uterine artery embolization is typically used to treat uterine fibroids.
- Hysterectomy: Hysterectomy is the only complete cure for adenomyosis but is not an ideal choice for many patients for obvious reasons. However, for the right patient who is experiencing extreme symptoms and has no interest in bearing children, this may be the treatment of choice.
If you’ve been experiencing symptoms that sound like adenomyosis, we want you to know that it’s very possible to reach a better quality of life. As a pelvic pain specialist in New York, Dr. Bahlani is dedicated to helping patients uncover the cause of their pain and working together to find solutions that fit your lifestyle. Contact Pelvic Pain Doc to book a consultation with Dr. Bahlani today.