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Overview

Adenomyosis - Symptom, Treatment And Causes

Adenomyosis is a condition whereby the endometrium, which is the inner lining of the uterus, break through the myometrium, the muscle wall of the uterus. This condition creates lower abdominal pain, along with severe menstrual cramps, bloating before the menstrual period often leading to heavy bleeding. Adenomyosis can happen in one place inside the uterus or even happen throughout in the uterine sack. Though this condition is not life-threatening, but the frequent pain and heavy bleeding that occurs because of this illness, can have a benign negative impact on a women’s life.

Ademomyosis is a common ailment that often occurs in women who are in their middle age and have children. It is also believed that women who had uterine surgery in the past are also at a risk of developing this agonizing malady. Although, doctors are at a loss in finding out the real cause behind the development of this disease, nevertheless, it is believed that several hormones (like prolactin, estrogen, progesterone and follicle stimulating hormones) can trigger this disease.

In the past, the only way to diagnose this disease was by performing a hysteroscopy on the patient, to examine the uterine tissue after visualizing it under a microscope. Nowadays, with development in biomedical science, this disease can be diagnosed even without any surgery. So, in the modern times, using a transvaginal ultrasound or a MRI, doctors can view the condition of the patient’s uterus with the help of state-of-art imaging technology.

To begin with, doctors primarily take a physical examination of the patient’s uterus if the physician suspect adenomyosis. Women suffering from this condition often have an enlarged and tender uterus. Although just performing an ultrasound on the patient doesn’t definitely diagnose this disease, but it aids in ruling out other diseases, which has similar symptoms like adenomyosis, like uterine fibroids. Treatment for this disease depends a lot on the severity of this condition. Often mild symptoms of adenomyosis, are treated with over-the-counter pain medications and nonsteroidal anti-inflammatory drugs. Patients are also advised to use heating pads to ease their lower abdominal cramps.

For patients with severe conditions, hormone therapy is prescribed for the patients, which aids in controlling heavy and painful periods. Levonorgestrel-releasing IUD, GnRH analogs and aromatase inhibitors are often used for treating severe adenomyosis patients.

Endometrial ablation and uterine artery embolism are also done to adenomyosis patients, which calls for minimal invasive surgery.

However, it has been observed that for severe adenomyosis, hysterectomy (surgical removal of the uterus) is the only treatment that definitely cures this painful disease.

Treatable by medical professional Require medical diagnosis Lab test always required Chronic: can last for years or be lifelong
Symptoms
Chronic pelvic pain Heavy menstrual bleeding A 'bearing' down feeling Pressure on bladder Dragging sensation down thighs and legs Painful vaginal intercourse

Popular Health Tips

Heavy Bleeding- It Could Be Adenomyosis!

Dr. Garima Kaur 93% (288 ratings)
MICOG, MS, MBBS
Gynaecologist, Delhi
Heavy Bleeding- It Could Be Adenomyosis!
Adenomyosis is a condition which occurs when the muscle wall of the uterus is broken by the endometrium lining. You experience pressure in the lower abdomen, menstrual cramps and bloating, before the onset of menstrual periods, resulting in heavy bleeding during the periods. This disorder is not life threatening but is known to cause pain and heavy bleeding. Symptoms- The symptoms of adenomyosis are severe pain during periods, prolonged periods and pressure in the abdominal area. You may also experience heavy bleeding during the periods and may also experience intense pain. Sex may be very painful as well. The lower abdomen might feel tender and bigger; this occurs when the size of the uterus increases in this particular condition. Causes- The exact cause of this disorder is not yet ascertained. However, certain possible causes could be: Congenital Defect: In this case, the condition is known to occur from birth wherein the endometrial tissue grows on the uterine muscle wall during the fetus formation. Invasive Growth of Tissues: This is said to occur when endometrial cells invade the uterus lining, leading to adenomyosis. This can also be triggered by a C-section operation. Inflammation During Childbirth: During the childbirth process, inflammation may occur in the lining of the uterus leading to this disorder. In addition to the possible cause, there are certain risk factors which increase the risks of the disorder, such as: Aging Giving birth to a child Surgery related to the uterus such as a C-section Treatment- Once you reach menopause, this disorder tends to subside. So depending on how close you are to menopause, the treatment is designed accordingly. The various treatments for adenomyosis are Anti-inflammatory Medications: If you are nearing menopause, then anti-inflammatory medications will be administered. This helps in reducing pain and the heavy blood flow. Hormone Medications: Hormone medications such as hormone patches can also help with the bleeding and pain. Hysterectomy: If the pain turns intense, then the doctor may recommend hysterectomy, a surgery to remove the uterus.

Everything You Want To Know About Endometriosis

FRCOG (LONDON) (Fellow of Royal College of Obstetricians and Gynaecologists), CCT (Lon), DNB (Obstetrics and Gynecology), MD
Gynaecologist, Mumbai
Everything You Want To Know About Endometriosis
Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus the endometrium grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs. With endometriosis, displaced endometrial tissue continues to act as it normally would it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. Endometriosis can cause pain sometimes severe especially during your period. Fertility problems also may develop. Fortunately, effective treatments are available. Symptoms The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual cramp that's far worse than usual. They also tend to report that the pain increases over time. Common Signs and Symptoms of Endometriosis may include: Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before your period and extend several days into your period. You may also have lower back and abdominal pain. Pain with intercourse. Pain during or after sex is common with endometriosis. Pain with bowel movements or urination. You're most likely to experience these symptoms during your period. Excessive bleeding. You may experience occasional heavy periods (menorrhagia) or bleeding between periods (menometrorrhagia). Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility. Other symptoms. You may also experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods. The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have intense pain, while others with advanced endometriosis may have little pain or even no pain at all. Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis. When to see a doctor See the doctor if you have signs and symptoms that may indicate endometriosis. Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms. Causes Although the exact cause of endometriosis is not certain, possible explanations include: Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle. Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells cells that line the inner side of your abdomen into endometrial cells. Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells cells in the earliest stages of development into endometrial cell implants during puberty. Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision. Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body. Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus. Risk factors Several factors place you at greater risk of developing endometriosis, such as: Never giving birth Starting your period at an early age Going through menopause at an older age Short menstrual cycles for instance, less than 27 days Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces Low body mass index Alcohol consumption One or more relatives (mother, aunt or sister) with endometriosis Any medical condition that prevents the normal passage of menstrual flow out of the body Uterine abnormalities Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you're taking estrogen. Complications Infertility The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. Inspite of this, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time. Ovarian cancer Ovarian cancer does occur at higher than expected rates in women with endometriosis. Although rare, another type of cancer endometriosis-associated adenocarcinoma can develop later in life in women who have had endometriosis. Diagnosis: To diagnose endometriosis and other conditions that can cause pelvic pain, the doctor will ask you to describe your symptoms, including the location of your pain and when it occurs. Tests to check for physical clues of endometriosis include: Pelvic exam. During a pelvic exam, the doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis, unless they've caused a cyst to form. Ultrasound. A transducer, a device that uses high-frequency sound waves to create images of the inside of your body, is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view of your reproductive organs. Ultrasound imaging won't definitively tell the doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas). Laparoscopy. Medical management is usually tried first. But to be certain you have endometriosis, the doctor may advise a surgical procedure called laparoscopy to look inside your abdomen for signs of endometriosis. While you're under general anesthesia, the doctor makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus. He or she may take samples of tissue (biopsy). Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options. Treatment for endometriosis is usually with medications or surgery. The approach you and the doctor choose will depend on the severity of your signs and symptoms and whether you hope to become pregnant. Generally, doctors recommend trying conservative treatment approaches first, opting for surgery as a last resort. Pain medications The doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others), to help ease painful menstrual cramps. If you find that taking the maximum dose of these medications doesn't provide full relief, you may need to try another approach to manage your signs and symptoms. Hormone therapy Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue. Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment. Therapies used to treat endometriosis include: Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. Most women have lighter and shorter menstrual flow when they're using a hormonal contraceptive. Using hormonal contraceptives especially continuous cycle regimens may reduce or eliminate the pain of mild to moderate endometriosis. Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink. Because these drugs create an artificial menopause, taking a low dose of estrogen or progestin along with Gn-RH agonists and antagonists may decrease menopausal side effects, such as hot flashes, vaginal dryness and bone loss. Your periods and the ability to get pregnant return when you stop taking the medication. Progestin therapy. A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms. Danazol. This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. However, danazol may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication. Conservative surgery If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery however, endometriosis and pain may return. The doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases. Assisted reproductive technologies Assisted reproductive technologies, such as in vitro fertilization (IVF) to help you become pregnant are sometimes preferable to conservative surgery. Doctors often suggest one of these approaches if conservative surgery doesn't work.
2750 people found this helpful

Heavy Bleeding- A Sign of Adenomyosis

Dr. Deepa Ganesh 88% (43 ratings)
M.B.B.S, M.S Obstetrics and Gynaecology, Diploma in Minimal Access Surgery, Fellowship in Minimal Access Surgery, Diploma in Advanced Modern Cosmetic - Plastic Gynaecology, Diploma in Minimal Invasive Surgery(Germany), Fellowship of International College of Robotic Surgeons
Gynaecologist, Chennai
Heavy Bleeding- A Sign of Adenomyosis
Adenomyosis is a condition which occurs when the muscle wall of the uterus is broken by the endometrium lining. You experience pressure in the lower abdomen, menstrual cramps and bloating, before the onset of menstrual periods, resulting in heavy bleeding during the periods. This disorder is not life threatening but is known to cause pain and heavy bleeding. Symptoms- The symptoms of adenomyosis are severe pain during periods, prolonged periods and pressure in the abdominal area. You may also experience heavy bleeding during the periods and may also experience intense pain. Sex may be very painful as well. The lower abdomen might feel tender and bigger; this occurs when the size of the uterus increases in this particular condition. Causes- The exact cause of this disorder is not yet ascertained. However, certain possible causes could be: Congenital Defect: In this case, the condition is known to occur from birth wherein the endometrial tissue grows on the uterine muscle wall during the fetus formation. Invasive Growth of Tissues: This is said to occur when endometrial cells invade the uterus lining, leading to adenomyosis. This can also be triggered by a C-section operation. Inflammation During Childbirth: During the childbirth process, inflammation may occur in the lining of the uterus leading to this disorder. In addition to the possible cause, there are certain risk factors which increase the risks of the disorder, such as: Aging Giving birth to a child Surgery related to the uterus such as a C-section Treatment- Once you reach menopause, this disorder tends to subside. So depending on how close you are to menopause, the treatment is designed accordingly. The various treatments for adenomyosis are Anti-inflammatory Medications: If you are nearing menopause, then anti-inflammatory medications will be administered. This helps in reducing pain and the heavy blood flow. Hormone Medications: Hormone medications such as hormone patches can also help with the bleeding and pain. Hysterectomy: If the pain turns intense, then the doctor may recommend hysterectomy, a surgery to remove the uterus.
2522 people found this helpful

Hypoactive Sexual Desire Disorder - How it Affects Men and Women?

Dr. Pradeep Kolhe 86% (20 ratings)
Postgraduate Diploma in Sexology , M.D., Ph.D.
Sexologist, Nagpur
Hypoactive Sexual Desire Disorder - How it Affects Men and Women?
Do you feel disinterested in getting physically close to your partner? If yes, then it can be a sign of HSDD, that is Hypoactive sexual desire disorder. It is a sex disorder marked by disgust and disinterest towards sex. This disorder affects both men and women. Men with Hypoactive Sexual Desire Disorder Men are generally perceived as highly sexual beings, but in reality, 1 out of 5 men may be suffering from HSDD. Some possible causes of male HSDD include: Psychological issues: Anxiety and stress due to the strain of family or relationship problems, rigours of daily life or mental disorders such as depression are some of the factors that influence sexual desire. Medical causes: Diseases (for example: diabetes), conditions (such as high cholesterol, high blood pressure and obesity) and drugs (such as hair loss medications) have adverse effects on sexual desire. Hormonal problems: Low levels of testosterone usually lead to low sexual desire. Other hormones, such as the thyroid hormone or prolactin (hormone that governs the development of breast milk) can also contribute to the cause. Low levels of dopamine: Dopamine is a neurotransmitter, which is responsible for the pleasure perception in your brain. Low levels of dopamine usually signify low sexual desire. How it can be treated ? If the cause is psychological, then sex therapy (psychological counselling based on sexual issues) is used to treat HSDD. But if it is hormonal, testosterone supplements are used. Women with Hypoactive Sexual Desire Disorder Female HSDD is more complicated and is difficult to diagnose. HSDD can affect women across all ages. In women, this disorder can have a wider spectrum of causes, which include: Interpersonal relationship problems: Certain problems such as the partner s performance issues, loss of emotional gratification with relationships, childbirth and becoming nothing, but only a loved one s caregiver can all lead to low sexual desire. Sociocultural influences: Media s portrayal of sexuality, peer pressure and job stress have negative influences on sexual desire. Low testosterone: Women produce testosterone as well, and similar to men, low levels of this sex hormone cause a significant dip in sexual desire. Medical problems: Mental illnesses such as depression or medical problems, such as fibroids or endometriosis (a disorder characterized by the growth of uterine tissues outside the organ) affect women, physically and mentally, thus making hypoactive sexual desire disorder a possibility. Medications: Excessive use of antidepressants, oral contraceptives and blood pressure drugs can lower sexual desire. Age: The androgen (sex hormone) levels lower drastically as a woman ages, thus negatively impacting her sexual desires. Treatment Sex therapy (therapy that concerns itself with counselling and addressing one s physical or psychological hindrances to sex) medication changes, diagnosing underlying medical problems, vaginal estrogens and testosterone therapy (therapy that helps in managing the effects of low levels of testosterone) are mostly used to increase sexual desire in women.
4457 people found this helpful

Hysterectomy - Know the Emerging Conservative Alternatives to it?

Advanced Infertility, Diploma in Obstetrics & Gynaecology, MBBS
IVF Specialist, Delhi
Hysterectomy - Know the Emerging Conservative Alternatives to it?
Like most things in life, the uterus also has both good and bad sides to it. It is a symbol of womanhood and also carries the developing baby. The bad side is that it brings with it (and its appendages) many problems including dysfunctional uterine bleeding, endometriosis, fibroids, pelvic inflammatory disease, uterovaginal prolapse, adenomyosis, a pelvic pain of unknown origin, cancer of the uterine cavity and other obstetric complications. Hysterectomy is one of the most commonly performed procedures and ensures complete relief from these symptoms. There are however, multiple procedures, which can be used to manage these conditions without having to resort to removal of the uterus. This can help in preventing complications from hysterectomy including prolonged recovery, infertility in women of childbearing age and loss of womanhood. Read on to know some of the emerging conservative alternatives to hysterectomy: Myomectomy: Where there are fibroids, which are in the smooth muscles of the uterus and show symptoms like pain and discomfort. In these, it is advisable to go for a myomectomy. This removes only the fibroid, leaving the uterus in place. It can be done in one of the 3 ways traditional surgical process through an incision; laparoscopically through minute incisions; and then through vagina. In all these, only the fibroid is removed and sent for biopsy to confirm it is benign. It is less invasive, requires less recovery time and helps retain the uterus. Uterine endometrial ablation: In cases of dysfunctional uterine bleeding or menorrhagia with no fibroids, the lining of the uterus could require removal. In these women, thermal balloon ablation, cryoablation, and radiofrequency ablation can be used. A small amount of extreme heat or cold or radio frequency waves are used to remove the uterine lining, thereby managing symptoms. Uterine artery embolization: In women with fibroids, the feeding arteries could be cauterised to ensure blood supply is stopped so that fibroid growth is stopped. With very promising success rates, this is gaining popularity as a conservative method. Laparoscopy and endometriosis excision: In endometriosis, where the uterine tissue is growing in areas outside the uterus, it could be removed laparoscopically after identifying the area of growth on ultrasound and laparoscopy. Vaginal pessary: In women with uterine prolapse, the uterus drops from its normal position, pushing against the vaginal walls. This can be due to vaginal childbirth, age, smoking and obesity. Vaginal pessary is where a removable device is placed into the vagina to prevent it from falling down. It is a temporary solution, but very useful in holding the uterus in place and relieve symptoms partially or completely. In all these, medical management (painkillers and hormone replacement), stress and weight management, quitting smoking, reducing alcohol are also essential.
3813 people found this helpful

Popular Questions & Answers

I am having adenoids I used homeopathic medicine as on to-day is not solved. Please guide me how to solve this adenoids.

Dr. Kiran Kalyankar 89% (345 ratings)
MD - Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS), Diploma in Yog and Ayurveda
Ayurveda, Navi Mumbai
Dear Lybrate user, adenoids can be cured with ayurvedic treatment. There are lots of good ayurvedic medicines which reduces size of adenoids and should be choosed as per individual body constitution. please take these primary medicines which will give you relief in complaints, though I will recommend to consult privately for complete treatment. 1) Loknath RAS 250 mg twice day 2) gandhak rasayan 500 mg twice day 3) laxmivilas RAS 250 mg twice day 4) kanchanar guggul 500 mg twice day. Hope this answers your question. Thank you.
2 people found this helpful

I am 33 F and have been diagnosed with Focal adenomyosis and bowel endometriosis. I have been trying to conceive for last 3 years. Kindly advise as to what Ayurvedic supplements I can take to conceive. Thanks.

Dr. Jatin Soni 96% (25242 ratings)
MBBS
General Physician, Mumbai
I will suggest you to go for surgery for bowel endometriosis because medicine in any form is not going to be helpful in curing

Hello doctors! my mom is a thyroid patient and is detected with adenomyosis .she can't bare that problem every month so docs advised for uterus removal. Is it safe for future health and what are its side effects? Regards.

Dr. Anuradha S.Kumar 90% (2778 ratings)
CCPH, BHMS
Homeopath, Bhilai
Removng of uterus is nt d solutn becoz nw d prblm will subside bt after tht complicatns WL arise lik jnt pain becoz uterus hs main actn ovr providing calcium to our body.
1 person found this helpful

I am 40 years old and I am having adenomyosis and used to have heavy bleeding every month so I been told to take primolut n for 21 days and darilong 7.5 after stopping after two days I got my periods but first day was only blood clots in urine second day was very little but I am getting severe headache and leg thighs and back paining please guide.

Dr. Vishwas Virmani 91% (16039 ratings)
BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Avoid bending in front. Postural Correction- Sit Tall, Walk Tall. Extension Exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times. Bhujang Asana -- Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day.
1 person found this helpful
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