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Adenomyosis is a condition affecting the way that the tissue lining the uterus, called endometrial tissue grows. Instead of remaining as uterine lining, endometrial tissue begins to develop on the uterus walls, leading to an enlarged and thickened uterus and significant pain. This should be thought as distinct from endometriosis, where endometrial tissue can be found in other organs or others parts of the body. Adenomyosis affects only the uterus, and almost always occurs in pre-menopausal women who have had at least one child.
The symptoms of this condition are often most noted during menstruation. Periods can be very heavy, they may have blood clots in them, and they can last longer than average. Cramping can be severe and instead of being restricted to the first one or two days of menstruation, it may last throughout a period. Women may also experience spotting or bleeding between periods, and many report pain when having sex too. Some also have a tender lower abdomen that might have a perceptible bulge or protrusion because the uterus is much larger than normal.
Women who experience these symptoms should see their doctors, as they can indicate more than one illness. Doctors usually diagnose adenomyosis through listening to patient’s symptoms, and by performing a pelvic exam, which can indicate enlargement of the uterus. It’s common for doctors to order sonograms (ultrasounds of the pelvis) or magnetic resonance imaging (MRI), too. In rare cases doctors may also want to take a sample of uterine lining to rule out other conditions. There isn’t actually a way to confirm the condition except by eliminating other potential causes, or by doing a hysterectomy and examining the uterus post-removal.
One issue with attempting diagnosis is that adenomyosis can be present along with other conditions like endometriosis. Confirming a second condition can be challenging. When doctors suspect that there are several conditions operating at once, they might recommend hysterectomy since it may difficult to treat all of them.
Though hysterectomy can be one treatment, it is usually the choice of last resort. The condition does resolve once menopause occurs, and many women may be helped by other measures that reduce pain and discomfort. These can include using anti-inflammatory pain medications prior to sexual intercourse and during menstruation. Some women are aided by using birth control pills since these shorten periods.
There is still very little known about the root causes of adenomyosis. Those most at risk have had at least one child, and may have had that child via caesarian section (c-section). There’s strong evidence that estrogen plays some role in the development of this condition because it will get better once the body no longer produces estrogen and a woman is post-menopausal.
As if endometriosis weren't bad enough, adenomyosis can show up. How awful. There are advantages to never having had children, and the decreased likelihood of getting this condition is one of them.
This is one of those ties when I might be tempted to just have a hysterectomy and have done with the condition. If I were done having children, I don't know that I would want to "hang on" until menopause, when the symptoms would probably disappear. As long as my ovaries were producing hormones, I wouldn't be in complete menopause-- I just wouldn't have a uterus complicating things.