Endometriosis and Adenomyosis

Adenomyosis and its relation to Endometriosis

Adenomyosis - Internal Endometriosis

There is a condition which is similar to endometriosis known as adenomyosis, in which the endometrial tissue (the uterine lining, glands, and connective tissue) invades the deeper muscle layers of the uterus. Usually there's a barrier between the endometrium and the deeper layers of the uterine wall that acts as a defence against invasion from endometrial tissue. Women who develop adenomyosis do not seem to have this defence.

Unlike endometriosis, some researchers believe that adenomyosis may set in after pregnancy and delivery; women in their forties and fifties who have given birth to at least one child are more likely to develop adenomyosis. Other researchers believe that, like endometriosis, genetics plays a role, and still others believe it may have to do with hormonal imbalance.

Symptoms of Adenomyosis

About 40% of cases of adenomyosis, women have no symptoms, but when they do, the symptoms are similar to endometriosis; painful and heavy periods and sometimes chronic pelvic pain. The more involved the uterine glands are, the heavier the flow; the deeper the penetration into the uterine wall, the greater the discomfort. An enlarged, soft, or tender uterus is a classic sign adenomyosis.

Diagnosis and Treatment

In the past, adenomyosis was diagnosed only by a pathologist, often after a hysterectomy was performed for another uterine problem. Adenomyosis is often present in conjunction with other uterine conditions such as fibroids. Therefore, to diagnose this condition accurately, your doctor must investigate thoroughly. Like Endometriosis, the diagnosis is difficult.

It may be possible to detect adenomyosis with a magnetic resonance imaging (MRI) scan or a hysteroscopy (a telescope, similar to the laparoscope, placed through the cervix). However, an MRI is expensive, while a hysteroscope will at least rule out fibroids under the uterine lining.

Until recently, a hysterectomy was the suggested course of treatment for adenomyosis, but many doctors believe that adenomyosis can be treated the same way as endometriosis. The treatment on offer is Danazol, progesterone, or oral contraceptives. If conservative regimens fail, then a hysterectomy is seen as the only solution by the medical profession.

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