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According to the Cleveland Clinic, adenomyosis affects 20% to 65% of the female population, however, it is still not a well-known or well-understood condition. The condition occurs when the inner lining of the uterus (called the endometrium) grows into the muscular wall of the uterus. The endometrium is the layer of the uterus responsible for periods in women or those assigned female at birth—it grows in preparation for pregnancy, and if pregnancy doesn’t happen, it’s discarded as menstrual blood and tissue from the uterus.
When adenomyosis occurs, the endometrium invades the muscle wall of the uterus. As this happens, the tissue continues to behave normally—growing, breaking down, and bleeding—all while stretching into the muscular wall of the uterus.
Below, we answer the question “what is adenomyosis?”, as well as offer advice for high-risk groups and treatment.
Women with adenomyosis can experience a range of discomfort as a result of the condition. The most common symptoms are cramping in the pelvic area, heavy or prolonged menstrual bleeding, bloating, and pain during intercourse. An enlarged uterus is also possible. Most women don’t know they have an enlarged uterus but will feel tenderness or pressure in the lower abdomen.
These symptoms generally aren’t harmful, but they can impact daily life. Women with excessive menstrual bleeding are at risk of becoming anemic. Anemia causes fatigue and can lead to other serious health problems; it occurs when there aren’t enough healthy red blood cells to carry oxygen to tissues in the body.
Who is at risk for adenomyosis?
The majority of adenomyosis cases are found in women or those assigned female at birth aged 40-60. While doctors aren’t sure what exactly causes adenomyosis, it’s thought to be correlated with estrogen levels. Older women who have been exposed to abnormal levels of estrogen for a longer period of time may be more likely to develop adenomyosis.
Other high-risk demographics are women who have given birth, women who have had a C-section, and women who have uterine fibroids.
Adenomyosis treatments: over the counter
There are a number of options to manage and treat adenomyosis, including surgical and non-surgical treatments.
Many women take birth control medication daily; hormonal medications like progesterone-only birth control can result in a thinner endometrium. Because adenomyosis is a condition where endometrial tissue grows in an abnormal location, progesterone-only birth control, which can cause the endometrium to be thinner, can help relieve the symptoms.
Anti-inflammatory medications like ibuprofen (Advil for example) and Tylenol can also help lessen the pain and cramping associated with adenomyosis. It’s important to note, neither these medications nor progesterone-only birth control truly treats adenomyosis—they only mask symptoms of the condition. When women stop taking the medication, the symptoms will return.
How I treated my adenomyosis
Hysterectomy for adenomyosis
Traditionally, a hysterectomy (uterus removal) was the only treatment option for adenomyosis that didn’t require the use of long-term medication. For women looking to get pregnant, recover quickly, or avoid a major surgical operation, a hysterectomy is not a viable option.
Uterine embolization for adenomyosis
An alternative to hysterectomy is uterine artery embolization (UAE), which is the same procedure used to treat uterine fibroids. UAE is a non-surgical treatment where the blood supply to the endometrial tissue that has invaded the muscle wall of the uterus is cut off. Without a blood supply, the endometrial tissue can no longer grow, break down, and bleed. UAE has been shown to be 75-90% effective for treating adenomyosis. Furthermore, a 7-year follow-up study conducted in 2017 followed women with adenomyosis following UAE treatment. After 7 years 82% of patients treated with UAE achieved significant long-term improvements in their symptoms and were able to avoid a hysterectomy.
In addition to the obvious benefits of avoiding a hysterectomy, UAE treatment is a minimally-invasive, same-day procedure that is covered by most major insurance companies. Compared to a hysterectomy, which can require overnight hospital stays, lengthy recoveries, and large incision scars, recovery from UAE doesn’t require a hospital stay and is normally complete in 5-7 days. All together this means UAE are easier on the body, more cost-effective, and have quicker recovery times, resulting in less time off work and faster relief.
With greater awareness, women can recognize symptoms of adenomyosis and seek treatment with as little disruption to their health and life as possible. If you are concerned that you have adenomyosis, we recommend you speak with a doctor immediately.
If you have an adenomyosis diagnosis and want to learn more about uterine artery embolization, book a free care consultation with a PainTheory Care Coordinator, or schedule an appointment with one of our partners located near you.
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