Adenomyosis: what it is, symptoms and possible causes

Adenomyosis, also called uterine adenomyosis, is a disease where there is a thickening within the walls of the uterus itself causing symptoms such as pain, bleeding or severe cramping, especially during menstruation. This disease has a cure through surgery to remove the uterus, however, this type of treatment is only done when the symptoms cannot be controlled with anti-inflammatory drugs or hormones, for example.

The first symptoms of adenomyosis can appear 2 to 3 years after childbirth, even in cases where the woman has adenomyosis since childhood, and they usually stop appearing after menopause, when the menstrual cycle stops happening.

main symptoms

The main symptoms of adenomyosis are:

• Belly swelling;
• Very strong cramps during menstruation;
• Pain during intimate intercourse;
• Increase in the amount and duration of menstrual flow;
• Constipation and pain when defecating.

Adenomyosis does not always cause symptoms, however, symptoms usually appear after pregnancy and disappear after menopause. In addition, adenomyosis can be one of the causes of dysmenorrhea and abnormal uterine bleeding and is often difficult to diagnose. Check for other signs of changes in the uterus.

The diagnosis of adenomyosis must be performed by the gynecologist, and is usually done by performing an MRI and by observing symptoms such as pain, heavy bleeding or complaints of difficulty getting pregnant. In addition, the diagnosis of the disease can also be made using other imaging tests, such as transvaginal ultrasound or hysterosonography, for example, which evaluate the thickening of the uterus.

Can adenomyosis affect pregnancy?

Adenomyosis can cause serious complications in pregnancy, such as ectopic pregnancy or miscarriage, for example, and regular monitoring by the obstetrician is recommended, so that these complications are avoided. In addition, in some cases adenomyosis can make it difficult for the embryo to attach to the uterus, thus making pregnancy difficult.

The symptoms of adenomyosis usually appear after pregnancy, due to the stretching of the uterus that occurs, and therefore, most women are able to get pregnant and have children before the onset of the disease.

See other causes that can lead to changes in the size of the uterus and make pregnancy difficult.

Causes of adenomyosis

The causes of adenomyosis are still not very well understood, but this condition can be the result of trauma to the uterus due to gynecological surgeries, more than one pregnancy in a lifetime or due to cesarean delivery, for example.

In addition, adenomyosis can be one of the causes of other problems such as dysmenorrhea or abnormal uterine bleeding, which is often difficult to diagnose.

How is the treatment done?

The treatment for adenomyosis varies according to the symptoms felt and should be guided by a gynecologist, and can be done with medication or by performing surgery. Thus, the most used treatments are:

• Treatment with anti-inflammatories, such as ketoprofen or ibuprofen, to relieve pain and inflammation;
• Treatment with hormonal drugs, such as a progesterone contraceptive pill, Danazol, contraceptive patch, vaginal ring or IUD, for example;
• Surgery to remove excess endometrial tissue inside the uterus, in cases where adenomyosis is located in a certain region of the uterus and is not deeply penetrated into the muscle;
• Surgery to remove the uterus, where a total hysterectomy is done, to completely remove the uterus. In this surgery, the ovaries usually do not need to be removed.

Surgery to remove the uterus completely eliminates the symptoms of the disease, but it is only performed in more severe cases, when the woman no longer intends to become pregnant and when adenomyosis causes constant pain and profuse bleeding. Learn more about treatment options for adenomyosis.

Is adenomyosis the same as endometriosis?

Adenomyosis is considered a type of endometriosis as it corresponds to the growth of endometrial tissue within the muscle of the uterus. Understand what endometriosis is.

In addition, there are several types of adenomyosis, and it can be focal, when it is located in a certain region of the uterus, or diffuse, when it spreads throughout the wall of the uterus, making it heavier and bulkier.

Watch the video with Dr. Helizabet Ribeiro, a gynecologist specializing in endometriosis who clarifies all doubts about this disease: