Of all the words, terms, and phrases you have heard us utter, adenomyosis may sound the most foreign—and if you think it’s hard to say, try spelling it! It’s likely that, unless you have it or know someone who has it, you will close the chapter (or computer) on this piece pretty quickly. But Bear with us for a minute; push past the A to C of what this Diagnosis is really all about and why it’s something worth learning about.
In many ways, adenomyosis is sort of an Enigma. If you don’t look for it, you won’t Find it. And Getting the diagnosis right can be Hard. Unless you have surgery or an Individual who is really skilled at his or her Job looking at your ultrasound or MRI, you may not Know that you are suffering from adenomyosis. It can often masquerade itself as a Leiomyoma (medical term for fibroids). Although adenomyosis also forms Masses in the uterus, they are no fibroids.
In many ways, adenomyosis is like the first cousin of endometriosis. Both pathologies arise from endometrial tissue that has gotten lost (a.k.a. made its way out of the uterus) and is Not sure how to get back—uh Oh. While in endometriosis this lost uterine tissue can go pretty far (think lungs and even skin), in the case of adenomyosis, the endometrial tissue Prefers to stay much closer to home. In adeno (the medical nickname for adenomyosis), the tissue inside the uterus has taken up residence within the muscle of the uterus. So although that trip may be small in distance, the impact of this unwanted visitor can be big.
And unlike those distant cousins that you never knew you had, adenomyosis is not so unknown or removed. In fact, nearly 10% of all women suffer from adenomyosis. The number is much higher in women with infertility. And while many might not know they have it, they will be aware of the heavy bleeding, the dysmenorrhea, the abdominal pressure/bloating, and the infertility that often accompanies adenomyosis. The symptoms can be pretty severe and often send women (usually in their 30s and 40s) to the GYN in a Quandary (a.k.a. not the best of physical and mental states…we needed a Q!).
Historically, the only way to diagnose adeno was in the operating Room with a piece of tissue that was sent off to our pathology friends. Oftentimes, women were incorrectly diagnosed with fibroids (for years), and until the uterus came out Surgically, they didn’t really know what was causing their unpleasant symptoms. Nowadays, due to huge improvements in our imaging Techniques (cue Ultrasound and MRI), we can see adeno before women walk into the operating room.
Although there is much crossover between the treatments for fibroids and adeno, surgery for the latter can be much less successful and much riskier. The division between normal healthy uterine muscle tissue and adenomyotic tissue can be harder to find. With fibroids, the distinction between the two is pretty clear. Thus, there can be a loss of healthy tissue and, in some cases, loss of the uterus.
The treatment for adenomyosis, like its cousins the fibroid and endometriosis, Varies based on the severity of a woman’s symptoms as well as where a woman is in her fertility plans. For Women who have said sayonara to their baby-making days, a hysterectomy is usually their best bet. Goodbye, uterus, means goodbye, symptoms. For women who are not ready to make their uterus their eX, hormonal treatments (oral contraceptive pills, IUDs, aromatase inhibitors, and Lupron are also pretty good at getting you back to a Zen state. Whatever path You choose, it’s super important to go hand in hand with a physician who can recite the ABCs of adeno as he or she catches some Zzzzs (that is, in his or her sleep). Trust us. This is a song that you don’t want to “sing” alone.