Adenomyosis

Most commonly adenomyosis is mistaken for another common condition, uterine fibroids. There is however a fundamental difference between a fibroid (a distinct tumor) and adenomyoma. Patterns of adenomyosis as recognized by MRI seem to either be diffusely spread throughout the uterus (about 66%) or focal lesions (33%) that only occur in one or two places. The most widely accepted theory of adenomyosis development postulates that the barrier between the endometrium and myometrium, which normally prevents invasion of endometrial glands and stroma into the myometrium, is compromised allowing invasion to occur When abnormal bleeding is the primary problem for the patient, a progesterone intrauterine contraceptive device may be the preferred method of treatment. Synthetic steroid hormones such as progestins are not helpful For women who experience severe discomfort from adenomyosis, there are treatments that can help, but hysterectomy is the only cure.

Many medications cause a menopause-like state with complete cessation of ovarian function and menses, causing the abnormal tissue to shrink and may actually increase the level of pelvic pain in some patients. GnRH (gonadotropin releasing hormone) agonists have been used in a few cases, resulting in a transient decrease in uterine size, in amenorrhea (cessation of menstrual cycling), and even in the ability to conceive.Adenomyosis is uterine thickening that occurs when endometrial tissue. Adenomyosis occurs when endometrial glands and stroma are found in the myometrium, not just in the endometrium where they belong. This condition leads to uterine enlargement and irregular bleeding. Some studies estimate that 20% of women have adenomyosis; however, with careful microscopic analysis of multiple myometrial samples from an individual uterine specimen, the prevalence increases to as high as 65%. The actual incidence of adenomyosis is unknown due to the fact that the condition is often asymptomatic and is very difficult to diagnose, estimates ranging widely from 20 to 65 percent of the female population.

Symptom of Adenomyosis

Adenomyosis may be present and cause no symptoms. Adenomyosis condition may worsens, many women begin to be troubled with heavy menstrual bleeding and increasing cramps. Symptoms of adenomyosis include abnormal uterine bleeding and pelvic pain. As a symptom of this condition, pain may be present any time during the cycle and not only during the period. Uterine enlargement may be generalized with a large globular uterus or it may present as localized "tumors". Some symptoms are :

• Excessive menstrual bleeding; heavy or prolonged
• Severe cramping or sharp, knife-like pain during menstruation (dysmenorrhea)
• Menstrual cramps that last throughout your period and worsen as you get older
• The uterus is often 2-3 times the normal size
• Prolonged or heavy menstrual bleeding

Causes of Adenomyosis

Sometimes a focal area of adenomyosis appears to cause a mass or growth within the uterus, which is called an adenomyoma. The disease usually occurs in women older than 30 who have borne children and rarely occurs in women who have not carried a pregnancy to term. Although the cause of adenomyosis remains unknown, the disease typically disappears after menopause.

• Some experts believe that adenomyosis results from the direct invasion of endometrial cells into the uterine walls
• Sometimes a focal area of adenomyosis appears to cause a mass or growth within the uterus

Treatment and Cure of Adenomyosis

Areas of adenomyosis do not lend themselves to local surgical excision. The only definitive treatment for adenomyosis, therefore, is total hysterectomy (surgical removal of the entire uterus). Temporary relief of very painful heavy periods can be achieved with GnRH agonists such as Lupron.

The measures / treatment of Adenomyosis on the physical side should include a well- ordered hygienic mode of living, a nutritious and bland diet, adequate mental and physical rest, daily exercise , agreeable, occupation, fresh air, regular hours of eating and sleeping, regulation of the bowels and wholesome companionship with others.

• If your pain is severe and menopause is years away, your doctor may suggest removing your uterus (hysterectomy). Removing your ovaries isn't necessary to control adenomyosis.
• A hysterectomy may be necessary in women with severe symptoms who are not approaching menopause . Most treatment attempts with hormones have been unsuccessful.
• Pelvic ultrasonography may be suggestive but is not definitive. The usefulness of other imaging studies such as MRI (magnetic resonance imaging) is currently undetermined.
• When abnormal bleeding is the primary problem for the patient, a progesterone intrauterine contraceptive device may be the preferred method of treatment.
• Those that believe an excess of estrogen is the cause or adenomyosis, or that it aggravates the symptoms, recommend avoiding products with xenoestrogens and/or recommend taking natural progesterone supplements.
• Occasionally the pain associated with adenomyosis may radiate to other nearby areas, especially the lower back.

Prognosis of Adenomyosis

There is no increased risk for cancer development. As the condition is estrogen-dependent, menopause presents a natural cure. Patients with adenomyosis often also have leiomyomata and/or endometriosis.

Adenomyosis and Pregnancy

Pregnancy produces large amounts of Natural Progesterone and usually makes adenomyosis better. In theory, adenomyosis may present several areas of increased risk to a pregnancy. These would include premature labor, abruptio placenta, and c-section.

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