What is adenomyosis?
Adenomyosis is a condition where the lining of the uterus grows into the muscle of the uterus. The usual symptoms of adenomyosis are heavy sore periods, bloating, and sometimes discomfort during sex. It is frequently associated with endometriosis, but some women can have adenomyosis without endometriosis.
How to diagnose adenomyosis
The diagnosis of adenomyosis used to only be made when a woman had had a hysterectomy and the uterus was examined by a pathologist. As ultrasound technology has improved then the diagnosis is now often made by ultrasound and more definitively by MRI. There are a number of features that make adenomyosis likely such as small cysts in the uterine muscle (myometrium), a thickened layer beneath the endometrium, a large bulky uterus with a very heterogeneous appearance to the myometrium. There is however no established scoring system for adenomyosis which makes most of the literature on adenomyosis confusing.
How to treat adenomyosis?
Adenomyosis is also associated with infertility and early pregnancy loss. The treatment of adenomyosis is difficult. Several trials have shown improvements in live birth rates in women who have had 3 months of downregulation prior to the replacement of an embryo. There are no proven treatments for women with adenomyosis outside of IVF. There are reports of a number of medications being trialled but no definitive answers as yet.
Occasionally the adenomyosis is just present in a localised lump in the uterus and may is able to be removed surgically but more often the adenomyosis infiltrates throughout the muscle of the uterus so is not able to be removed.