Adenomyosis
Adenomyosis is more than just a medical diagnosis. It is constant pain, fatigue, irregular cycles that prevent you from living a full life. You may think that this is “normal” or that it will always be like this, but it is not. In this article, we will tell you how to recognize adenomyosis, what treatments are available, and how to regain your comfort and peace of mind. We understand how difficult it is, but together with doctors, you can cope. You deserve to feel good every day.
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What is adenomyosis?
Adenomyosis of the uterus is a condition in which the cells of the inner layer of the uterus (endometrium) grow into the muscle layer. Because of this, the tissues change: they enlarge, become painful and can become inflamed.
The main feature of adenomyosis is that it is not limited to pain or irregular periods. It affects general well-being, causes fatigue, heaviness in the lower abdomen and other symptoms that interfere with normal living.
It is important to understand that the pathology does not develop instantly. Its cause may be associated with hormonal changes, previous surgeries on the uterus or even a genetic predisposition. But no matter how the circumstances develop, this condition can be diagnosed and treated.
Types of adenomyosis
Let's look at each variety in more detail to understand how they differ.
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Focal
Focal adenomyosis occurs when the inner layer of the uterus (endometrium) grows into the muscle in patches. These look like small "islands" in different parts of the uterus. At first, the disease may go unnoticed, but over time the patches grow, causing pain and discomfort. Menstruation becomes painful, and spotting may occur between cycles.
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Diffuse
Diffuse adenomyosis is when the endometrium penetrates the muscular layer evenly, without separate areas. The uterus increases in size, and constant pain appears in the lower abdomen, which intensifies before menstruation. Often, menstruation becomes very heavy and long, which greatly exhausts the body. Women also complain of a feeling of heaviness in the pelvic area, which does not go away even after the end of the cycle.
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Nodal
The nodular form appears as dense formations inside the muscular layer of the uterus. These nodes, unlike fibroids, consist of glandular tissue surrounded by muscle cells. The nodes cause severe pain, especially during menstruation, and may be accompanied by heavy bleeding. In some women, this leads to anemia, which makes them feel weak and tired.
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Mixed
With the mixed form, signs of different types of adenomyosis are combined in one uterus. For example, the tissues can be affected evenly, as with the diffuse form, but at the same time, separate foci or nodes are formed inside the muscle layer. Symptoms can be varied: from constant pain and heavy periods to severe discomfort on ordinary days.
The first sign that is alarming is painful and heavy menstruation. The pain may appear several days before the cycle begins, intensify during menstruation and not go away immediately after it ends.
Another characteristic sign is spotting before and after menstruation.
What else is worth paying attention to:
- Irregular menstrual cycle, with prolonged and heavy bleeding
- Constant heaviness or feeling of pressure in the lower abdomen
- Pain during intercourse
- General deterioration in health caused by anemia due to blood loss (weakness, dizziness)
At later stages, the pathology can lead to a noticeable increase in the uterus, which is sometimes perceived as bloating or even roundness of the abdomen.
The disease is often associated with hormonal disorders. Estrogens, which control the growth of the endometrium, can stimulate its abnormal behavior. For example, excess estrogen levels or imbalances contribute to the progression of the pathology.
Childbirth and surgeries on the uterus are another common cause. Any trauma to the wall can become an "entry gate" for endometrial cells. This applies to both cesarean section and other interventions, such as curettage.
Factors that increase the risk:
- Hormonal disruptions, especially in reproductive age;
- Surgical interventions on the uterus (cesarean section, curettage, abortions);
- Inflammatory diseases of the pelvic organs;
- Hereditary predisposition;
- Long-term use of hormonal drugs without medical supervision.
Age also plays a role. Adenomyosis is more common in women over 30–40 years old, especially if they have already given birth. However, it can also develop in young girls if other provoking factors are present.
Stages of development of adenomyosis
Adenomyosis develops gradually, and doctors distinguish four stages depending on the depth of penetration of the endometrium into the muscular layer.
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First stage
The endometrium is just beginning to grow into the muscular layer, affecting its superficial part. Symptoms at this stage may be weakly expressed or completely absent. Some women complain of mild pain during menstruation, but most often the disease goes unnoticed.
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Second stage
At this stage, half of the thickness of the muscle layer is affected. The pain becomes more pronounced, menstruation becomes more abundant, and spotting may occur before and after the cycle. The uterus begins to slightly increase in size, which sometimes causes a feeling of heaviness in the lower abdomen.
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Third stage
The endometrium penetrates almost to the entire depth of the muscular layer. Symptoms intensify: pain becomes constant, periods are longer and more painful. The woman may notice severe fatigue due to blood loss. The uterus increases significantly.
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Stage four
The endometrium reaches the serous layer - the outer shell. At this stage, the symptoms become extremely pronounced: constant pain, irregular cycle, heavy bleeding. The enlargement of the uterus can be visible to the naked eye. This is the most severe stage, requiring serious treatment, most often surgical.
Treatment of adenomyosis
Conservative treatment
In the early stages of adenomyosis or with moderate symptoms, doctors try to avoid surgery. The main goal is to relieve pain, reduce heavy periods and slow the progression of the disease. Hormonal therapy is most often used for this. It helps to reduce the level of estrogen - hormones that provoke the growth of the endometrium.
Some patients are given hormonal intrauterine systems, such as the levonorgestrel IUD. It acts locally: reduces inflammation and pain, makes menstruation less heavy. Doctors can also prescribe painkillers if the symptoms interfere with life and work.
Conservative treatment is suitable for those cases when a woman plans to preserve the uterus and fertility or when surgical intervention is not yet required.
Surgical treatment
If the disease progresses or the symptoms significantly worsen the quality of life, surgical treatment is prescribed. This may be an organ-preserving operation, when only the affected areas are removed, and the uterus remains intact. This approach is especially important for women who want to preserve the ability to become pregnant.
In severe cases, when the uterus is severely affected, doctors may suggest its removal (hysterectomy). It completely eliminates the problem, but is used only after all other options have been exhausted.
If you are faced with adenomyosis or have noticed symptoms that prevent you from living a full life, do not delay your visit to the doctor. At the K+31 clinic (Moscow), we offer accurate diagnostics, modern treatment methods and an attentive attitude to each patient.
Our advantages:
- Experienced doctors who will help you choose the best treatment method
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Take care of your health today. Sign up for a consultation at "K+31" - we will help you regain comfort and confidence in your body!
General information
Complications of adenomyosis
If adenomyosis is not treated, it can significantly worsen the quality of life. Constant pain, heavy menstruation and other symptoms often cause not only physical but also emotional exhaustion. However, these are not the only risks.
As the disease progresses, the following may develop:
- Anemia. Due to the regular loss of large amounts of blood, a woman's hemoglobin level decreases, which leads to weakness, dizziness and chronic fatigue
- Chronic pelvic pain. The pain becomes constant, interferes with normal work, exercise and an active life
- Infertility. Adenomyosis can disrupt the functioning of the uterus, making it difficult to conceive or carry a pregnancy
- Endometriosis. Endometrial cell growth can extend beyond the uterus, which worsens the condition
- Psycho-emotional problems. Constant discomfort and pain negatively affect mood, cause depression or anxiety
In more severe stages, adenomyosis can cause a noticeable enlargement of the uterus. This not only causes pain and heaviness, but also creates a cosmetic defect - roundness in the lower abdomen.
Answers to popular questions
Doctors' answers K+31:
Is it true that adenomyosis cannot be cured?
Adenomyosis is a chronic condition, but it can be kept under control. In the early stages, hormone therapy or other methods can minimize symptoms and stop the progression of the disease. Even in severe stages, there are solutions, including surgeries that return a woman to a comfortable life. The main thing is to see a doctor in time to find the right treatment.
What to do if adenomyosis is diagnosed after 40 years?
Many women worry when they learn about the diagnosis at the age of 40+. But this is no reason to panic. After the onset of menopause, the symptoms of adenomyosis often weaken, as the level of estrogens decreases. Treatment at this age is selected taking into account your plans and well-being: if the symptoms interfere with your life, the doctor will offer methods that will alleviate the condition, but will also take into account possible changes in the hormonal background.
Is it possible to play sports if you have adenomyosis?
Yes, exercise is possible, but with some restrictions. For example, heavy physical activity, especially weight lifting, is best avoided as it can increase pain and pressure on the pelvic area. Light exercise, yoga, swimming, and walking are great ways to stay fit and improve circulation without the risk of aggravating symptoms. The key is to choose activities that do not cause discomfort.
Why does the lower back often hurt with adenomyosis?
Lumbar pain is one of the frequent companions of adenomyosis. This is due to the fact that the enlarged uterus begins to affect the nerve endings in the pelvic area, causing pain that "radiates" to the lower back. Sometimes this pain may seem similar to that caused by radiculitis or other back problems, but the cause lies precisely in the uterus.
Is it possible to prevent the development of adenomyosis?
It is impossible to completely guarantee that adenomyosis will not occur, but it is quite possible to reduce the risk. Regular examinations by a gynecologist, care for hormonal balance and timely treatment of pelvic inflammatory diseases help maintain the health of the uterus. It is especially important to take care of yourself after operations on the uterus - for example, a cesarean section or curettage.
If the pain gets worse, does this mean the disease is progressing?
Not always. Pain may increase even in a stable condition, for example, due to stress, physical activity or temporary hormonal changes. However, a sharp deterioration in symptoms is a reason to consult a doctor to rule out disease progression or complications.
Does adenomyosis affect weight?
Adenomyosis itself does not cause weight gain. But the hormonal imbalances associated with the condition can affect your metabolism, increasing the likelihood of extra pounds. In addition, hormone therapy sometimes causes fluid retention, which can temporarily add weight.
Why check the intestines if the problem is in the uterus?
In later stages, adenomyosis can affect nearby organs, including the intestines. This manifests itself as constipation, discomfort during bowel movements, or even a feeling of “fullness” in the abdomen. Checking the condition of the intestines helps to exclude other causes of such symptoms and accurately determine the influence of the uterus.
Does adenomyosis affect mood?
Yes, and very much so. Constant pain, fatigue due to anemia, anxiety due to the diagnosis - all this can cause irritability, loss of strength and even depression. Treatment helps to cope not only with physical symptoms, but also with their emotional consequences. If you find it difficult to cope with this condition, do not hesitate to talk to your doctor about it. Sometimes you may need additional help from a psychologist.
Can adenomyosis cause pain during exercise?
Yes, especially if the activity increases pressure in the pelvic area, such as running, intense exercise, or heavy lifting. The pain in such cases is due to the enlargement of the uterus and its impact on nearby tissues and nerves.
Can adenomyosis be confused with uterine fibroids?
Yes, such cases do occur. Both diseases can cause an enlarged uterus, heavy periods, and pain. However, the nature of these conditions is different: myoma is a benign tumor, and adenomyosis is the growth of the endometrium into the muscular layer of the uterus. For an accurate diagnosis, doctors use ultrasound, MRI, and sometimes hysteroscopy.
Can adenomyosis “hide” behind normal tests?
Unfortunately, yes. For example, a regular smear or blood test will not show changes associated with adenomyosis. Therefore, it is important for the doctor to prescribe a comprehensive examination, including ultrasound or MRI, if there are complaints of pain or cycle irregularities.
How to prepare for pregnancy if I have adenomyosis?
If you are planning a pregnancy, consult a gynecologist in advance. The doctor will assess the condition of the uterus, prescribe treatment to reduce inflammation and improve the chances of conception. Sometimes preliminary therapy is required to prepare the uterus for bearing a child.
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