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Adenomyosis is a medical condition that occurs when tissue from the lining of the uterus (endometrium) grows into the muscular wall of the uterus (myometrium). This can lead to an enlarged and tender uterus, along with various symptoms.

Here's an overview of adenomyosis, including its cause, symptoms, prevalence, diagnosis, treatment, and prognosis:

– Prevalence

Adenomyosis is a common condition, particularly in women in their 30s and 40s who have had children. The prevalence of adenomyosis varies, but it may affect up to 20-35% of women.

Cause

The exact cause of adenomyosis is not fully understood, but several theories have been proposed:

Genetic Predisposition

Gene alterations in some individuals will predispose for development of adenomyosis

Invasive Growth

It is believed that endometrial tissue may invade the myometrium during menstruation, childbirth or uterine surgery.

Estrogen

High levels of estrogen, which can stimulate the growth of endometrial tissue, may play a role in the development of adenomyosis.

Hormonal Changes

Changes in hormonal balance, particularly between estrogen and progesterone, may contribute to the condition.

Uterine Inflammation

Chronic inflammation in the uterine lining or muscle layer may be associated with adenomyosis.

Symptoms

Adenomyosis can cause a range of symptoms, which may include:

  • Menstrual Pain

    Painful menstruation (dysmenorrhea) is a common symptom. The pain is often described as a deep, aching, or heavy sensation in the lower abdomen or pelvis.

  • Heavy Menstrual Bleeding

    Menstrual bleeding may be abnormally heavy (menorrhagia) and may be accompanied by clots.

  • Pelvic Pain

    Chronic pelvic pain, not limited to menstruation, can be a persistent symptom.

  • Enlarged Uterus

    The uterus may become enlarged, leading to a feeling of fullness or pressure in the lower abdomen.

  • Painful Intercourse

    Pain or discomfort during sexual intercourse (dyspareunia) may occur.

Diagnosis

Diagnosing adenomyosis may involve:

Medical History

A healthcare provider will inquire about symptoms, medical history, and risk factors.

Physical Examination

A pelvic examination may be performed to assess the size, shape, and tenderness of the uterus.

Imaging

Transvaginal ultrasound is often used to visualize the uterus and assess for signs of adenomyosis. Magnetic resonance imaging (MRI) can provide more detailed images and may be used in some cases.

Treatment

Treatment for adenomyosis aims to manage symptoms and improve quality of life. Treatment options may include:

Pain Medications

Over-the-counter pain relievers or prescription medications may be used to manage pain and discomfort.

 

Minimally Invasive Procedures

Procedures such as uterine artery embolization (UAE) or laparoscopic excision of adenomyosis can be considered for symptom relief.

Hormonal Therapy

Hormonal treatments, such as hormonal birth control methods (e.g., birth control pills, hormonal IUDs), may help control symptoms by regulating menstrual cycles and reducing the growth of endometrial tissue.

Hysterectomy

In severe cases or when other treatments are ineffective, a hysterectomy (removal of the uterus) may be recommended. This is a definitive treatment that eliminates adenomyosis but also results in loss of fertility.

– Prognosis

The prognosis for adenomyosis varies depending on the severity of symptoms and the chosen treatment approach. Many individuals can manage their symptoms effectively with medical treatment, avoiding the need for more invasive interventions like surgery. In cases where a hysterectomy is performed, the prognosis is typically excellent because adenomyosis does not recur after the uterus is removed.

It's important for individuals experiencing symptoms of adenomyosis, such as pelvic pain or heavy menstrual bleeding, to seek medical evaluation and discuss treatment options with a healthcare provider. Treatment can greatly improve quality of life for those affected by this condition.

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