Adenomyosis is a disease that occurs when the cells that normally line theuterusgrow into the muscular tissue of the uterine wall. It occurs most often in women older than 30 who have had a full-term pregnancy. It is rare in women who have not had a full-term pregnancy.
Adenomyosis does not occur aftermenopause. But adenomyosis that was present before menopause may be diagnosed after menopause. It may also be found in tissue samples after pelvic surgery in postmenopausal women.
The cause of adenomyosis is not fully understood. Some researchers believe that it is the result of damage to the inner wall of the uterus during pregnancy, labor, delivery, or a surgical procedure.
Most women with adenomyosis do not have any symptoms. Adenomyosis is frequently found in uterine tissue biopsiesafter pelvic surgery such as laparotomyor laparoscopyhas been done. When symptoms are present, they include:
Heavy or prolonged menstrual periods (menorrhagia).
Painful menstruation (dysmenorrhea).
Recent onset of menstrual cramping that is gradually getting worse from one period to the next.
Exams and tests
When symptoms occur, the evaluation of suspected adenomyosis may include:
History of symptoms, menstrual periods, and family history.
Pelvic exam, which may reveal a large, soft, or tender uterus.
The diagnosis of adenomyosis can be made only after a pathologist examines uterine wall tissue samples. Adenomyosis is often discovered after a hysterectomy.
Most women with adenomyosis do not have any symptoms. When pelvic pain or heavy menstrual bleeding is present, suspected adenomyosis is often successfully treated with nonsteroidal anti-inflammatory drugs (NSAIDs). A hysterectomymay be needed if you have severe symptoms but are not approaching menopause. Symptoms go away after menopause is complete or after hysterectomy.
What to think about
The use of birth control pills may make symptoms of heavy bleeding or pain worse. Symptoms go away after menopause is complete or after a hysterectomy.
When to call
If you have symptoms of adenomyosis, call your doctor to schedule an appointment.
ByHealthwise Staff Primary Medical ReviewerSarah A. Marshall, MD - Family Medicine Kathleen Romito, MD - Family Medicine Martin J. Gabica, MD - Family Medicine Specialist Medical ReviewerKevin C. Kiley, MD - Obstetrics and Gynecology