More than half of women who menstruate experience several days of mild pain every month, but more severe pain that interferes with daily living is cause for concern.
Adenomyosis is More than Period Pain
Painful periods, or primary dysmenorrhea, and disorders of the reproductive organs, or secondary dysmenorrhea, include endometriosis, fibroids, urinary disorders and the lesser-known adenomyosis. Adenomyosis occurs when tissue that normally lines the uterus grows into the uterine wall. This is different from endometriosis where tissue grows outside the uterus.
Adenomyosis is difficult to diagnose, and most women don’t report it. It is currently estimated to affect around 20-35% of women. While women of all ages may experience adenomyosis, recent research shows that the condition is diagnosed most often in pre-menopausal women in their 30s and 40s who have been pregnant more than one time.
Adenomyosis is a benign condition, which means it’s non-cancerous and is generally not considered a “serious” medical condition, but it can affect a woman’s quality of life.
Symptoms of Adenomyosis
Some women may not experience symptoms of adenomyosis, or the symptoms may mimic other reproductive conditions. These two factors make adenomyosis difficult to diagnose, but the condition is usually caught during a routine physical exam or ultrasound.
Symptoms of adenomyosis may include:
- Abnormal uterine bleeding
- Chronic pelvic pain
- Enlarged or tender uterus
- Fertility issues
- Painful intercourse
- Period pain
Diagnosing Adenomyosis
It’s important to share all new or unusual symptoms with your OB-GYN, even if you’ve mentioned them before. If a medical provider suspects adenomyosis, it can be diagnosed through imaging procedures including:
- 3D ultrasonography. Ultrasounds use soundwaves to take pictures of organs in the body. 3D ultrasonography may capture the portions of the uterus thickened by adenomyosis.
- Doppler ultrasound. A Doppler ultrasound uses soundwaves to show blood moving through blood vessels in the body. A Doppler ultrasound may show increased blood flow to uterine tissue, indicating adenomyosis.
- Magnetic resonance imaging (MRI). An MRI is a very accurate form of medical imaging which is used to diagnosis adenomyosis. It is usually not the first imaging test conducted during diagnosis.
- Transvaginal ultrasound. This ultrasound takes images of the reproductive system through a wand placed in the vagina. It may detect enlargement of the uterus or thickening of the uterine walls typical in adenomyosis.
Treatment Methods
There is no cure for adenomyosis other than removal of the uterus by a procedure called a hysterectomy. Most adenomyosis treatment manages the symptoms, and your healthcare provider may consider the patient’s age, symptom severity and future fertility when choosing the appropriate treatment. Treatments may include:
- Hysterectomy. Women with severe adenomyosis who don’t wish to preserve their fertility may consider removal of their uterus.
- Medical management. Hormonal and non-hormonal medications can help manage severe period pain and control inflammation. Over-the-counter pain relievers may help with general discomfort. For long-term medication management, your doctor may suggest gonadotropin-releasing hormones which help with estrogen production, combined oral contraceptives and intrauterine devices or non-steroidal anti-inflammatory drugs (NSAIDS).
- Uterine artery embolization. This minimally invasive surgery restricts the blood vessels to the affected parts of the uterus.
- Watchful waiting. For women with asymptomatic adenomyosis, a physician may choose to observe the condition over time without treating the condition right away.
Put an End to Period Pain
It’s important to maintain regular appointments with an OB-GYN to treat reproductive conditions and reduce period pain. Symptoms don’t need to be “severe” to affect quality of life. To get the most out of every appointment, be sure to share any changes in symptoms and ask any questions you might have.
