Treatment for adenomyosis first relies on ruling out other uterus diseases. Focal adenomyosis, adenomyosis and pregnancy, as well as adenomyosis and cancer are all issues your gynecologist in Queens, NYC must consider before recommending diagnostics and treatment that may include adenomyosis ultrasound or an adenomyosis hysterectomy. Don’t wonder about adenomyosis vs endometriosis or about a myometrial cyst; get help.


As if monthly shedding of your uterine lining wasn’t enough of an inconvenience, many women suffer from a variety of uterus diseases as well. Although many of them are not life-threatening, they can cause unwanted symptoms, disrupt daily life, and even lead to dissatisfaction with your sexual experiences. One such disease is called adenomyosis.

Adenomyosis is a condition in which the endometrium, or inner lining of the uterus, breaks through into the deeper muscle layer of your uterus, called the myometrium. It’s a subdivision of endometriosis, which is when endometrium grows into the area outside your uterus. Although benign, it can be debilitating enough to impair your quality of life. It can be diffuse, occurring all over the uterus, or it can be localized to one area, which is called focal adenomyosis.

Causes? A Few Good Guesses

The number of women it affects is unclear because until recently, adenomyosis was diagnosed only by pathological findings after a hysterectomy, which coincidentally is the only curative treatment for adenomyosis. Even though it’s seen mostly in women in their 40s and 50s, there may be many women who are symptomless or who develop symptoms that get worse as they get older.

The reason the symptoms get worse as you get older is that certain uterus diseases might be influenced by hormones. With the gradual and prolonged exposure to estrogen as a woman grows older, displaced endometrial tissue may proliferate and cause symptoms. Even though a specific organic cause hasn’t been identified, studies suggest that hormones like estrogen, progesterone, prolactin, and follicle stimulating hormone, could have a major impact on adenomyosis, especially since the disease disappears after menopause.

Other Possible Causes

There are also other hypotheses as to the cause of adenomyosis. Different schools of thought have to do with how the endometrial tissue is initially displaced into the myometrium. Some of the theories include:

  • Direct invasion after a surgical intervention like a Cesarean section or uterine incisions
  • Developmental origin from when endometrial tissue in your uterus first formed in the fetus
  • Uterine inflammation after childbirth that results in the loss of boundary cells between the areas in your uterus
  • Stem cell origin when bone marrow stem cells invade the myometrium

Regardless of the cause of the displacement, the growth of the endometrial cells in the myometrium fluctuates with hormone levels. This is one of the reasons that hormone therapy is a mainstay of treatment for adenomyosis.

Symptoms Include Pain, But So Much More

Symptoms of adenomyosis can resemble other uterus diseases like leiomyoma, uterine fibroids, or myometrial cysts. Your specific history and an OB/GYN exam provide a clearer picture for a proper diagnosis of adenomyoma. Some risk factors that may predispose you to developing adenomyosis include being middle-aged, having had previous uterine surgery like a C-section or fibroid removal, and having had children.

Additionally, symptoms are not always characteristic of just one disease. Pain and discomfort range from mild to severe. Some of the other common symptoms include:

  • Sharp knife-like pain or cramping in your lower abdomen during menstruation (dysmenorrhea)
  • Lower abdominal pressure or tenderness
  • Bloating before your period
  • Heavy and prolonged period
  • Frequent pain and heavy bleeding
  • Blood clots
  • Spotting between periods
  • Pain before, during, or after sex (dyspareunia)

Even though the symptoms are troubling, the complications may have a bigger impact on your life. Heavy and prolonged periods may lead to chronic anemia. Adenomyosis may have an impact on fertility and the constant pain can lead to depression, irritability, anxiety and a feeling of helplessness.

Difficult Diagnosis

Because imaging technology wasn’t as developed as it is today, the way a diagnosis of adenomyosis could be reached was after a hysterectomy. Uterine tissue was sent to the histopathology lab for analysis, and the condition was discovered. Even today, a confirmed diagnosis of adenomyosis is from a histopathological analysis.

But with recent developments, your Queens, New York City gynecologist can view changes in your uterine tissue and take steps to confirm adenomyosis or rule out other diseases. Your gynecologist makes a list of possible diagnoses, depending on your specific history and his examination findings. Make sure you tell your doctor:

  • When your pain started
  • Where it’s located
  • Any exacerbating or relieving factors
  • Any prior medications, treatments, or surgeries
  • Your history of childbirth
  • Any other diseases you have
  • Characteristics of your menstrual cycle

With this information, the best OB/GYN in Queens, NYC performs a physical exam of your pelvic region, looking for specific signs like tenderness or swelling. To get a better view of your uterus, you may need an adenomyosis ultrasound, a sonohysterography, or an MRI. An adenomyosis ultrasound helps rule out other diseases. An MRI can confirm the diagnosis of adenomyosis. Blood tests and a biopsy may also be advised to expose anemia and rule out more serious conditions like cancer, which can cause similar symptoms.

Help Is Available and Accessible

If your life isn’t impacted profoundly, measures such as non-steroidal anti-inflammatory drugs (NSAIDS), warm baths, or heating pads during painful episodes may work as treatments. If you have more painful issues, hormone therapy or minimally invasive procedures like uterine artery embolization — which decreases your bleeding — and endometrial ablation — which has been used as a treatment for fibroids — are helpful.

Another consideration for treatment may be performed if you believe you’ve completed your childbearing. If you’re nearing menopause, your symptoms cause you undue inconvenience, and you have completed your family, the cure for adenomyosis is an adenomyosis hysterectomy or surgical removal of your uterus. This should end your symptoms as well as menstruation.

As a best in class Queens gynecologist, Dr. James  Gohar provides highly personalized and comprehensive care. His philosophy regarding the doctor/patient relationship is based on trust and has earned him one of the most respected reputations  in Queens NY.

For more information about the adenomyosis treatment options or to schedule a consultation with the (gynecologist) OBGYN doctor, the best rated adenomyosis treatment specialist, Dr. James Gohar, please contact our Queens office.

Gynecologist Dr. James Gohar (OBGYN Doctor)
Forest Hills Medical Services
108-16 63rd Rd
Forest Hills, NY 11375
☎ (718) 897-5331