What Is Adenomyosis?
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 unpleasant symptoms, disrupt daily life, and even negatively affect your sex life. One such disease is called adenomyosis.
Adenomyosis is a condition in which the endometrium, or the inner lining of the uterus, breaks through into the deeper muscle layer of your uterus, called the myometrium. Although benign, this condition can be debilitating enough to affect 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
There are also other hypotheses as to the cause of adenomyosis. Some of the theories include:
- Uterine inflammation during childbirth. Your uterus may become inflamed post-partum, causing a break in the boundary of cells lining the uterus.
- Invasive tissue growth. An invasion of endometrial cells into the lining of your uterus can occur from incisions during surgery, such as a C-section. These cells may take root and grow outside their normal environment.
- Developmental origins. The invading cells may have been deposited while the uterus and other reproductive organs were forming in utero.
- Stem cell origins. Stem cells from bone marrow can migrate throughout your body. These cells may inadvertently become endometrial cells.
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.
Getting a Proper Diagnosis
Previously, even the best doctor could diagnose adenomyosis only by examining uterine cells under a microscope after performing a hysterectomy. Today, new imaging technology allows your Forest Hills OB/GYN specialist to see and accurately pinpoint locations and amounts of the displaced cells.
After taking a thorough medical history and performing a medical exam that includes a pelvic examination, your gynecologist specializing in adenomyosis can use an MRI or a transvaginal ultrasound to rule out any other conditions — without the need for surgery. Occasionally, the best method for diagnosing your condition may be to conduct an endometrial biopsy. Advanced diagnostic tools increase the chances of accurate diagnosis and more effective treatment options.
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.
The best OB/GYN in Queens, NYC that are part of the Forest Hills Medical Services team will perform 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 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.
Deciding On the Right Treatment Option
No two patients with adenomyosis are alike. And that means that treating this condition will be different for everyone. There are several factors that will determine which course of treatment is the best for you, including your age, your risk factors, your medical history, and how bad your symptoms are.
Treatment usually starts with ”watchful waiting“ and progresses to pharmaceutical therapy that may have some side effects but most of the time does not interfere with daily activities. However, many patients may require additional treatment to manage more severe symptoms of adenomyosis.
Your physician should discuss with you the pros and cons of minimally invasive, uterus-sparing therapies, like uterine fibroid embolization (UFE), a procedure that has been proven very effective in the treatment of adenomyosis. You will likely also discuss surgical interventions such as a hysterectomy.
In the end, the key to choosing the right treatment for adenomyosis is to get the right diagnosis and familiarize yourself with your treatment options. Remember, asking questions and being an informed patient will help you ensure that you get the best care for you and your specific symptoms and circumstances.
Forest Hills Medical Services is a comprehensive clinical practice. In our office we believe that how you are treated is just as important as the medical care we provide. We are dedicated to providing the highest quality obstetrics and gynecology with warmth and compassion. Our physicians are easy to talk to and our entire staff is friendly and attentive to your needs.
The best gynecologists in Queens who are part of the Forest Hills Medical Services team are renowned for their extensive skills in diagnosing and treating adenomyosis and uterine fibroids.
We will listen to all your concerns and together we will come up with the treatment plan that works for you and your unique circumstances.
Call FHMS to meet our staff in our state-of-the-art offices and be heard.
Gynecologists Dr. James Gohar (OBGYN Doctor), Dr Nithya Gopal and Maris Huffman, NP
Forest Hills Medical Services
108-16 63rd Rd
Forest Hills, NY 11375
☎ (718) 897-5331