Lookalike Diseases: Fibroids, Endometriosis, Adenomyosis, and Uterine Polyps
Many women have experienced PMS before, but when symptoms interfere with quality of life, it’s time to speak with a women’s health specialist. Reproductive health disorders often share symptoms with other conditions, and it’s not uncommon for a woman seeking answers to be misdiagnosed. When it comes to diagnosing a woman’s extreme PMS symptoms, there are four possible culprits that all share a similar symptom profile.
Here are four lookalike diseases that can cause menstrual irregularities, pelvic pain, and fertility-related complications:
Known as the “sister” disease to endometriosis, adenomyosis is a condition in which the tissue that lines the uterus (known as the endometrium) grows into the uterus’ muscular walls (known as the myometrium). These cells continue to be stimulated as normal endometrial tissue would, thickening, breaking down, and bleeding during each menstrual cycle. However, instead of peeling off and shedding, the trapped tissue builds up and scars within the uterus, resulting in an enlarged, tender uterus accompanied by symptoms like heavy or prolonged menstrual bleeding, painful cramps, and abdominal pressure and bloating.
Other symptoms include:
- Anemia from heavy menstrual bleeding
- Pain during sexual intercourse
- Pressure on the bladder and rectum
- Painful bowel movements
- Painful urination
- Nerve numbness which can cause leg or bowel pain during periods
While adenomyosis is sometimes called internal endometriosis, the key difference is that with adenomyosis, there is a physical thickening of the uterus due to the lining growing deep into the muscle wall. The lining does not go past the uterus itself whereas with endometriosis, the lining spreads outwards and attaches to nearby pelvic structures.
Endometriosis is a condition in which the tissue that lines the uterus (known as the endometrium) is found outside the uterus, typically on surrounding reproductive organs within the pelvic cavity and lower abdomen. During a woman’s menstrual cycle, the displaced tissue continues to be stimulated as normal endometrial tissue would, thickening, breaking down, and bleeding. However, since the tissue is outside the uterus it has no way of shedding or exiting the body.
As a result, the presence of this abnormal tissue can cause painful side effects, including painful periods, pelvic pain, and pain with sex.
Other symptoms include:
- Heavy menstrual bleeding
- Spotting or bleeding between periods
- Pain while going to the bathroom during your period
- Pain in your stomach, low back, or rectum
- Problems with fertility
- Unexplained tiredness or lack of energy
- Digestive or gastrointestinal issues or symptoms
- Pain in the lower abdomen
- Diarrhea or constipation
These areas of tissue growth, sometimes referred to as patches, lesions, or nodules, can also attach to any of the spaces between the bladder, uterus, vagina, and rectum.
When endometriosis tissue sticks to different organs, it can sometimes fuse those organs together, distorting the female anatomy and causing painful inflammation. While it is not completely understood why or how endometriosis causes fertility problems, it’s thought that distortion of the fallopian tubes or ovaries are to blame, as well as inflammation which can negatively affect the function of the ovary, egg, fallopian tubes, or uterus. Other ways in which endometriosis negatively impacts a woman’s quality-of-life include bladder issues, bowel issues, and ovarian cysts.
According to UCLA Obstetrics and Gynecology, it is estimated that between 3% and 10% of reproductive-age women are affected by endometriosis.
Fibroids are noncancerous masses that can develop in and around the uterus, and are the most common tumor of the reproductive tract. Made up of muscle cells and other tissue, fibroids can grow in the wall of the uterus, on the outside of the uterus, just underneath the uterine lining, or on small stalks inside or outside the uterus.
It’s possible to have more than one type of fibroid, just like it is possible to have more than one fibroid. These growths can cause a range of debilitating symptoms, the most common being heavy, prolonged, or painful periods and moderate to severe menstrual cramps.
Other symptoms include:
- Unpredictable menstrual cycles
- Pain during sex and loss of libido
- Pelvic pressure, distended and bloated abdomen
- Pelvic pain, lower back pain, and pain in the back of the legs
- Anemia that can lead to a lack of energy and fatigue
- Weak bladder control, frequent urination because of bladder pressure
While up to 80% of women will develop fibroids by the age of 50, many women go through life never realizing they have fibroids. Only symptomatic fibroids are recognized as a health condition that requires treatment. Fibroids are the leading cause of hysterectomy in the U.S. However, this benign condition is treatable through non-surgical alternatives. A recent study suggests that nearly 1 in 5 women who undergo a hysterectomy for a benign condition may not need it.
Fibroids disproportionately affect African-American women, who are three times more likely to develop fibroids. Additionally, family history of uterine fibroids, and environmental factors such as obesity, onset of menstruation at an early age, use of birth control, and a deficiency in vitamin D are also known risk factors. A woman’s fertility may be impacted by fibroids, and 1 in 4 women who have endometriosis are also diagnosed with fibroids.
Uterine polyps are overgrowths of endometrial tissue that are attached to the inner wall of the uterus by a large base or a thin stalk. These soft, bulb-shaped red masses can range from a few millimeters to several centimeters in diameter. Uterine polyps occur when the cells of the uterine lining (the endometrium) multiply too many times, forming sacs of excess tissue.
While polyps and fibroids are often compared, fibroids are different because they are made of muscle cells. Fibroids also tend to affect women during their reproductive years, whereas uterine polyps tend to affect women just before or after experiencing menopause. However, both conditions can be found in different age groups. Not all polyps are symptomatic, but they can cause irregular menstrual bleeding, heavy menstrual bleeding, bleeding or spotting between periods, or periods of an unpredictable time, length, or flow.
Other symptoms include:
- Abnormal vaginal discharge
- Bleeding after menopause
- Pelvic pressure
- Abdominal or pelvic pain
- Painful sexual intercourse
- Bleeding after sexual intercourse
- Urinary frequency
Uterine polyps rarely become cancerous, but it’s estimated that between 1-2% of premenopausal women and 5 to 6% of postmenopausal women are affected by cancerous polyps. A more common issue associated with polyps is fertility. Depending on the location of the uterine polyp, it may obstruct the opening of the fallopian tubes and prevent a fertilized egg from attaching to the uterus. However, treatment may make a difference.
When menstrual cramps are debilitating, a larger medical issue could be to blame. If you’re based in the New York area, the skilled team at Forest Hills Medical Services is equipped with the expertise, technology, and tools to diagnose and treat your symptoms. Call (718) 897-5331 to schedule a consultation with one of our gynecologists today.