Many women make the erroneous assumption that as they near menopause, they can expect lighter bleeding. While this is sometimes the case, it is just as likely that they may experience heavier bleeding in the perimenopausal years, those years leading up to menopause. Sometimes, heavier bleeding will also occur with severe menstrual cramps that are debilitating and a monthly period that never seem to end.
These symptoms will usually eventually cause a woman to seek out help from her gynecologist, where after further testing, a diagnosis of adenomyosis may be given. While almost every woman is familiar with endometriosis, most have never heard of adenomyosis. Here is what you need to know about this painful and annoying condition.
What Is Adenomyosis?
This condition is caused when the cells that normally line the uterus, the endometrium, find their way into the uterine muscle wall, the myometrium. This differs from endometriosis, where those cells travel outside the uterus and attach to other organs, such as fallopian tubes, ovaries, and the tissue lining your pelvis.
What Are The Symptoms Of Adenomyosis?
In addition to extremely heavy bleeding, which usually includes large clots of tissue, and severe menstrual cramps that can almost resemble labor contractions in their severity, anemia from the blood loss is also common. The uterus is generally enlarged, which may give the abdomen a swollen appearance in thin women. It can also feel tender to the touch. The uterus itself eventually becomes hardened. Additionally, situational depression can result as the severity of the symptoms tends to inhibit normal activities.
How Is Adenomyosis Diagnosed?
A post-hysterectomy pathology is the only way to definitively diagnose the condition, however, imaging procedures, such as a transvaginal ultrasound, can fairly reliably predict the condition. An MRI can be even more useful in evaluating the uterus as it can better differentiate between other conditions that may present with similar symptoms, such as uterine fibroids.
How Is Adenomyosis Treated?
The only cure for adenomyosis is a hysterectomy. The ovaries are usually left intact unless there is another valid reason for removing them. However, other treatment options may be considered, especially if the condition presents is a younger woman who still wants children. The most common treatment for older women is the placement of an intrauterine device (IUD) that also has hormones. The hormones drastically reduce the symptoms. After menopause is complete, all symptoms go away and the IUD can be removed.
If you think you're suffering from this condition, contact George L Stankevych, MD.