What is Adenomyosis?


Image: Shutterstock/ Shidlovski

Adenomyosis is an incredibly painful condition that affects many women. And when you have fibromyalgia in addition to adenomyosis, it complicates the treatment options you have available to you. But no one should have to suffer from two painful conditions at the same time, which makes finding a way to treat adenomyosis in spite of your fibromyalgia important.

So, what exactly is adenomyosis? And what can you do to treat it?

What is Adenomyosis?

Adenomyosis is a condition caused when the tissue within the lining of the uterus begins to grow into the muscles tissue surrounding it. This tissue continues to slough away during the menstrual cycle, which leads to heavy and often painful menstrual periods. The growth of the tissue also leads to an enlarged uterus and frequent cramps that can range from mildly uncomfortable to miserably painful.

Adenomyosis is considered a benign condition since it isn’t fatal or particularly dangerous physically, but the painful periods it causes to can severely limit your quality of life.

We don’t know what causes adenomyosis, but a number of possible causes have been suggested. The most likely explanation is that hormonal changes trigger the growth of the uterine tissue. Abnormally high levels of a number of hormones like estrogen, progesterone, and prolactin might be causing the natural replenishing process of the uterus to accelerate, leading to runaway growth.

Adenomyosis frequently occurs in women in late childbearing age and often subsides after menopause. That lends further evidence to support the idea that hormones are to blame for the condition.

Diagnosing, adenomyosis is difficult, but there are few things doctors can do if they suspect you might be suffering from it. The first step is a physical exam where a doctor can check for tenderness around the uterus. And they can also perform an ultrasound to look for abnormalities in the uterus, which can at least rule out other possible causes for the pain like uterine fibroids, or benign tumors that develop in the uterine wall.

How can you Treat it?

There aren’t many good treatment options for adenomyosis. And the way a doctor might try to treat it depends on a number of factors like how severe the pain is, how widespread the growth is, and whether a woman wishes to have children in the future.

The most basic treatment is usually mild pain killers like NSAIDs. NSAIDs, or non-steroidal anti-inflammatory drugs, are a class of drugs that includes things like aspirin and ibuprofen. They work by blocking the pain receptors in the brain and in cases of mild cramping caused by adenomyosis, they might be enough to help with the pain.

In addition, you might find relief with some of the usual methods used to treat menstrual cramping like over-the-counter drugs or using a heating pad on the affected area. And doctors sometimes prescribe hormonal supplements to treat the condition. Hormone-based birth control can often reduce the severity of symptoms. And certain birth control devices like an IUD can completely stop menstrual periods, which helps to reduce symptoms.

But in cases of severe adenomyosis, these methods might not be enough. There are surgical options that are more effective. The first is something called “uterine artery embolization.” Essentially, tiny particles are implanted into the arteries of the uterus which cuts off the flow of blood to the uterine wall, restricting its growth. This is most effective when the growth is small and limited to one part of the uterus.

The only true cure for adenomyosis is a hysterectomy. In this procedure, the uterus is totally removed. Obviously, this is far from an ideal solution. It eliminates the possibility of having children and is very invasive, carrying the normal range of surgical risks.

And it’s particularly risky when you have fibromyalgia. There’s evidence that major physical trauma like a surgery can make your fibromyalgia symptoms significantly worse. And people with fibromyalgia usually take longer to recover from surgery than most people. That recovery period is also full of frequent fibro flares, where your daily symptoms get worse.

It may seem like that makes surgery off the table for people who suffer from fibromyalgia, but there are a few things you can do that might reduce the side effects of surgery. First, make sure that your doctors administer more local anaesthesia into the incision, which will prevent your nerves from sending pain signals to the brain. And ensure that you’ve received any pre-operative medications at least 90 minutes before surgery so they have time to kick in.

It’s up to you and your doctor to determine if surgery is a good option for you. But let us know, do you suffer from adenomyosis? What works for you?

Tell us in the comments.