Every month, like clockwork, you brace yourself for the tidal wave that no painkiller has the power to numb. You lay in bed, curled up with a heating pad, tears dried from the pain. If you’re nodding your head, feeling a sense of familiarity as you read this, you know you’re not just having bad cramps.
The truth is, it’s not all in your head.
Meet Adenomyosis. Many of you may not have heard of adenomyosis, often called the evil twin of endometriosis.
So, what’s the difference between the two?
Adenomyosis vs. endometriosis
Like most twins, there are similarities and differences. The difference between adenomyosis and endometriosis involves how and where the endometrial tissue grows in and around your reproductive organs. For instance:
- Endometriosis is when the tissue grows outside the uterus.
- Adenomyosis is when the tissue embeds deep into the uterine muscle wall, which causes your uterus to thicken and enlarge. As the muscle gets inflamed and irritated, it causes—you guessed it—pain, pressure, and heavy periods. You feel like your uterus is mad all the time and won’t let you forget it.
It is possible to have both. And like twins, that have similar traits, the same goes for adenomyosis and endometriosis; many of the symptoms can overlap.
Now you know the difference, let’s get to know adenomyosis better.
Understanding Adenomyosis
What we want you to know: if you’re dealing with constant pain or heavy periods that feel like they’re ruling your life, remember it’s not all in your head. Approximately 2% to 5% of adolescent women with these symptoms can have adenomyosis. While 1 in 3 women may never have signs and symptoms, others may experience the following.
Symptoms and signs to watch out for
- Painful menstrual cramps
- Heavy menstrual bleeding
- Pelvic pain
- Painful intercourse
- Infertility
- Enlarged uterus
- Bloating
- Painful sex (dyspareunia)
- Iron deficiency due to heavy periods
If your symptoms feel like they’re screaming while the world tells you to whisper, it’s time to listen to your voice and take action.
Speaking of action, based on your symptoms, your doctor will suggest one or more of the following tests to diagnose adenomyosis:
Diagnostic tests to confirm adenomyosis
- Pelvic exam – During your pelvic exam, your healthcare provider will look to see if your uterus has gotten larger or is painful to touch.
- Ultrasound – Your specialist will use a transvaginal ultrasound to view if there is a thickening of your uterine wall.
- MRI scans – Can allow your healthcare provider to get a closer look at certain areas of your uterus and any thickening or enlargement that may be present.
Once you receive the all-important confirmation, the good news is that treatments are available. What treatment your specialist will recommend depends on your circumstances. After all, this is not a one-size-fits-all journey.
Management and treatment of adenomyosis
Because estrogen promotes endometrial tissue growth, you might find that the symptoms will go away once you enter menopause.
In the meantime, to help manage your symptoms and the heavy bleeding, pain management strategies and non-invasive procedures are available, including surgery in some cases. Such treatments can include:
- Pain medications – This includes Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or Advil.
- Hormonal medications – Options such as birth control pills and hormonal intrauterine devices (IUD) can help manage heavy menstruation.
As mentioned, in some circumstances, your doctor may recommend surgery. These include:
- Adenomyomectomy – This surgery involves removing the adenomyosis from your uterine muscle.
- Hysterectomy – During this surgery, your specialist will remove your uterus. A hysterectomy is often the very last option.
Seeking advice and treatment before it’s too late
Adenomyosis doesn’t get as much attention as endometriosis or PCOS. Why? Although it is still a mystery in the medical world, yet, it impacts thousands of women.
Don’t wait until the pain becomes unbearable.
Contact our team if you suspect or have symptoms of adenomyosis. Dr Kothari will listen to you and answer any questions you may have.