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Adenomyosis is often linked to endo - 11% of women with adeno will also have endo. It is endometrial tissue found within the myometrium, the muscle walls of the uterus. It tends to be a little like a root network, with lots of "branches" which may travel wherever and mass wherever.
What are the symptoms?
Adeno cannot be shed during menses, so it can cause pain and cramping, as well as prolonged, heavy or irregular bleeding.
How is it diagnosed?
Typically, adeno causes the uterus walls to become "boggy", soft and swollen. It can grow to the size of early pregnancy, and weigh double the normal uterus weight. It can only be diagnosed by pathology, usually following a hysterectomy, before that it can only be suspected by pelvic or visual scan.
Increasingly, MRI (magnetic resonace imaging) is being used to diagnose adeno and endo. Masses over 5mm can be seen via MRI.
Biopsy is not used to diagnose adeno, since it is not accurate enough, especially if the adeno is diffuse.
What treatment is there? Is there a cure?
Treatment for adeno is vaguely similar to endo. It can be treated medically, for example with GnRHa drugs to try to shrink the adeno and buy some time or with a progesterone intrauterine device, such as the Mirena.
If an area of the muscle has little tissue left, with lots of adeno, it may be called an adenomyoma, and can be removed and the uterus resected - called an adenomyomectomy. Again, this is only a short term measure used in women who wish to have children.
Uterine ablation can be used if the primary symtom is bleeding. This is only for women who have completed their families since this removal of the endometrial tissue means that future pregnancies cannot implant.
The definitive treatment for adeno is a hysterectomy. Removal of the entire uterus will also completely remove the adeno, so it is a "cure" of sorts |
