January 8, 2024
What is Adenomyosis?
Adenomyosis is a condition where the lining of the womb extends abnormally deep into the uterus. The uterine tissue and cells grow deep in the muscular wall of the uterus and thickens it.
The displaced tissue will break down and bleed during a menstruation cycle, and this can cause discomfort and painful periods. It may also lead to abnormally heavy periods and bloating.
Adenomyosis is quite common - one study found anywhere from 20%-88% of women will experience symptoms.
Adenomyosis vs Endometriosis
Many women have likely heard of endometriosis(AKA endo) but adenomyosis is much less well-known and discussed, despite the two conditions being very similar. In fact, it is very common for the two conditions to be misdiagnosed as each other, or for them to both be present at the same time.
A common method of discussing the difference between endometriosis and adenomyosis is ‘inside vs outside’.
Endometriosis is a condition where tissue that should be on the inside of the uterus grows on the outside. Adenomyosis sees uterine tissue growing deeper than it should.
Endometriosis = outside.
Adenomyosis = inside.
The symptoms, causes, diagnosis and treatment for both conditions are all very similar.
What are the Symptoms of Adenomyosis?
Sometimes, adenomyosis produces no signs or symptoms, or only mild discomfort. However, when it does present symptoms, adenomyosis can result in:
- Heavy or prolonged periods
- Severe cramping or sharp, knifelike pelvic pain during menstruation
- Chronic pelvic pain
- Painful intercourse
- Tenderness or swelling in your abdomen (which may indicate an enlarged uterus)
One study found that the spectrum of severity of the clinical symptoms can vary from no symptoms (33% of respondents) to chronic pelvic pain (77%) and heavy menstrual bleeding (40 – 60%).
How Can You Relieve Pain From Adenomyosis?
Like many conditions, treatment options vary based on the severity of symptoms, and adenomyosis is no different.
At one end of the scale you have lifestyle changes and home remedies, right through to surgical intervention at the other end.
Lifestyle Remedies
If you’ve suffered from painful periods or pelvic pain for some time you may have discovered a home remedy you can turn to to help relieve the pain. Common examples include a warm bath, a hot water bottle placed on your stomach, or over-the-counter pain medication, which we will discuss next.
Yoga has also been shown to provide pain relief, with certain poses activating areas commonly associated with uterine or pelvic pain. We covered this topic in detail in our blog, 7 yoga poses for adenomyosis and endometriosis.
If yoga isn’t your thing, simply increasing the amount of light-to-moderate exercise you do can help improve your symptoms. Our muscles are meant to move and stretch, and exercises such as walking or swimming can help strengthen your lower back and pelvis, which may lead to reduced pain.
Finally, you can look to make dietary changes to find pain relief. It is very important to discuss serious changes to what you eat with a certified nutritionist as they can help you track your intake and may be able to identify a suitable diet that reduces inflammation while ensuring adequate nutrition.
Pain Relief Medication
Anti-inflammatory drugs such as ibuprofen can help relieve the pain. Pain relief medication such as panadol is also a good choice.
Hormone Medication
Birth control pills (combined estrogen-progestin) may help lessen the bleeding and pain associated with adenomyosis. Birth control pills that are progestin-only, such as an intrauterine device (IUD), can help relieve pain as they can cause your menstrual cycle to stop.
Gonadotropin-Releasing Hormone Agonists (GnRHa) can be used to bring about medically-induced temporary menopause, which can shrink adenomyotic tissue. However, due to side effects, this treatment is usually only an option for 3-6 months and once treatment is stopped symptoms may return.
Pain Relief Devices
Recent technological advances have meant a range of pain-relief devices are readily available to help with painful periods or symptoms of uterine conditions such as adenomyosis, fibroids and endometriosis.
A transcutaneous electrical nerve stimulation machine, better known as a TENS machine, is one such device that can provide pain relief.
Studies have shown that a TENS machine can help provide pain relief for women suffering painful periods, a common symptom of adenomyosis, which makes it a solution worth trying if you have been diagnosed with adenomyosis.
Hysterectomy
Often viewed as the ‘only true solution’ to uterine conditions, a hysterectomy can remove 100% of your adenomyosis and is used to treat severe cases of adenomyosis. However, it’s not the only surgical option available, and minimally-invasive treatments such as uterine artery embolisation are viable alternatives to a hysterectomy for many women.
Endometrial Ablation
Endometrial ablation is a minimally invasive procedure that reduces menstrual flow by destroying (ablating) the uterine lining.
This treatment reduces abnormal bleeding and is done through a combination of heat, microwave energy, hot water, and electric current to destroy the lining of the uterus.
Pregnancy is unlikely to occur following endometrial ablation and is a factor that must be considered during your choice of treatment option.
Uterine Artery Embolisation
Uterine Artery Embolisation, or UAE, is our preferred treatment choice for patients diagnosed with adenomyosis due to the benefits it provides when compared with more traditional surgical options.
A small incision is made in the wrist or groin, and a catheter is inserted. Through this catheter, a needle is placed and guided through the arteries to the pelvis using x-ray guidance. Once in place, tiny particles are inserted into the arteries supplying blood to the adenomyotic tissue, reducing blood supply, causing the tissue to shrink over time and reducing the symptoms.
Relieving Your Adenomyosis Symptoms
If you’ve been diagnosed with adenomyosis, or are suffering from pelvic pain that is unusually strong, it may be time to speak with a professional. At Northern Beaches Interventional Radiology, we are experts in minimally invasive treatment options for conditions such as adenomyosis. Book a consultation today and let us develop the perfect treatment plan for you.
