The Link Between Adenomyosis And Endometriosis - What You Need to Know

Living with a uterine condition can create a number of challenges. It’s important that you understand how your condition affects your health and what you can do to manage it effectively.

By learning more about the link between adenomyosis and endometriosis, you can enhance your knowledge of your health and discover new approaches to symptom management. 

While adenomyosis is often associated with endometriosis, the two conditions have several key differences that could affect your diagnosis and treatment pathway. 

What links adenomyosis and endometriosis, and how could this connection influence your next steps in looking after your wellbeing? Here’s everything you need to know.

Defining Adenomyosis

Adenomyosis is a condition that causes the endometrial tissue that usually lines the uterus to grow into its muscular wall. 

In patients with adenomyosis, displaced endometrial tissue continues to function as normal, thickening, breaking down, and bleeding throughout the stages of a menstrual cycle. This can cause uterine enlargement, leading to heavy and painful periods.

Symptoms

Patients with adenomyosis may experience:

• Heavy or prolonged menstrual bleeding
• Severe menstrual cramping
• Chronic pelvic pain
• Painful intercourse 

Causes

The causes of adenomyosis are unknown. However, some practitioners have theories that the condition may be a result of invasive tissue growth, abnormal endometrial tissue development in-utero, or uterine inflammation related to pregnancy and childbirth. 

Risk factors for adenomyosis include middle age, childbirth, or prior uterine surgery (such as fibroid removal or a C-section). 

Diagnosis and treatment

Diagnostic procedures for adenomyosis may range from a clinical evaluation of your symptoms to a urine test, a pelvic exam, and ultrasound or MRI imaging. 

Adenomyosis is often treated using anti-inflammatory medications or estrogen-progestin hormone medications. In severe cases, a medical provider may suggest a hysterectomy.

Defining endometriosis

Endometriosis is a painful condition that causes tissue similar to the endometrium, which usually lines the uterus, to grow outside of the uterus. 

In patients with endometriosis, endometrial-like tissue continues to thicken, break down, and bleed throughout the menstrual cycle. However, as the tissue is not in the uterus, it becomes trapped, leading to the development of scar tissue and fibrous adhesions. 

Most often, this affects the ovaries, fallopian tubes, and pelvic tissues. Endometriosis can lead to heavy, painful periods and may also cause fertility problems. 

Symptoms

Patients with endometriosis may experience:

• Excessive bleeding, including heavy periods or bleeding between periods
• Painful periods
• Severe pelvic pain and menstrual cramping 
• Pain with urination and bowel movements
• Painful intercourse
• Infertility issues
• Symptoms of fatigue, nausea, bloating, diarrhea, or constipation 
  
  

Causes

The exact cause of endometriosis is not known. Some theories believe that it could be a result of retrograde menstruation, in which menstrual blood and endometrial cells flow back to the pelvic cavity instead of exiting the body. 

Other theories involve the transformation of peritoneal cells or embryonic cells or surgical scar implantation. Endometriosis may also relate to an immune disorder that prevents the immune system from eradicating misplaced endometrial-like tissues. 

Risk factors for endometriosis include early-onset menstruation, late-onset menopause, short menstrual cycles, low body mass index, high estrogen levels, and disorders of the blood or reproductive tract. You may be at a higher risk of endometriosis if you have never given birth or if you have a close relative diagnosed with the condition. 

Diagnosis and treatment

Endometriosis is usually diagnosed via a combination of pelvic exam, ultrasound, and magnetic resonance imaging. In some cases, your doctor may refer you to a surgeon for a laparoscopy, which allows the surgeon to look inside your abdomen for signs of endometrial-like tissue. 

Treatment options for endometriosis usually include anti-inflammatory medications and hormone therapy, including hormonal contraceptives. You may also need surgery to remove endometrial tissue that grows outside the uterus. Some patients also pursue fertility treatments. 

What links adenomyosis and endometriosis?

There is a link between adenomyosis and endometriosis, despite both conditions demonstrating their own unique features. 

Key similarities and differences

Adenomyosis involves endometrial tissue that grows in the muscular wall of the uterus. Endometriosis causes endometrial-like tissue to grow outside of the uterus. 

In both disorders, endometrial and endometrial-like tissues that grow where they shouldn’t lead to overlapping symptoms, including period pain, pelvic pain, heavy menstrual bleeding, and painful intercourse. 

However, in adenomyosis, pain is often associated with uterine enlargement. In endometriosis, patients are more likely to experience additional symptoms, including bloating, ovulation pain, and even infertility. Endometriosis patients may also experience symptoms in other parts of the body, depending on where abnormal tissue growth occurs. 

One of the main differences between adenomyosis and endometriosis is that adenomyosis can be cured by hysterectomy. Endometriosis currently does not currently have a known cure. 

Is it possible to be diagnosed with both adenomyosis and endometriosis?

It is common for patients to experience both adenomyosis and endometriosis as comorbid conditions. Exact figures are unclear, but estimates predict that around one-third of endometriosis patients also experience adenomyosis. 

Do you need further support or resources to help you with your uterine health? Contact Northern Beaches Interventional Radiology today.