What is Adenomyosis? Symptoms & Treatment Options

In a (pea)nutshell, adenomyosis is a medical condition that isn’t widely discussed but can significantly impact daily life, causing painful periods and even infertility.

So, what exactly is adenomyosis?

Here’s all you need to know about adenomyosis symptoms, treatments, and potential complications.

In this article: 📝

What is adenomyosis?

Before we dive into defining adenomyosis, it’s helpful to understand the anatomy of your uterus.

The uterus has three tissue layers:

• Endometrium: The inner lining of the uterus that sheds during your period
• Myometrium: The muscular outer layer that expands through pregnancy and contracts during labor
• Perimetrium: The outer serous layer covering the uterus, helping to reduce friction
  Endometrial tissue is usually only found in the endometrium, but with adenomyosis, it protrudes into the muscular layer of the myometrium.

When this happens, the displaced endometrial tissue continues to act the same way inside the myometrium as it does in the endometrium.

Think all that normal period stuff of thickening, breaking down, and bleeding.

And this often results in painful, heavy periods.

It can also lead to an enlarged uterus, painful sex, and infertility.

Doctors aren’t sure what causes adenomyosis.

We know it normally gets better after menopause.

But of course, if you’re suffering from sore monthly cramping and pain during sex — this isn’t much comfort.

Luckily, hormonal therapies help some people.

If this doesn’t make a difference, doctors can perform a hysterectomy, where the womb is removed completely. [1]

What does adenomyosis pain feel like?

Some people with adenomyosis won’t have symptoms at all.

Others might experience mild discomfort, like the occasional stomach ache.

For other people, though, adenomyosis can feel incredibly painful.

It results in things like:

• Severe cramping pain during periods – often described as sharp, knifelike pains.
• Chronic pelvic pain – that occurs all month round.
• Heavy periods that last longer than the average period length (i.e. more than seven days)
• Painful sex

It can also increase the size of your uterus – sometimes called “adenomyosis belly.”

This leads to feelings of pressure and tenderness in the stomach.

For some people, an enlarged womb may be visible from the outside.

Is adenomyosis a serious condition?

If adenomyosis affects your daily life in any way – then yes, it’s a serious condition.

Even though some people don’t get any symptoms at all, it can lead to problems like infertility further down the line.

Again, unlike endometriosis, doctors have not found clear links between adenomyosis and pregnancy, but there is some evidence that one of the reasons it can lead to infertility is the increased risk of pregnancy loss [2].

Other pregnancy complications can arise during labor or with pre-term delivery (when a baby is born before 37 weeks of pregnancy).

Adenomyosis can also affect other aspects of daily life.

For instance, if your stomach isn’t feeling great, this has knock-on impacts on things like exercise and diet.

It barely needs saying, but this can also have a massive impact on your emotional well-being.

If you’re experiencing dysfunctional periods, please do not suffer in silence and talk to your healthcare provider about ways they can ease your symptoms.

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What are the dangers of adenomyosis?

If you have long, heavy periods because of uterine adenomyosis, this can lead to things like chronic anemia, where the body doesn’t have enough healthy red blood cells or hemoglobin. [3]

Anemia often results in extreme tiredness and a host of other issues.

Of course, the pain and heavy bleeding caused by adenomyosis can also disrupt your everyday life, sexual enjoyment and confidence, and general health.

If you’re worried you might start bleeding or are in pain, you might avoid activities you enjoy – leading to feelings of isolation and depression.

Mental health symptoms arising from adenomyosis are just as serious as any physical health symptoms.

What is the best treatment for adenomyosis?

When it comes to adenomyosis treatment, there are a few non-surgical options you could try before having a hysterectomy.

The problem is that adenomyosis often takes a long time to diagnose.

Many people experience symptoms for months or years without knowing what causes them.

The only way to diagnose adenomyosis for sure used to be examining the uterine tissue after a hysterectomy.

But thanks to advances in adenomyosis ultrasound technology, it’s now possible to pick up the signs before resorting to such a final intervention.

Treatment can involve:

• Managing the pain with heating pads and over-the-counter painkillers. [4]
• Non-hormonal therapies like mefenamic acid or tranexamic acid, which reduce pain and heavy bleeding during your period. [5]
• Hormonal treatments like the oral contraceptive pill, hormonal coils, implants, or injections. There are also drugs like Zoladex that mimic a false (clinical) menopause. [6]
• Surgery, namely a hysterectomy (removing the womb).
  Uterine artery embolization is another choice.

This is when small particles are injected into blood vessels, aiming to block off blood supply and make the adenomyosis shrink.

Is adenomyosis worse than endometriosis?

So what about adenomyosis vs. endometriosis?

Endometriosis and adenomyosis are similar conditions.

Both involve the lining of the womb.

Both can be painful.

And both can cause issues like anemia, heavy and painful periods and problems conceiving.

One really isn’t worse than the other because they affect people in so many ways and severities.

Because endometriosis results in tissue growing outside the womb and can involve the ovaries, bowels, and fallopian tubes), there is a stronger correlation with infertility.

That’s because it can cause scarring on the ovaries and fallopian tubes, which blocks sperm and the descent of an egg into the uterus.

Endometriosis is also linked to PCOS polycystic ovary syndrome. [7]

What happens if adenomyosis goes untreated?

If left untreated, the heavy periods caused by adenomyosis increase your risks of anemia.

It can also lead to long-term pain and problems with sex.

The condition can also make it difficult to conceive.

There are also risks of pregnancy loss and early labor (i.e. childbirth before week 37).

Even if you’ve already had a child, it can be difficult to get pregnant again.

In fact, adenomyosis is more commonly diagnosed in pre-menopausal women aged 40 or above who’ve had children before.

What foods to avoid if you have adenomyosis

As well as medical treatments, you could also try a special adenomyosis diet which can help some symptoms – but this should be done under the guidance of a healthcare practitioner. [8]

They may advise you to avoid eating too much of the following foods:

• Refined white flour and refined grains, as lots of people say they worsen adenomyosis symptoms
• Dried fruits as well as mango, banana, plums, and citrus fruits
• Vegetables such as cauliflower, onion, and garlic which often lead to an upset stomach
• Too much dairy – think milk, full-fat yogurt, and cream
• Spicy food, which can aggravate inflammation and tummy problems
• Fried food with lots of oils like butter or hydrogenated oils
• Fatty, sugary, and salty food (especially meat-based fast food)
• Caffeinated drinks (like tea and coffee) and keeping alcohol to a minimum
  We know none of this is very nice.

But there is help available out there and multiple treatment options, so please speak to a gynecologist about your struggles.

And if you need support along the way, your Peanut community is there for you.