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ID: 144
Category: Obstetrics and Gynecology
CreatedBy: 1
UpdatedBy: 1
createdon: 09 Feb 2023
updatedon: 05 Apr 2023

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Author: Khoa Tran
Published Feb 09, 2023
Updated Apr 05, 2023

Table of contents

Adenomyosis

Etymology and Pronunciation

Adenomyosis (ad-uh-noh-mahy-OH-sis)
aden - Greek for "myo"
myo - Greek for "muscle"
-osis - Greek suffix for "disease"

History of Adenomyosis

Adenomyosis is a medical condition that affects the uterus, where the tissue that lines the uterus starts growing into the muscle wall of the uterus. This condition was first described by the German pathologist Carl von Rokitansky in 1860, who called it "endometriosis interna" because he observed endometrial tissue growing into the myometrium.

In 1908, Thomas Cullen, an American gynecologist, described the condition in more detail and coined the term "adenomyosis" to describe the presence of endometrial glands and stroma within the myometrium. He noted that the condition was more common in women who had given birth and that it caused painful and heavy periods.

Recently studies have shown that the condition is more common in women over the age of 30, those who have had multiple pregnancies, and those who have had previous uterine surgery. It is also more common in women with a history of endometriosis.

Modern Understanding of Adenomyosis

Adenomyosis is a medical condition that affects the uterus. It occurs when the tissue that normally lines the uterus starts to grow within the muscular wall of the uterus. This growth can cause a range of symptoms, including menstrual cramps, heavy bleeding, irregular periods, and pelvic pain. This growth can cause the uterus to enlarge and become tender, leading to discomfort and pain, especially during menstrual periods and sexual intercourse.

In some cases, adenomyosis can also cause heavy and prolonged menstrual bleeding, as well as bloating and digestive discomfort. The exact cause of adenomyosis is unknown, but it is thought to be related to hormonal changes, endometrial tissue that has been displaced from its normal location, or injury to the uterine wall.

Diagnosis of adenomyosis usually involves a combination of imaging tests, such as magnetic resonance imaging (MRI) and transvaginal ultrasound, as well as a biopsy. Blood tests and hormone replacement therapy (HRT) may also be used to help diagnose the condition.

It is important for women who are experiencing symptoms of adenomyosis to speak with their healthcare provider. With proper treatment and lifestyle changes, many women are able to manage their symptoms and live a healthy, fulfilling life.

Causes of Adenomyosis

Adenomyosis is most commonly diagnosed in women in their 30s and 40s who have had children, but the condition can occur at any age. Women who have had multiple pregnancies or uterine surgeries may be at higher risk for developing adenomyosis.

The exact cause of adenomyosis is not known, but there are several theories. Some experts believe that it may be caused by hormonal imbalances, particularly high levels of estrogen, which can lead to abnormal growth of the endometrial tissue. Other theories suggest that adenomyosis may be caused by uterine inflammation or damage, or by genetic factors.

There are also some risk factors that may increase the likelihood of developing adenomyosis, including:

- Age: Adenomyosis is more common in women in their 30s and 40s.
- Childbirth: Women who have had children may be at higher risk for developing adenomyosis.
- Uterine surgery: Women who have had previous surgeries on the uterus, such as a C-section or fibroid removal, may be at higher risk for adenomyosis.
- Hormonal imbalances: High levels of estrogen, or other hormonal imbalances, may contribute to the development of adenomyosis.
- Endometriosis: Women with endometriosis, a condition in which the tissue that normally lines the uterus grows outside of it, may be at higher risk for adenomyosis.

It is important to note that not all women with these risk factors will develop adenomyosis, and some women without any of these risk factors may still develop the condition.

Treatments for Adenomyosis

The treatment of adenomyosis depends on the severity of symptoms and the desire for future fertility. Treatment options may include:

- Pain relief medications: Over-the-counter pain relievers such as ibuprofen and acetaminophen may help relieve pain associated with adenomyosis. Stronger prescription pain medications may also be prescribed.
- Hormonal therapies: Hormonal therapies, such as birth control pills, intrauterine devices (IUDs), or hormonal injections, can help regulate the menstrual cycle and reduce symptoms of adenomyosis by lowering the levels of estrogen in the body.
- Gonadotropin-releasing hormone (GnRH) agonists: These medications work by temporarily suppressing ovarian function and reducing the levels of estrogen in the body. GnRH agonists are typically used for short periods of time due to their side effects and potential impact on bone health.
- Uterine artery embolization (UAE): UAE is a minimally invasive procedure that involves blocking the blood supply to the uterus. This can help reduce the symptoms of adenomyosis by shrinking the uterus and reducing bleeding and pain.
- Hysterectomy: In severe cases where other treatments have failed or future fertility is not desired, a hysterectomy may be recommended. This surgery involves the removal of the uterus and is considered a definitive treatment for adenomyosis.

It is important to discuss the benefits and risks of each treatment option with a healthcare provider to determine the best course of action for each individual case.

Symptoms

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Painful bowel movements or urination during menstrual periods
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Anemia due to heavy menstrual bleeding
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Pelvic pain
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Heavy or irregular periods
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Painful intercourse (sex)
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Infertility
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Menstrual cramps

Confirmation Tests

- Ultrasound
- MRI
- Biopsy
- Blood test

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