Pearl obstetrics | gynaecology


Adenomyosis

  • Painful periods
    Adenomyosis
    Under-recognised, this condition leads to painful, heavy periods.

Adenomyosis

 

What is adenomyosis?

Adenomyosis is like endometriosis, but it’s in the wall of the womb. It is benign, but it causes pain and heavy periods that can be very severe. Sometimes however, there are no symptoms and the condition is picked up on ultrasound or MRI scan, done for another reason. It is seen most often in women in their 40s.

 

What causes adenomyosis?

No-one knows. Genetics & hormones are influential – but these aren’t the complete answer.

 

What are the symptoms of adenomyosis?

  • Painful periods
  • Heavy periods with clots
  • Long periods
  • Back pain
  • Abdominal pain
  • Bloating
  • Pain during sex
  • No symptoms are also common

 

What are the types of adenomyosis?

Adenomyoma
A solid benign tumour. A localised firm collection that can be mistaken for a fibroid.

Diffuse adenomyosis
The condition spreads out in the womb,  and the whole uterus becomes enlarged and tender.

 

Diagnosis

Diagnosis can be difficult. Ultrasound can be helpful, as can MRI. But the appearances on imaging do not correlate with symptoms. Definitive diagnosis is often only made after a hysterectomy.

 

Fertility

Fertility is often not affected. But sometimes fertility can be influenced in several ways

  • Possible damage and scarring to the uterus
  • Inflammation may be toxic to sperm & embryos
  • Miscarriage may be slightly more common

 

If you have been diagnosed with adenomyosis then consider getting pregnant, sooner rather than later, in case you are one of those affected by the small reduction in fertility.

 

Treatment of adenomyosis

Medical treatments

  • Painkillers
  • Tranexamic acid. A clotting medication to reduce bleeding.
  • Hormones eg the pill, or high dose progestins like Provera, inhibit adenomyosis.
  • The Mirena intrauterine device is helpful as it inhibits development of adenomyosis.
  • Novel hormonal treatments are in development.

 

Surgical treatments

  • Hysterectomy is the mainstay of treatment
  • The innovative treatment myolysis – localised destruction at laparoscopy – can be tried. It’s a bit hit & miss, and there is a risk of uterine rupture in subsequent pregnancy however.
  • Occasionally it may be possible to excise adenomyosis, if it is the localised adenomyoma type.

 

Natural treatments for adenomyosis

  • Agnus Casta | Chaste tree. This plant has hormonal effects that help with menstrual pain due to adenomyosis. It is also used in PMS | PMT. Take 1g daily
  • Vitamin E tablets. Vitamin E is useful for period pain due to adenomyosis, and is also used in IVF to enhance egg & endometrial quality. Take 500-1000 units twice daily before & during the period.
  • Vitamin B6. Useful for several menstrual problems such as adenomyosis, endometriosis, period pain, PMS | PMT, and is used in IVF to enhance egg quality.
  • Zinc. Zinc supplementation (normal doses only) may be helpful in adenomyosis if you have a poor diet.

Adenomyosis

Call us for assessment if you suspect or have been diagnosed with this condition.


PEARL obstetrics | gynaecology

Our office is situated opposite Glengarry Private Hospital in Perth. We provide easy free parking. We're easily accessible from Joondalup, Hillarys, Stirling, Currambine, Ocean Reef, Beldon, Connolly, Edgewater, Wanneroo, Burns Beach, Sorrento, Padbury, Marmion, Watermans Bay, North Beach, Karrinyup, Gwelup, Carine, Balcatta, Westminster, Mirrabooka, Malaga, Hamersley, Koondoola, Girrawheen, Marangaroo, Greenwood, Warwick, Madeley, Darch, Wangara, Kallaroo, Craigie, Heathridge, Woodvale, Scarborough, Doubleview, Innaloo, Osbourne Park, Wembley Downs, Tuart Hill, Trigg, North Beach. The Western suburbs (Cottesloe, Claremont, City Beach, Floreat, Swanbourne) are all within easy reach.