Do you also have a period that makes you feel miserable every month? You may not be able to do your normal activities due to unbearable stomach cramps and heavy bleeding. You may think, "This is normal for us women." But that's not always the case. Sometimes, the cause of this severe pain and heavy bleeding can be a condition called adenomyosis. Today, we'll talk about this in a simple way that you can understand.
Simply put, what is adenomyosis?
To understand this, let's first learn a little about our uterus. The inner wall of the uterus is made of a special membrane. We call this the endometrium. It is this membrane that is shed every month during menstruation. Outside this membrane is a thick wall made of uterine muscles. It is called the myometrium.
Now, in a condition called adenomyosis , what happens is that the cells that belong to the endometrial lining, which is inside the uterus, don't just stay there, but also start to grow into the muscle layer of the uterus (myometrium).
Think of it like paint that you want to apply to a wall inside a house, but it spreads through the wall and gets between the bricks. When this membrane grows into the muscle in this way, the uterus gradually begins to thicken and grow. Sometimes the uterus can grow to twice or even three times its normal size . This is called adenomyosis.
What are the symptoms of this condition?
Surprisingly, not everyone with adenomyosis has symptoms. Some women may have the condition without any symptoms. But for those who do, it can be a bit bothersome. Let's take a look at the main symptoms.
| Symptom | A simple explanation |
|---|---|
| Severely painful menstruation (Dysmenorrhea) | You may experience a sharp, unbearable pain that goes beyond a normal stomach ache. |
| Heavy menstrual bleeding (Menorrhagia) | The blood may come out in large clots. The bleeding may be so heavy that you have to change your sanitary napkin every hour. |
| Pelvic Pain | Not only during menstruation, but also on other days, you may feel persistent pain or heaviness in the lower abdomen. |
| Pain during sexual intercourse (Dyspareunia) | For some people, sexual intercourse can be a painful experience. |
| Adenomyosis Belly | As the uterus enlarges, the lower abdomen may feel protruding, heavy, or bloated. |
| Difficulty having children (Infertility) | Although rare, this condition can cause problems with conceiving a child. |
Why does this happen? What are the risk factors?
In fact, doctors still don't have a 100% definitive answer as to why some women develop adenomyosis. But there are a few things they think may play a role. Research has found that hormonal changes, genetic influences, and inflammatory conditions in the body may be contributing factors.
However, several factors have been identified that increase the risk of this condition.
- Age: This condition is most common among women between the ages of 40 and 50.
- Having children: This risk is higher for women who have given birth to at least one child.
- Uterine surgery: If you have previously undergone surgery to remove uterine fibroids or a D&C (dilation and curettage), your risk may be slightly increased.
- Having endometriosis: People with a condition called endometriosis are more likely to develop adenomyosis.
What is the difference between adenomyosis and endometriosis?
These two names are often confused. Both are caused by the growth of a tissue similar to the lining of the uterus (endometrium) in the wrong place. The difference is in the location.
Adenomyosis: The lining of the uterus grows into the muscular wall of the uterus itself.
Endometriosis: A condition in which tissue similar to the lining of the uterus grows outside the uterus , for example on the ovaries, fallopian tubes, or elsewhere in the abdomen.
Simply put, adenomyosis is a problem that occurs inside the uterus. Endometriosis is a problem that occurs outside the uterus.
Could this be cancer? What are the complications?
This is a fear that many people have. But one thing you can rest assured about is that adenomyosis is not cancer. And it does not turn into cancer.
But if left untreated, one of the main complications that can occur is anemia, which means a decrease in blood in the body . Because when you have heavy menstrual bleeding, a large amount of iron is removed from the body. Because of this, you may feel tired, weak, and cold all the time.
Additionally, persistent pain can affect your daily life and mental health.
How does a doctor diagnose this?
When you tell your doctor about your symptoms, he or she may examine you and suspect this condition. To confirm this, they will usually do one or more of these tests.
- Pelvic Exam: When your doctor examines you, he or she will check to see if your uterus is slightly enlarged, soft, or painful to the touch.
- Ultrasound Scan: In this, a scan, especially a transvaginal ultrasound, can clearly see if the walls of the uterus have thickened or if there are any changes in it.
- MRI scan: In some cases, an MRI scan can provide a more in-depth, clearer picture of the condition of the uterus.
Sometimes, your doctor may decide to take a small sample of the lining of your uterus (biopsy) to make sure there is no other serious condition.
What are the available treatments?
Since adenomyosis is often dependent on the hormone estrogen, these symptoms usually go away after menopause , when your periods stop completely. But you don't have to suffer until then. There are various treatments to help manage your symptoms. Your doctor will choose the treatment that's right for you based on your age, the nature of your symptoms, and whether you want to have more children.
| Treatment method | Description |
|---|---|
| Painkillers | Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help control menstrual pain. |
| Hormone therapy | Birth control pills, hormonal IUDs, and other methods can help control heavy bleeding and pain. There are also hormonal injections like Depo-Provera. |
| Non-hormonal drugs | Medications such as tranexamic acid can reduce the amount of menstrual bleeding. |
| Adenomyomectomy | This involves surgically removing only the tissue that has grown into the muscle, without removing the entire uterus. |
| Hysterectomy | If no other treatment can control the symptoms and you no longer wish to have children, a hysterectomy is the last resort. After this, you will no longer have periods and you will not be able to have children. |
When should you definitely see a doctor?
If you have any of the symptoms below, don't just assume "this is normal" and definitely see a doctor for advice.
- Heavy menstrual bleeding: If you have to change sanitary pads about once an hour.
- Severe stomach pain: If the pain is so severe that you cannot even do normal tasks.
- If you experience pain during sex .
- If you feel a constant feeling of heaviness or fullness in the lower abdomen .
Even if these symptoms are not caused by adenomyosis itself, they could be caused by another condition that needs treatment. Therefore, it is very important to see a doctor.
Take-Home Message
- Adenomyosis is the growth of the lining of the uterus into the muscle of the uterus. This is not cancer .
- Severe menstrual pain and heavy bleeding are not always "normal." They can be a symptom of an underlying medical condition.
- There are very effective medications and surgical treatments to control these symptoms, so there is no need to suffer in pain.
- If you have any of these symptoms, don't be afraid or embarrassed to talk to your doctor about them. That's the first step to a healthy life.
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