Does Adenomyosis Have Stages?

A woman’s reproductive system is highly complex, and while experts do possess a great deal of information on the intricacies of how everything functions and works together, significantly less is known about conditions that inhibit its delicate balance. Despite the many advancements in medical research, there is still a substantial gap in the understanding of many reproductive conditions and their underlying causes.

Some of these issues include PCOS (polycystic ovary syndrome), uterine fibroids, endometriosis, and adenomyosis. Today we are going to take a look at adenomyosis, which is a rarer and less explored gynecological condition. We are going to provide an overview of the condition along with the symptoms it can create, and how it is diagnosed, and we will answer the question, “Does adenomyosis have stages?”

A Description Of Adenomyosis

Every month, the lining of a woman’s uterus builds up and becomes thicker to prepare for the possible implantation of an embryo. If a pregnancy does not occur, this lining is shed during the monthly menstrual cycle.

When these same types of lining cells build up in alternate locations, other conditions occur. Most people are aware of a condition called endometriosis, where these cells build up outside the uterus, but when these rogue cells build up within the muscular wall of the uterus, the condition is known as adenomyosis. The difference between the two conditions is where these abnormal lining cells choose to grow.

Symptoms Associated With Adenomyosis

The abnormally growing cells that makeup adenomyosis behave just like they would if they were in their rightful position, lining the uterus. They build up, become thicker, and then cause heavy bleeding during a woman’s normal menstrual cycle. Other symptoms include:

  • Painful periods;
  • Abnormal bleeding sometimes leads to anemia (between periods, heavy, and prolonged);
  • Enlarged uterus;
  • Severe cramping;
  • Fatigue;
  • Infertility;
  • Pain during sex.

How Is Adenomyosis Diagnosed?

Historically, the only way this condition could be diagnosed was after the uterus was removed through a hysterectomy. After removal, the uterus was dissected and examined for abnormalities. Today, we have more advanced diagnostic tools such as ultrasound and MRI imaging; however, this condition is often misdiagnosed before either of these options is used.

The symptoms of adenomyosis mimic those of other conditions, which often causes confusion when medical professionals attempt to investigate their underlying cause. Sometimes hysteroscopy is used to visualize the uterine cavity to inspect for abnormalities and collect biopsy samples to help diagnose adenomyosis.

The best diagnostic tool for diagnosing these types of gynecological conditions is magnetic resonance imaging (MRI). This type of imaging provides a highly detailed representation of the interior of the uterus, which helps medical professionals visualize any abnormal migration of endometrial tissue into the walls of the uterus.

MRI image of the adenomyosis uterus
A uterus with adenomyosis (uterine enlargement due to diffuse dark thickening with tiny white dots)

Does Adenomyosis Have Stages?

There have been many attempts over the years to categorize or classify the stages and symptoms of adenomyosis, but unfortunately, to date, a reliable system has not been identified. This is mainly due to the complexities of the disease and distinguishing between adenomyosis and other abnormalities of the endometrial area. The symptoms of this and other conditions are often so similar that it is hard to establish a baseline for a system for categorizing different levels or stages of adenomyosis. Another challenge is that women with serious chronic symptoms often are referred for hysterectomy.

Adenomyosis Terminology

Since there are no clear stages of adenomyosis, there are some terms that are used to describe the condition that help medical professionals understand the pattern and degree when diagnosing adenomyosis. These terms include:

Diffuse
This term is used when the growth of the disease is present throughout the entire uterus and is not limited to one area.
Focal
When the term focal is used, this indicates that the abnormal tissue growth is localized to one specific area and is not found in various places within the uterus.
Nodular
If the condition presents with distinct growths that look like small lumps or raised areas, then they will describe the condition as nodular adenomyosis. These nodules usually cause painful symptoms that are accompanied by heavy bleeding during the menstrual cycle.
Cystic
When the condition is accompanied by small cysts that are filled with a dark brown color fluid, it is called cystic adenomyosis and is a very rare form of the disease. The cysts are usually no larger than 2cm and are known to cause chronic pelvic pain and heavy bleeding.
Uterine Fibroid Embolization in Atlanta, GA

Does Adenomyosis Require Treatment?

Sometimes, adenomyosis causes only mild discomfort, and women do not even know the source. It may only act up during their menstrual cycle and does not require any significant treatment.

In other cases, the symptoms caused by the condition can affect their career, social engagements, intimate relationships, and even pose serious risks to their health. Heavy and prolonged bleeding can cause a condition called anemia, which can result in fatigue, headaches, dizziness, and even a life-threatening iron deficiency.

Treatments offered for adenomyosis range from mildly effective to drastic and include:

  • Anti-inflammatory over-the-counter medication;
  • Hormone therapy;
  • An IUD;
  • Estrogen-inhibiting drugs (side effects: create menopause symptoms such as hot flashes, night sweats, etc.);
  • Surgery to remove adhesions (adenomyomectomy, which is done to remove adenomyotic tissue while controlling bleeding, followed by uterine reconstruction);
  • Uterine ablation (destroys the entire lining of the uterus. This may help curtail heavy bleeding temporarily, but it does not eliminate the growths, and it eliminates the possibility of becoming pregnant);
  • Hysterectomy surgery (removal of the uterus).

Holistic Lifestyle Habits That May Help Adenomyosis Symptoms

This condition often causes chronic fatigue and weight gain, so many women find that modifying their lifestyle is helpful in controlling symptoms. Some of these lifestyle choices include:

  • Practicing relaxation techniques;
  • Focusing on eating a well-rounded, healthy diet;
  • Getting an adequate amount of sleep every night;
  • Not smoking;
  • Getting regular exercise;
  • Avoiding alcohol consumption (which increases estrogen levels and can exacerbate symptoms).

What Is The Best Way To Control Adenomyosis And Its Symptoms?

Adenomyosis can often be treated and the symptoms controlled without using medications that create unpleasant side effects or by drastic uterus-removing surgery. Uterine artery embolization (UAE) is a treatment that will work in about 80% of cases to significantly reduce or eliminate the symptoms created by adenomyosis.

It works by blocking the vital blood supply needed by the rogue-growing cells to stay alive. With their lifeline cut off, these cells begin to die, taking with them inflammation, heavy bleeding, pain, and more. Women who have been trying to get pregnant with adenomyosis may find their fertility enhanced after the UAE procedure.

Unfortunately, most women are never given this non-surgical option as a choice for treatment for their adenomyosis because it is not performed by an OB/gyn. UAE is done as an outpatient procedure in under an hour by specially trained interventional radiologists like Dr. John Lipman or Dr. Mitchell Ermentrout at the Atlanta Fibroid Center. There is no invasive surgery or a long recovery time, and patients gain an enhanced quality of life.

If you are experiencing symptoms as outlined above or have been diagnosed with fibroids or adenomyosis, contact the Atlanta Fibroid Center today and find out if UAE would be a good fit for you. We have helped women for over 25 years become free from the debilitating symptoms caused by these abnormal uterine growths. Make your appointment today to come in and talk with the UAE experts at Georgia’s fibroid center of excellence, the Atlanta Fibroid Center.

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