Does Adenomyosis Cause An Enlarged Uterus?

Yes, one of the symptoms of adenomyosis is an enlarged uterus. The uterus can become two or three times its normal size.

How Big Is A Uterus With Adenomyosis?

The enlargement of the uterus with adenomyosis may be subtle or as pronounced as the uterus of a woman who is 12-14 weeks pregnant. This would be approximately triple its normal size.

How Does Adenomyosis Cause A Large Uterus?

Adenomyosis occurs when the same type of cells that make up the inner lining of the uterus begin to infiltrate the layer beneath it in the uterine wall. These cells also act just like the cells in the uterine lining and they build up and then shed (bleed) during menstruation. As these abnormal cells continue to grow and multiply, they increase the thickness of the uterine wall and expand its girth.

Can A Large Uterus Caused By Adenomyosis Affect Your Bladder?

An enlarged uterus caused by adenomyosis can exert pressure on your bladder and cause discomfort, including frequent urination or other urinary tract issues. Other side effects that can be attributed to an oversized uterus include bloating, fertility problems, abnormal vaginal bleeding, back pain, and constipation.

How Would I Know If I Have An Enlarged Uterus Due To Adenomyosis?

One indication that you may have a large uterus is cramping or lower abdominal pain. You may also experience bloating or chronic pressure in the abdomen.

Sometimes an OB-gyn can determine that a woman’s uterus is enlarged by the way it feels during a pelvic exam. They would not be able to diagnose adenomyosis without the use of another diagnostic test.

Most patients with an enlarged uterus due to adenomyosis also have corresponding symptoms. These symptoms are typically the same that are often present with uterine fibroids; namely heavy uterine bleeding and pelvic pain. However, in general, if you ask the adenomyosis patients which is worse they will typically say the pain, while most fibroid patients will say the opposite and note that the bleeding is worse. To makes matters even more confusing, many patients with adenomyosis also have fibroids and adenomyosis can also be present in a less common focal form which can look like a fibroid on a low-resolution pelvic ultrasound study. This is one reason to use the much higher resolution pelvic MRI in these patients.

What Is the Best Imaging Test To Diagnose An Enlarged Uterus From Adenomyosis?

An MRI offers the best accuracy in diagnosing adenomyosis and determining enlargement of the uterus. The much higher resolution of the 3D images provided by an MRI scan can help doctors identify increased thickness in the junctional zone of the uterus – the area between the lining and the muscular wall of the uterus.

The normal thickness of this zone is between 5 mm and 8 mm and with adenomyosis, it is defined as 12mm or thicker. Between 8 and 12 mm, it can be suggested but not definitive unless there are also cystic changes present within the junctional zone. A Radiologist can often determine the presence of an enlarged uterus due to adenomyosis by interpreting the MRI scan.

How Is Adenomyosis Treated?

There are only two treatment options for patients with symptomatic adenomyosis that have been shown to significantly improve or eliminate the symptoms in the significant majority of treated patients. The first is a hysterectomy and should be reserved as a last resort option. The other is uterine artery embolization (UAE) is a non-surgical procedure that is highly effective in treating adenomyosis and can restore your uterus to its normal size and provide relief from your symptoms.

If you have symptoms such as pelvic pain and pressure, heavy periods, frequent urination, painful intercourse (sex), etc, contact the Atlanta Fibroid Center. Set up a consultation to learn more about how we can help you.