When something strange is going on with your period, you have unusual pain in your lower belly, super heavy bleeding, or something just feels off, it can be tricky to determine what is going on because there are a variety of conditions that create similar symptoms. Two of the most common causes of menstrual irregularities or chronic discomfort are adenomyosis and fibroids.
Both can produce similar symptoms, but they are two very different conditions. Today, we are going to compare adenomyosis vs. fibroids and provide an overview of each condition, how to tell the difference between fibroids and adenomyosis, and the best treatment for both.
What Is The Difference Between Adenomyosis And Fibroids?
Fibroids
Uterine fibroids are benign, non-cancerous growths that form in the uterus and are made from muscle and fibrous tissue. They can vary in size from as small as a pea to as large as a melon. Some women have just one fibroid; most have many. Fibroids are very common, particularly in women of color.
They mostly occur in women during their 30s and 40s, although African-American women get fibroids earlier than other racial groups, and sometimes even present in teenage women. There is no known cause for uterine fibroids, but research has discovered that certain circumstances may make some women more likely to develop them.
Some women do not experience any symptoms, but others can have debilitating symptoms like heavy, prolonged periods, pelvic pain, pressure, bloating, frequent urination, and problems with fertility. In most cases, fibroids are not dangerous, but they can significantly affect your quality of life, especially if they grow large or are numerous.
Adenomyosis
Adenomyosis is a condition that occurs when the lining inside the uterus (the part that bleeds and sheds during your period) starts growing into the muscular wall of the uterus. This can cause the uterus to become misshapen, swollen, and thicker than normal, resulting in very heavy bleeding that lasts longer than normal, chronically painful periods, and severe cramping.
There are different types of adenomyosis, including:
- Diffuse adenomyosis
- The most common type happens when the rogue tissue spreads throughout the entire muscle wall of the uterus.
- Focal adenomyosis
- The abnormal tissue grows grouped into one spot or area instead of spreading out.
- Adenomyoma
- Specific type of focal adenomyosis which can be easily confused for a fibroid on pelvic ultrasound.
Adenomyosis vs Fibroids Ultrasound
Ultrasound is used most often to check what is going on inside your uterus because most OB/GYN offices have one on site and the cost is less expensive than an MRI. When looking at adenomyosis vs. fibroids on an ultrasound image, it can sometimes be tricky to tell them apart.
Fibroids are round or oval-shaped masses, but adenomyosis is harder to spot particularly when it is diffuse. Diffuse adenomyosis enlarges the uterus without a discrete mass. The area beneath the lining (subendometrium) becomes thickened which accounts for the enlargement of the uterus. This often changes the appearance of the uterus on a pelvic ultrasound.
The words often in the Radiology ultrasound report used to describe this is a heterogenous echotexture of the uterus. When there is focal adenomyosis or an adenomyoma they are often incorrectly diagnosed as fibroids because they can look similar on an ultrasound. Many doctors recommend an MRI scan, which gives a clearer picture and helps them make a correct diagnosis.
Adenomyosis vs. Fibroids: Why MRI Is the Gold Standard for Correct Diagnosis
At Atlanta Fibroid Center we frequently see patients diagnosed with uterine fibroids but after reviewing their MRI images, Dr. John Lipman sometimes discovers that a patient has adenomyosis or both, uterine fibroids and adenomyosis. It's very important to diagnose conditions correctly, but in case of adenomyosis it's not easy to do without MRI.
Can You Have Adenomyosis and Fibroids?
Yes, it is quite common to have adenomyosis and fibroids at the same time, which can make their symptoms worse. They may experience even heavier periods, more cramping, and more abdominal pressure, and having both at once can make it harder for the doctor to figure out what is really causing the problem.
If you have fibroids and adenomyosis at the same time, it can make finding a suitable treatment a bit more complicated. The good news is that there is a great option called uterine artery embolization (UAE) that can treat both these conditions simultaneously. It is important that you find a specialist like Dr. John Lipman at the Atlanta Fibroid Center, who is an expert in treating both conditions..
How to Tell the Difference Between Fibroids and Adenomyosis?
Both fibroids are adenomyosis enlarge the uterus; often described as a certain size pregnant uterus. Fibroids are discrete masses and can be felt on physical exam. Both of these conditions cause heavy bleeding and pelvic pain. However, in general for women with fibroids, the bleeding is worse than the pain, whereas with patients with adenomyosis, the pain is typically worse.
Also, painful sex (dyspareunia) is more commonly seen with adenomyosis, while women with fibroids more commonly have increased urinary frequency. Ultimately, the best way to separate these two entities is to obtain a pelvic MRI examination.
Can Fibroids Be Misdiagnosed as Adenomyosis?
It is not likely that fibroids would be misdiagnosed as adenomyosis, but it often happens the other way around. Misdiagnosing adenomyosis as a fibroid or fibroids can have significantly negative consequences for the woman if she is interested in fertility, and surgical myomectomy is the treatment option chosen. Fibroids, being discrete masses, can be removed surgically (i.e., myomectomy).
However, adenomyosis is typically diffuse and can be seen on MRI imaging, but is “invisible” to the gynecologic surgeon. Therefore, the surgeon who thinks his patient has a fibroid but in reality has adenomyosis will be surprised when the surgeon cuts the woman open, only to find an enlarged uterus, but there is no fibroid to remove.
This is very disappointing to both the woman and the gynecologist. It is therefore important to talk to a doctor who has a lot of experience with both fibroids and adenomyosis, like Dr. John Lipman, who specializes in non-surgical treatments at Atlanta Fibroid Center.
Adenomyosis Symptoms: Why Adenomyosis Is Often Misdiagnosed (And What to Do About It)
Adenomyosis is not an easy condition to diagnose. Adenomyosis has a lot of common symptoms with uterine fibroids and endometriosis, and it is hard to identify on an ultrasound.
What Is A Good Treatment For Adenomyosis And Fibroids
Uterine artery embolization (UAE) is a non-surgical treatment that can help women who have uterine fibroids or adenomyosis or both. It works by blocking the blood vessels that supply blood to the fibroids or the thickened area of the uterus caused by adenomyosis, and without this blood supply, they cannot survive, so the growths gradually shrink and die.
UAE is done by an interventional radiologist like Dr. John Lipman by making a small cut in the skin, usually near the groin, and then using a tiny catheter (like a long piece of spaghetti) to reach the arteries that bring blood to the uterus. Then, he sends very small particles (about the size of grains of sand) through the catheter into those arteries that block the blood flow to the fibroids or adenomyosis tissue. Without blood, the tissue shrinks, and symptoms like heavy bleeding and pain are significantly reduced or completely eliminated.
UAE is performed as an outpatient procedure with a short (5-7 day) recovery at home. It is much safer than surgery, much less invasive, and has a much shorter recovery than surgery. UAE has a 90% success rate for significantly improving or eliminating the symptoms of fibroids. It is definitely worth trying first before undergoing surgery or having your uterus removed.
How Uterine Artery Embolization (UAE) Works for Adenomyosis
Uterine artery embolization (UAE) is a non-surgical treatment option for adenomyosis. In this video, Dr. John C. Lipman of Atlanta Fibroid Center explains how the procedure works and what to expect after the procedure if you are suffering from adenomyosis.
Atlanta Fibroid Center Offers UFE Treatment
If you are suffering from painful periods, heavy bleeding, pain during sex, having to get up to use the bathroom in the middle of the night, etc., you might have uterine fibroids or adenomyosis. The experts at Atlanta Fibroid Center can help you determine the underlying cause of your symptoms and discuss the benefits of UFE and whether it might be a good solution for you.
Adenomyosis and uterine fibroids can both mess with your quality of life, and you do not have to live with them anymore. The Atlanta Fibroid Center can help you find freedom from painful fibroid symptoms and regain your quality of life. Set up a consultation today to find out if UFE would be right for you!
Patient: "I Feel Amazing after UFE"
A patient of Dr. John Lipman shares her experience with UFE after her procedure at Atlanta Fibroid Center. UFE (uterine fibroid embolization) brought her significant relief and helped her avoid fibroid surgery, risks, and long recovery times associated with any surgery. UFE is a nonsurgical fibroid treatment that is minimally invasive, and patients can go home the same day with just a bandaid.
