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What Causes Adenomyosis? You Asked, We Answer


“You have adenomyosis”, – 1 in 10 women will hear these words from their doctor at some point in life (most frequently in their 30s or 40s, although adenomyosis can develop in women of all ages). What is this condition? What causes adenomyosis?

Adenomyosis is sometimes called “internal endometriosis” equating this condition to a type of endometriosis.

Although these conditions can have similar symptoms and both can be hard to diagnose, these are two distinct medical conditions.

Infographic: Adenomyosis in Numbers

What Is Adenomyosis: Adenomyosis Risk Factors

The uterus is lined with a mucous membrane called the endometrium. It grows during menstrual cycles preparing to receive a fertilized egg.

If a pregnancy does not occur, the surface layer is sloughed, which is responsible for the bleeding seen with a woman’s period.

The endometrium is separated from the muscular layer of the uterus by a thin layer of tissue.

Normally, endometrium can only grow in the direction of the uterine cavity simply thickening during the menstrual cycle.

When a woman has adenomyosis, endometrium grows through the dividing tissue (between endometrium and uterine muscles called the sub-endometrium) and starts invading the muscular wall of the uterus.

In response to the appearance of endometrial tissue in the uterine walls, a thickening occurs, which is called adenomyosis and often leads to enlarged uterus and other unpleasant and painful symptoms.

Adenomyosis and Uterine Fibroids

The sub-endometrium is typically less than 1 centimeter in thickness (less than the width of a finger).

When the sub-endometrium is >12mm (1.2 cm), adenomyosis is present. This is often accompanied by cystic changes in the sub-endometrium which are easily seen on a Magnetic. Resonance Imaging exam of the pelvis; making it the gold standard for imaging fibroids or adenomyosis.

While, the uterine enlargement from significant adenomyosis is seen on pelvic ultrasound, the thickening of the sub-endometrium and cystic changes are often missed.

Not uncommonly, the patient’s adenomyosis is not recognized or mistakenly called fibroids. This is particularly true if these patient’s are African-American because these women disproportionately suffer with fibroids.

This emphasizes the importance of getting a second opinion from an experienced Interventional Radiologist like Dr. John Lipman or Dr. Rochelle Wolfe of the Atlanta Fibroid Center.

The Atlanta Fibroid Center has the largest experience in the non-surgical treatment of both uterine fibroids and adenomyosis.

What Causes Adenomyosis? You Asked – We Answer

It is very important to correctly diagnose both, adenomyosis and uterine fibroids as quickly as possible.

Both of these conditions can be treated with uterine artery embolization (UAE) also known as uterine fibroid embolization (UFE).

UAE/UFE is a nonsurgical, outpatient procedure that is safer than surgery, has shorter recovery time, and allows women to keep their uterus.

This minimally invasive procedure has high success rates (90% for treatment of uterine fibroids and 80% for treatment of adenomyosis) while reducing risks of surgical complications and recurrence to almost zero.

So What Causes Adenomyosis?

The exact cause of adenomyosis (just like fibroids) is still unknown.

It is assumed that all factors that violate the barrier between  endometrium and the muscular layer of the uterus can potentially lead to adenomyosis.

The following factors can contribute to the development of adenomyosis:

– Immune system issues;
– Abortions, cesarean sections;
– Use of intrauterine device (IUD);
– Inflammatory processes in the uterus;
– Dysfunctional uterine bleeding;
– Childbirth (especially with complications);
– Surgical interventions.

Other potential risk factors:

– Early onset of menstruation;
– Birth control pills;
– Obesity;
– Living in areas with poor environmental conditions;
– Frequent allergies;
– Frequent infections;
– Digestive system disorders;
– Hypertension;
– Inactive lifestyle;
– Intrauterine development issues;
– Stress leading to weakened immune system.

While the exact reasons for adenomyosis are unknown, and there is no reliable answer, “what causes adenomyosis?”, statistics show that the onset of this condition is often asymptomatic (in about 50% of cases), and symptoms appear in later stages of adenomyosis development.

Uterine artery embolization successfully treats adenomyosis (and uterine fibroids) in all stages.

To learn more about UAE/UFE, adenomyosis symptoms, and pregnancy with adenomyosis, contact Atlanta Fibroid Center at 770-953-2600 or make an appointment online.