“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?
What Is Adenomyosis?
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, the endometrium can only grow in the direction of the uterine cavity simply thickening during the menstrual cycle.
When a woman has adenomyosis, the endometrium grows through the dividing tissue that lays between the endometrium and uterine muscles and is called the sub-endometrium and starts invading the muscular wall of the uterus. Adenomyosis is sometimes called internal endometriosis equating this condition to a type of endometriosis.
In response to the appearance of endometrial tissue in the uterine walls, a thickening occurs, which is called adenomyosis and often leads to an enlarged uterus and other unpleasant and painful symptoms.
Infographic: Adenomyosis in Numbers
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 the 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 include:
- Early-onset of menstruation;
- Birth control pills;
- Living in areas with poor environmental conditions;
- Frequent allergies;
- Frequent infections;
- Digestive system disorders;
- Inactive lifestyle;
- Intrauterine development issues;
- Stress leading to a weakened immune system.
While the exact reasons for adenomyosis are unknown, and there is no reliable answer to 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.
Why Is Adenomyosis Often Misdiagnosed as Uterine Fibroids?
The sub-endometrium is typically less than 1 cm thick or less than the width of a finger. When the sub-endometrium exceeds 1.2 cm, a condition is qualified as adenomyosis. This is often accompanied by cystic changes in the sub-endometrium which are easily seen on a magnetic resonance imaging exam of the pelvis but often misdiagnosed on ultrasound imaging. That is why MRI makes 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 diagnosed as uterine fibroids.
This emphasizes the importance of getting a second opinion from an experienced interventional radiologist like Dr. John Lipman of the Atlanta Fibroid Center®. Dr. Lipman has the largest experience in the non-surgical treatment of both uterine fibroids and adenomyosis.
How Are Adenomyosis and Fibroids Treated?
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 non-surgical, outpatient procedure that is safer than surgery, has a shorter recovery time, and allows women to keep their uterus. This minimally invasive procedure has a high success rate – 90% for the treatment of uterine fibroids and 80% for the treatment of adenomyosis – while reducing risks of surgical complications and recurrence to almost zero. 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.