Adenomyosis

What is Adenomyosis?

Adenomyosis is an abnormal disorder that affects the female reproductive system. In this condition, the endometrial tissue of the uterus extends into the uterine muscle. These trapped cells are stimulated by menstrual cycle hormones, as in the endometrial lining of the uterus. It has the potential to intensify menstrual cramps and bleeding. Symptoms of adenomyosis differ during the menstrual cycle due to the increased and decreased levels of estrogen, which differ in shedding the uterus lining. After menopause, when a patient's oestrogen levels gradually decline, symptoms usually go away or improve.

What are the Types of Adenomyosis?

The following are two primary forms of adenomyosis:

• Focal adenomyosis : Endometrial tissue is present in limited regions, causing localised lesions, which doctors refer to as adenomyomas.
• Diffuse adenomyosis : This condition is more challenging to treat since it affects a large portion of the uterus and is widely infiltrated.

What are the Causes of Adenomyosis?

Although it is not clear what exactly causes adenomyosis, there are usually several factors that are linked to adenomyosis:

• Hormonal Factors : Hormonal imbalance can alter the normal boundary between the endometrium and myometrium, leading to infiltration of endometrial tissue into the myometrium. Furthermore, adenomyosis may result from variations in oestrogen levels.
• Inflammation : It has been suggested that chronic uterine inflammation is a contributing factor. The inflammatory process in the uterine lining can weaken the uterine tissue and allow endometrial cells to enter the myometrium.
• Prior uterine surgery : In any surgery performed on the uterus, like caesarean or uterine fibroid, there is a likelihood of inciting adenomyosis.

What are the Symptoms of Adenomyosis?

Common symptoms include:

• Menstrual Pain : Several women with adenomyosis may experience severe and prolonged cramping during menstruation.
• Heavy menstrual bleeding : The excessive menstrual bleeding may occur due to adenomyosis. Clots may also be present in the flow of menstrual blood.
• Pelvic pain and pressures : Some individuals who have adenomyosis report constant pain in the pelvis or a sensation of a lump in the lower abdomen.
• Bloating : Bloating is a common symptom of adenomyosis and can manifest as feeling full, feeling pressured, or a protruding abdominal bump.

How is Adenomyosis Diagnosed?

Diagnosis requires a careful approach:

1. Pelvic Examination

In a pelvic examination, a clinician can determine that the uterus is enlarged, tender, or boggy. On its own, it is not diagnostic; however, it assists in determining the further course of action.

2. Transvaginal Ultrasound

A transvaginal ultrasound is the commonly used initial imaging examination. It helps detect:

• Thickened uterine walls
• Lack of homogenous muscle texture.
• Cysts within the myometrium.

It is a primary screening instrument, though not always conclusive.

3. MRI Scan

MRI is considered one of the most consistent non-invasive techniques for assessing adenomyosis. It gives a proper visualisation of:

• Junctional zone thickening
• Diffuse or focal lesions
• Fibroids or endometriosis co-existence.

Excluding fibroids, endometriosis, and other pelvic conditions is paramount, as their symptoms may be similar. Proper diagnosis would lead to proper treatment planning. Women with fertility issues need to be carefully examined by reproductive experts. This will make the treatment plan complementary to the pregnancy objectives and to symptom alleviation.

How is Adenomyosis Treated?

The degree of treatment is based on its severity, symptoms, age and future pregnancy wishes.

1. Mild Cases

• Anti-inflammatory pain relievers such as NSAIDs.
• Birth control pills or hormone patches.
• IUDs are also used to stop bleeding and pain.

2. Moderate to Severe Cases

• Uterine Artery Embolisation (UAE): This minimally invasive procedure cuts off the blood supply to the area, providing relief from symptoms.
• Adenomyomectomy: Excision of focal adenomyosis, if feasible.

3. Fertility-Focused Treatment

For those wishing to conceive:

• Medical means for the stabilisation of symptoms.
• IVF is sometimes used when the disease has affected the fertility or natural conception is not possible.
• Follow-ups and personalised actions help to increase the success rates despite the condition.

4. For Non-Fertility Patients

• In case of severe symptoms, which are non-responsive to any other intervention, a hysterectomy can be recommended. This is usually a last resort.

The management has to be personalised and address the woman's symptoms, reproductive plans, and general health.

When Should Someone See a Doctor for Adenomyosis?

A patient should consult a medical professional in case of any persistent symptoms, including severe cramps, heavy bleeding, pelvic pain, or inability to conceive. Timely consultation prevents symptom aggravation and allows them to be treated individually. Much attention should be paid, especially by people who have a history of uterine surgery or irregular menstrual cycles.

Why Choose Indira IVF for Adenomyosis Treatment?

Indira IVF is a sophisticated adenomyosis treatment facility that offers cutting-edge reproductive techniques, expert examinations, and sophisticated diagnostic tools. Their highly qualified reproductive professionals and laparoscopic surgeons provide minimal evaluation and customised care. The clinics have state-of-the-art ultrasound equipment, the best fertility laboratories, and a holistic care model that facilitates symptom relief and reproductive planning.