Adenomyosis

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Published: Sept. 26, 2008
Updated: Sept. 26, 2008

Adenomyosis is uterine thickening that occurs when endometrial tissue, which normally lines the uterus, extends into the fibrous and muscular tissue of the uterus.

The presence if endometrial tissue within the wall of the uterus can cause abdominal pain and abnormal bleeding.

Symptoms

  • The uterus is often two to three times the normal size
  • Prolonged or heavy menstrual bleeding
  • Painful menstruation, including new onset of menstrual cramping that becomes increasingly worse
  • In many cases, the woman may not have any symptoms

Diagnosis

Adenomyosis is very difficult to diagnose without removing the uterus or performing a biopsy of uterine muscle suspected of containing adenomyosis.

Some of the more advanced imaging techniques may help identify adenomyosis but do not offer treatment. Adenomyomas (a mass of adenomyosis) may be confused with fibroids on ultrasound.

This is often a diagnosis made by the surgeon at the time of hysterectomy or by the pathologist at the time of pathologic evaluation.

Treatment

Anti-inflammatory medications, progestins, and Lupron can temporarily suppress the discomforts of adenomyosis.

Symptoms usually resolve after menstruation ceases (menopause). A hysterectomy completely resolves symptoms.

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