Adenomyosis
What is Adenomyosis?
Adenomyosis (ad-uh-no-my-O-sis) is a condition that affects many women, especially those in their 30s and 40s.
Adenomyosis occurs when the tissue that normally lines the inside of the uterus (endometrium) begins to grow into the muscle wall of the uterus. This condition causes the uterine walls to thicken, leading to an enlarged and often tender uterus. This can significantly impact your day-to-day life, especially if it goes untreated.
Adenomyosis affects about 20-35% of women. It’s often misdiagnosed because its symptoms overlap with other conditions like fibroids or endometriosis.
Symptoms
Adenomyosis symptoms can vary in intensity, but they typically include:
- Menstrual Pain: Severe menstrual cramps are a common symptom. These aren’t your typical cramps; they can be intense enough to interfere with your daily activities.
- Heavy Menstrual Bleeding: Women with adenomyosis often experience heavy, prolonged periods. This can lead to anemia, fatigue, and a significant impact on quality of life.
- Chronic Pelvic Pain: Beyond just menstrual pain, chronic pelvic pain is a frequent complaint. This pain can persist between periods, creating a constant sense of discomfort.
- Enlarged Uterus: Adenomyosis can cause the uterus to enlarge and become tender, leading to feelings of pressure or bloating in the abdomen.
- Pain During Intercourse: Many women with adenomyosis report discomfort or pain during sexual activity, which can affect intimate relationships and emotional well-being.
- Fertility Issues: In some cases, adenomyosis can lead to difficulties with fertility, making it harder to conceive or maintain a pregnancy.
Causes and Risk Factors of Adenomyosis
- Hormonal Imbalance
Estrogen, the hormone that regulates the menstrual cycle - Chronic inflammation of the uterine lining, possibly due to childbirth or surgery.
- Previous Uterine Surgery
- Age and Childbirth
Medications
For many women, the first line of treatment involves managing symptoms with medications. Over-the-counter pain relievers like ibuprofen or naproxen can help reduce menstrual cramps and pelvic pain. Hormonal therapies, such as birth control pills or hormonal IUDs, can also help manage heavy bleeding and alleviate pain by controlling the menstrual cycle.
Surgical Options
When medications aren’t enough, or if symptoms are particularly severe, surgery may be an option. Where other treatments have failed, a hysterectomy (removal of the uterus) may be recommended. This procedure completely eliminates adenomyosis but is a significant surgery with a longer recovery time.
Non-Surgical Treatments
Endometrial Ablation
Endometrial ablation, also sometimes referred to as a uterine ablation procedure, offers several benefits for women experiencing heavy menstrual bleeding. As a minimally invasive, non-surgical procedure, it significantly reduces menstrual flow, with some women experiencing little to no bleeding afterward. It provides a quick recovery with minimal discomfort, allowing most patients to return to normal activities within a few days.
Unlike hormonal treatments, endometrial ablation does not require ongoing medication and can be a good alternative for those who cannot tolerate hormones. Also,by avoiding the need for a hysterectomy, endometrial ablation provides a less invasive option for symptom relief while preserving the uterus.
After their endometrial ablation procedure, many women experience improved quality of life, reduced anemia, and relief from the fatigue and discomfort caused by excessive bleeding. However, this procedure is not recommended for women who wish to become pregnant, as it can make future pregnancies high-risk, and it may not be the most effective treatment for adenomyosis in all cases.
Embolization
In the past, the primary treatment for adenomyosis often involved a hysterectomy (surgical removal of the uterus). However, at ECCO, we offer safer alternatives including embolization. Embolization is a minimally invasive procedure that effectively targets the affected tissue while preserving the uterus.
During the procedure, your interventional radiologist carefully guides a thin catheter into the arteries supplying blood to the abnormal tissue, using real-time X-ray fluoroscopy to pinpoint the exact location. A specialized solution of embolizing particles is then injected into these arteries, blocking blood flow and causing the affected tissue to shrink and gradually die off.
This outpatient procedure is performed in our state-of-the-art office-based laboratory, eliminating the need for hospitalization. Because there are no surgical incisions, the risks are minimal, and the uterus remains intact, meaning you may still have the ability to become pregnant if desired. Many patients experience significant symptom relief—often as soon as their next menstrual cycle—without the long recovery or risks associated with surgery.
Why Choose ECCO Medical?
If you’re struggling with adenomyosis, our team, led by board-certified interventional radiologist Dr. Aaron Kovaleski, has extensive experience and expertise in performing UFE, with a focus on patient care and successful outcomes. We are dedicated to providing the support you need throughout the entire treatment process. To learn more about how UFE can help with adenomyosis, contact us today for a consultation.
