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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

How is Adenomyosis treated?

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.

  • Endometrial Ablation: This procedure involves removing the lining of the uterus to reduce heavy bleeding. It’s less invasive than a hysterectomy but may not be a permanent solution for adenomyosis.
  • Hysterectomy: In more severe cases, 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.
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Non-Surgical Treatments

Embolization


In the past, traditional treatment has involved hysterectomy (surgical removal of the uterus) or ablation. At ECCO, we prefer a safer, gentler, minimally-invasive procedure called Embolization.

During this procedure, your interventional radiologist introduces a thin catheter into the arteries that feed the tissue, pinpointing the exact location via X-ray fluoroscopy. The doctor then injects a solution of embolizing particles into the arteries to close them, which causes the tissues they feed to shrink and die.

The embolization procedure is performed in our office-based laboratory on an outpatient basis. Because there are no incisions, there are few risks from the procedure itself, and the lack of trauma to the uterus means that you may retain your ability to become pregnant, if you so choose. Most patients report significant reductions of their reported symptoms, often as quickly as the next menstrual cycle.

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.