Uterine adenomyosis is a condition in which tissue from the inner lining of the uterus grows into the muscle wall of the uterus (myometrium) causing heavy, menstrual painful periods.
Adenomyosis is frequently seen along with other uterine problems such as endometriosis, a condition in which endometrial cells (the lining of the uterus) grow outside of the uterus. Both adenomyosis and endometriosis cause pain, but endometriosis does not usually result in heavy menstrual periods.
Uterine artery embolization blocks the blood supply to the uterus, which helps shrink uterine adenomyomas but the only cure for adenomyosis is surgical removal of the uterus (hysterectomy).
Treatments that may reduce heavy bleeding due to adenomyosis include:
- Intrauterine devices (IUDs), specifically one which releases the hormone progestin
- Endometrial ablation is a surgery to scar the lining of the uterus, which makes periods lighter
- Uterine artery embolization
Treatments for pain due to adenomyosis include:
- Birth control pills
- Over-the-counter pain medications, such as ibuprofen (Advil, Motrin)
- Leuprolide (Lupron, Eligard) which causes the ovaries to stop producing estrogen and progesterone
The Adenomyosis Advice Association’s recommended diet includes foods such as:
- Fruits
- Vegetables
- Whole grains
- Beans and legumes
- Coconut or almond milk (avoid soy milk)
- Nuts
- Eggs
- Fresh fish
- Honey and molasses
- Fruit teas
- Cold-pressed olive oil
- Certain herbs: garlic, basil, cinnamon, caraway, dill, ginger, parsley, peppermint, rosemary, sage, and thyme
Foods that may aggravate adenomyosis symptoms that the Adenomyosis Advice Association recommends limiting or avoiding include:
What Are Symptoms of Adenomyosis?
Symptoms of adenomyosis include:
- Heavy periods
- Prolonged menstrual bleeding
- Painful periods/menstrual cramping (may be severe)
- Chronic pelvic pain
- Lower abdominal pain or tenderness
- Abdominal bloating/swelling
- Pelvic pressure
- Blood clots in the pelvis and legs
- Painful intercourse
- Pain in the back and legs
What Causes Adenomyosis?
The cause of adenomyosis is unknown but the condition may be due to:
- Hormones
- Bone marrow stem cells enter the uterine muscle
- Inflammation of the uterus following childbirth
Risk factors for developing adenomyosis include:
- Early age of menstrual onset
- Short menstrual cycles
- Childbirth
- Cesarean section
- Middle age
- Previous uterine surgeries
- Removal of uterine fibroids (myomectomy)
How Is Adenomyosis Diagnosed?
If adenomyosis is suspected, a medical history and pelvic examination is performed. A pelvic exam may find an enlarged and soft uterus. The uterus may also be mobile, meaning it moves around and is not fixed in place.
An imaging test such as ultrasound may indicate a suspected diagnosis of adenomyosis, however, the only way to confirm a diagnosis of adenomyosis is based on pathology of the uterus which is evaluated after removal of the uterus (hysterectomy).
Imaging tests may include:
Blood tests may be used to rule out pregnancy, check for anemia, or exclude other conditions.
In some cases, an endometrial biopsy is performed in which a small piece of tissue from the lining of the uterus is removed and sent to a lab for examination. It is usually performed to rule out endometrial hyperplasia (thickening of the lining of the uterus) or cancer.
From
https://www.adenomyosisadviceassociation.org/What-Should-I-Eat-.html
https://www.uptodate.com/contents/uterine-adenomyosis-the-basics?search=Adenomyosis&source=search_result&selectedTitle=1~55&usage_type=default&display_rank=1
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194011