Adenomyosis

INTRODUCTION:

• Adenomyosis is a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). 
• Adenomyosis is a common condition.
• It is most often diagnosed in middle-aged women and women who have had children.

ETIOLOGY:

• Hormones : including estrogen, progesterone, prolactin, and follicle stimulating hormone — may trigger the condition.
• Some studies also suggest that women who have had prior uterine surgery may be at risk for adenomyosis.

CLASSIFICATION:

• Focal: As the name indicates, focal adenomyosis is adenomyosis in one particular site of the uterus.
• Adenomyoma: Adenomyoma is a form of focal adenomyosis, but it is more extensive, as it results in a uterine mass or benign tumor, similar to uterine fibroma.
• Diffuse: Unlike the other two classifications, diffuse adenomyosis is spread throughout the uterus

SYMPTOMS:

While some women diagnosed with adenomyosis have no symptoms, the disease can cause:

• Heavy, prolonged menstrual bleeding
• Severe menstrual cramps
• Infertility
• Abdominal pressure and bloating
• Painful periods and cramps (dysmenorrhea)
• Heavy menstrual bleeding (menorrhagia), which can include clots
• Painful bowel movement (dyschezia)
• Bladder symptoms including uncomfortable urination (dysuria), burning urination or blood in the urine (hematuria)
• Peripheral nerve numbness or weakness (neuropathy), which can cause leg or bowel pain during periods
• Pain upon sexual intercourse (dyspareunia)
• Inflammation of the uterus
• Deficiency of blood cells or hemoglobin (anemia)
• No symptoms: It can be common for some woman to present with no symptoms at all and not even know they have the disease  

• Physical examination
• MRI
• Transvaginal ultrasound