Adenomyosis


Adenomyosis or internal endometriosis occurs when the tissue that lines the inside of the uterus penetrates the myometrium, or muscular lining of the uterus.

During menstruation, the tissue inside the myometrium swells and bleeds in the same way as the lining of the uterus. This causes blood to pool within the uterine muscle, where it can form benign tumours known as adenomyomas.

Causes

Although the specific cause of adenomyosis is not known, its growth is associated with the hormonal activity of the ovaries and in particular with the production of oestrogen.

Women over 40 who have had more than one childbirth are more likely to develop adenomyosis, particularly if they have had a caesarean section or other uterine surgery.

Symptoms

Menorrhagia (heavy or prolonged menstrual periods)
Dysmenorrhoea (painful menstrual periods)
Dyspareunia (pain during sexual intercourse)
Metrorrhagia (bleeding not related to menstruation)
Anaemia caused by heavy bleeding
Lower back pain

Diagnosis

In addition to a review of the patient's medical history, diagnostic procedures for adenomyosis include:

- A pelvic examination
- A transvaginal ultrasound or Gynecological vaginal ultrasound
- An MRI may be useful when ultrasound does not yield definitive results
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