April is Adenomyosis Awareness Month and we feel it’s important to talk about this lesser known, harder to diagnose GYN condition, causing debilitating symptoms that disrupt women’s lives. Adenomyosis commonly affects women in their forties and fifties, although it can occur among teenagers as well, and it is referred to as endometriosis inside the uterus. With adenomyosis the cells that line the inside of the uterus start growing into the muscle of the uterus, which can result in a somewhat enlarged womb. This can cause very painful periods and heavy bleeding.
The exact cause is still unknown, but it seems that childbearing, previous uterine surgery, short menstrual cycles, and early age of first period may be risk factors. Adenomyosis is a chronic GYN condition and it can be temporarily managed with medication, hormone suppression and birth control, however the only cure is hysterectomy.
SYMPTOMS & DIAGNOSIS
Up to 30% of women dealing with adenomyosis have no symptoms at all, and for the rest they vary greatly. Severe symptoms include debilitating pelvic pain and heavy, prolonged menstrual bleeding.
Diagnosis is often made with a high index of suspicion based on the patient’s reported symptoms. Adenomyosis can occur simultaneously with other conditions and it is sometimes missed by clinicians. They can assume symptoms like heavy bleeding are caused by another GYN condition like fibroids. However, if only the fibroids are removed, the adenomyosis will still be there and the patient will continue to struggle with heavy bleeding.
An MRI is the best imaging study to diagnose adenomyosis but is very expensive. An ultrasound can also be used to look for adenomyosis but it is less sensitive than an MRI. As imaging studies are not completely accurate, a definitive diagnosis of adenomyosis can be achieved only by having a pathologist examine the uterus after a hysterectomy has been completed.
THE DIFFERENCE BETWEEN ADENOMYOSIS AND ENDOMETRIOSIS
Although adenomyosis and endometriosis can occur together, they are not the same condition. With endometriosis the endometrial cells (the lining of the uterus) are in a location outside of the uterus, while with adenomyosis these cells exist or grow into the uterine wall. Although both can cause pain, endometriosis does not always cause heavy bleeding. Also, with endometriosis a diagnostic laparoscopy will allow the doctor to make a thorough evaluation of the condition and how extensive it is.
MINIMALLY INVASIVE ADENOMYOSIS TREATMENT AT CIGC
There is not a clear separation between adenomyotic tissue and normal uterine tissue, which is why the only cure for adenomyosis is a hysterectomy. It is important to choose an adenomyosis specialist who is trained in minimally invasive procedures and can perform a partial hysterectomy while leaving the ovaries intact to prevent early menopause. Adenomyosis is a disease of the uterus and does not affect the ovaries.
Women who still wish to conceive can temporarily manage symptoms of adenomyosis with medication: continuous birth control pills, hormonal suppression and Depo-Provera, or the Mirena IUD.
At CIGC, adenomyosis surgery is performed using the DualPortGYN surgical technique: two 5 mm incisions and 1 week recovery time following the hysterectomy procedure.
BOOK A CONSULT
If you would like to get an evaluation with a trained GYN specialist at CIGC to go over your options for minimally invasive adenomyosis treatment, call 888-SURGERY or contact us online. Women travel to the DC area from all around the country for CIGC’s innovative procedures through our travel program.
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