Adenomyosis is a condition that affects a relatively large percentage of women of reproductive age. Adenomyosis presents with symptoms that include painful, heavy periods, unusually long periods, severe pelvic pain, and painful intercourse. Adenomyosis also causes an enlarged uterus and can cause infertility, recurrent miscarriages or premature birth. With adenomyosis, the endometrial tissue that forms in the lining of the uterus invades and grows inside the wall of the uterus, specifically the myometrium which is the muscular wall of the uterus. The tissue causes the uterus to swell to double or even triple its normal size.
Diagnosis of adenomyosis
Adenomyosis is most often diagnosed when a woman seeks medical help for one of the symptoms, such as severe pain, irregular periods or inability to conceive, or repeated miscarriages. If adenomyosis is suspected to be possible, the specialist will confirm the diagnosis using the following tests:
- Pelvic examination: Your doctor may notice that you have an enlarged uterus, which is softer and painful to the touch.
- Transvaginal ultrasound: Using sound waves to image your pelvic organs can show thickening of the muscle wall of the uterus.
- Magnetic resonance: An MRI may show uterine wall thickening or uterine enlargement, which is usually indicative of adenomyosis.
- Biopsy: In severe cases and as a last resort, a biopsy of the uterus proves adenomyosis, but this can only happen after a hysterectomy (removal of the uterus).
Causes, treatment and possible risks
Because the symptoms of adenomyosis are similar to other diseases, such as endometriosis and uterine fibroids, a medical diagnosis is essential. Most cases of adenomyosis occur in women over the age of 35. The growth of the tissue inside the uterine wall depends on estrogen, so treatment may include hormonal drugs. Doctors also consider other treatment options, including uterine artery embolization.
The exact cause of developing adenomyosis is not known, however, many researchers believe that the cause of the condition could be due to the following:
- Invasive tissue growth that occurs when cells invade the muscle of the uterine wall.
- Inflammation of the uterus after childbirth can cause a tear in the lining of the uterus and allow cells to invade.
- The development of the fetus can lead to abnormal positioning of the endometrial tissue.
Risks for developing adenomyosis include:
- Previous surgery on the uterus, such as curettage, removal of uterine fibroids, or caesarean section.
- Childbirth
- age over 35, however, recently, doctors have seen an increase in adenomyosis diagnoses in younger women.
How adenomyosis affects your fertility
Recent studies show that adenomyosis often occurs at the same time as other conditions that affect fertility, such as endometriosis, uterine polyps, and fibroids. Adenomyosis alone can affect implantation, the receptivity of the uterine lining and could potentially distort the fallopian tubes preventing fertilization. As mentioned above, if you become pregnant you are at a much higher risk of miscarriage or premature birth than normal. This is why it is so important to work with a specialist if you are diagnosed with adenomyosis.
The most successful way to conceive and get pregnant is through IVF combined with GnRH agonists (Lupron). Lupron is a successful way to reduce estrogen and slow the growth of adenomyosis, improving the chances of implantation through IVF. However, because the condition carries twice the risk of miscarriage, in many cases surrogacy is indicated, along with IVF using your eggs and your partner's sperm.
Treatment of adenomyosis
If you have been diagnosed with adenomyosis, you know that the condition itself can bring about changes in your life. Pain and heavy bleeding make it difficult to make plans and these excruciating periods leave you exhausted and fertility concerns add to it. This is the time to be as kind to yourself as possible and, by all means, seek professional medical help. While much is still being discovered and understood about adenomyosis in the medical community, it is important to find a team that will care for you and help you on your journey. As with any medical diagnosis, your experience is yours and unique to you. Contact today the Center for Reproductive Medicine “Dr. Alexandros Traianos" and together we will help you find the answers you are looking for. For information call the phone 
(+30) 2310 277 032 or send a message to 
email alexandrostraianos@gmail.com.
