Adenomyosis: What You Need to Know
Adenomyosis is a medical condition that has become a growing concern for some women who are trying to get pregnant. This condition often starts to affect female health after age 35.
Adenomyosis occurs when endometrial tissue begins to grow into the muscle layers of your uterus. Normally, your endometrial tissue lines your uterus. But if you have adenomyosis, the tissue begins to implant itself into your uterine muscle.
About 1 in 100 women will have adenomyosis in their lifetime. Women in their 30s and 40s who have had one or more children are most at risk for adenomyosis and infertility.
Here is a list of common adenomyosis symptoms. If these symptoms are happening to you, and you are having trouble getting pregnant, talk to your doctor.
- Painful cramping and heavy bleeding during your period
- Passing blood clots during menstruation
- Unexplained bleeding between your periods
- Pain during sex, especially around the time of your period
- Swelling or tenderness in your lower belly
Also, if you have adenomyosis, your uterus may become two or three times larger than normal. In addition, adenomyosis can cause problems with infertility.
Testing and treatment for adenomyosis and infertility
Before you can begin adenomyosis infertility treatment, your doctor will want to run a number of tests, including:
- Blood work
- A pelvic exam and ultrasound
- Magnetic resonance imaging (MRI) scans
If your adenomyosis symptoms are mild, and your doctor approves, you may just try pain relief medication to reduce any discomfort. However, if you are unable to achieve pregnancy after six months, talk with a fertility specialist. He or she may recommend adenomyosis hormonal and surgical treatments.
Adenomyosis fertility treatments
Make an appointment with a fertility specialist if you have adenomyosis and infertility. The following treatments may help reduce your adenomyosis symptoms, increasing your chances of becoming pregnant in the future:
- Birth control pills
- Intrauterine devices (IUD)
- Gonadotropin-releasing hormone (GnRH) agonists
Some women are able to conceive within a few months after completing these hormonal therapies. If these treatments don't help, your doctor may recommend surgery to help you get pregnant.
Adenomyosis and endometriosis
Adenomyosis may sound similar to other reproductive health conditions like endometriosis and uterine fibroids. Here is how they are different: Endometriosis occurs when endometrial tissue spreads outside of the uterus to other areas of the body. In those cases, the tissue can invade the pelvic region, including the ovaries, fallopian tubes, bladder, and other areas. Alternatively, fibroids are benign growths that appear in the uterus. Remember, adenomyosis is the condition where the tissue grows into the uterine muscle, sometimes causing uncomfortable symptoms and infertility.
Questions for your doctor about adenomyosis
Talk openly with your doctor if you are concerned about adenomyosis and infertility. Here are some questions you can ask your doctor:
- Will medication or surgical treatments for adenomyosis help me get pregnant?
- What are the side effects, risks and benefits of the different adenomyosis fertility treatments?
- Can I start with just medication treatment? How successful might that be?
Help is available for adenomyosis
If you have adenomyosis, medical and surgical treatment options may help to restore your fertility. If you are done having children, a hysterectomy often cures adenomyosis. And, if left untreated, adenomyosis often goes away when you reach menopause.
- Devlieger, R., D'Hooghe, T., & Timmerman, D. (2003). Uterine adenomyosis in the infertility clinic. Human Reproduction Update. 9(2), 139-147;
- Matalliotakis, I., Katsikis, I., & Panidis, D. (2005). Adenomyosis: What is the impact on fertility? Current Opinion in Obstetrics & Gynecology. 17(3), 261-264;
- MayoClinic.com: Adenomyosis.