What is adenomyosis, a form of endometriosis inside the uterus? – She

Published on March 25, 2023 at 10:00 am

Severe pain during menstruation is, as with endometriosis, a symptom of adenomyosis.

Severe pain during menstruation is, as with endometriosis, a symptom of adenomyosis. – ©Moyo Studio

This Saturday, March 25, in different places around the world, women and men will meet during the EndoMarch, a march to advance research on endometriosis. Increasingly studied, this chronic disease is very close to another pathology which is less well known to the general public. This is adenomyosis.

According to the French association for the fight against endometriosis, EndoFrance, adenomyosis is “defined as being endometriosis internal to the uterus”. More precisely, “it is an anomaly of the junction zone between the endometrium (mucous membrane which lines the uterus) and the myometrium (muscle of the uterine wall) which will let the cells of the endometrium infiltrate the myometrium”.

With endometriosis, endometrial cells migrate abnormally outside the uterine cavity to sometimes grow on other organs. With adenomyosis, changes only occur inside the uterus. 11 to 30% of the female population would be affected, in a quarter of cases between 36 and 40 years old, according to EndoFrance.

What are the symptoms ?

The symptoms of adenomyosis are very similar to those of endometriosis. Among them, very heavy and long menstruation (menorrhagia), bleeding outside menstruation (metrorrhagia), pain during menstruation (dysmenorrhea), pain during sexual intercourse (profound dyspareunia), and pain between menstruation, notes the IFEM Endo endometriosis institute. In some cases, adenomyosis is “associated with uterine fibroids, which are also a cause of bleeding and pelvic pain.” But sometimes adenomyosis has no symptoms.

How to diagnose it?

An ultrasound and then a hysteroscopy (examination that allows you to visualize the inside of the uterus) make it possible to diagnose adenomyosis.

According to EndoFrance, “we encounter the most adenomyosis in women who have had several children, or who have a very developed endometrium (uterine mucosa) (we then speak of endometrial hyperplasia)”.

What are its consequences?

The Endo France association is reassuring. Adenomyosis is “a frequent and benign pathology in the medical sense of the term”, even if it can be very difficult to live with on a daily basis.

On the other hand, if the adenomyosis is very large, it can make it difficult to implant the embryo and lead to a greater risk of miscarriage.

How to treat adenomyosis?

If the person with adenomyosis does not want to get pregnant, it is mainly hormonal treatments, such as a progestogen or an IUD, which will be used to relieve the symptoms, in particular heavy periods. Some health professionals also recommend other forms of care, for example from nutritionists and osteopaths.

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