DefinitionAdenomyosis is uterine thickening that occurs when endometrial tissue, which normally lines the uterus, moves into the outer muscular walls of the uterus.
Alternative NamesEndometriosis interna; Adenomyoma
Causes, incidence, and risk factorsThe cause is unknown. Sometimes adenomyosis may cause a mass or growth within the uterus, which is called an adenomyoma.The disease usually occurs in women older than 30 who have had children.
SymptomsLong-term or heavy menstrual bleedingPainful menstruation , which gets increasing worsePelvic pain during intercourseNote: In many cases, the woman may not have any symptoms.
Signs and testsDuring a pelvic exam, the doctor may find an soft and slightly enlarged uterus. The exam may also reveal a uterine mass or uterine tenderness.An ultrasound of the uterus may help tell the difference between adenomyosis and other uterine tumors. MRI can be helpful when ultrasound does not give definite results.
TreatmentMost women have some adenomyosis as they near menopause but few women have symptoms, and most women don’t require any treatment.In some cases, pain medicine may be needed. Birth control pills and a progesterone-containing intrauterine device (IUD) can help decrease heavy bleeding.A hysterectomy may be necessary in women with severe symptoms.
Expectations (prognosis)Symptoms usually go away after menopause. A hysterectomy completely relieves symptoms.
Calling your health care providerCall for an appointment with your health care provider if you develop symptoms of adenomyosis.
ReferencesKatz VL. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 18.Meredith SM, Sanchez-Ramos L, Kaunitz AM. Diagnostic accuracy of transvaginal sonography for the diagnosis of adenomyosis: systematic review and metaanalysis. Am J Obstet Gynecol. 2009;201:107.e1-6.