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Adenomyosis

By

Charlie C. Kilpatrick

, MD, MEd, Baylor College of Medicine

Last full review/revision July 2019 by Charlie C. Kilpatrick, MD, MEd

In adenomyosis, tissue from glands in the lining of the uterus (endometrium) grows into the muscular wall of the uterus. The uterus becomes enlarged, sometimes doubling or tripling in size.

How many women have adenomyosis is unclear, partly because it is hard to diagnose.

Adenomyosis causes symptoms in only some women, usually those aged 35 to 50. Some women with adenomyosis also have endometriosis or fibroids.

The cause of adenomyosis is unknown. Adenomyosis may be more common among women who have had more than one pregnancy.

Symptoms

Symptoms of adenomyosis include heavy and painful periods (dysmenorrhea), vague pain in the pelvic area, and a feeling of pressure on the bladder and rectum. Sometimes sexual intercourse is painful.

Symptoms usually disappear or lessen after menopause.

Diagnosis

  • Ultrasonography or magnetic resonance imaging

Doctors may suspect adenomyosis when they do a pelvic examination and discover that the uterus is enlarged, round, and softer than normal.

Doctors often diagnose adenomyosis based on the results of pelvic ultrasonography or magnetic resonance imaging (MRI). Ultrasonography is often done with a handheld ultrasound device inserted into the vagina (called transvaginal ultrasonography).

However, for a definitive diagnosis of adenomyosis, doctors must examine tissues taken from the uterus. The only way to obtain these tissues is to remove the uterus (hysterectomy).

Treatment

  • A levonorgestrel intrauterine device
  • Birth control pills
  • For severe symptoms, hysterectomy

Using a intrauterine device (IUD) that releases a synthetic female hormone called levonorgestrel can help control the bleeding and painful menstrual periods. Doctors may recommend taking birth control pills (oral contraceptives).

Analgesics may be taken for pain.

If symptoms are severe, a hysterectomy is done. A hysterectomy completely relieves symptoms.

Drugs Mentioned In This Article

Generic Name Select Brand Names
levonorgestrel MIRENA, PLAN B

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