Adenomyosis | Dr Lora Liu | Pelvic Rehabilitation Medicine

Dr. Lora Liu explains what adenomyosis is and how it can be treated.

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Adenomyosis is where the endometrial glands and stroma are not limited to the endometrium. They end up in the myometrium, which is the outer layer of the uterus, which is the muscle of the uterus. It's basically endometriosis of the uterus. Women generally complain of uterine pain. They can have a lot of cramping associated with their periods or heavy uterine bleeding, central pain. The way adenomyosis is diagnosed, you can see signs of it on imaging such as ultrasound or MRI. CT scans usually won't pick that up, but the definitive diagnosis is with tissue, and that's usually with a hysterectomy.

For women who are not yet done having babies and want to have more kids and we think that they may have adenomyosis, we can again, manage your symptoms. Most of the time, it's just with hormones, such as the progesterone only IUD. Sometimes, combined oral contraceptive medications can help and then again, with just the symptoms with pain, painful periods. A lot of times, nonsteroidal anti-inflammatory drugs such as Motrin, ibuprofen, or Advil can also help with that.

Some of the risk factors for developing adenomyosis are prior uterine surgeries, such as an open myomectomy or a C-section because that enables the endometrial cells to spread into the muscle of the uterus. Women who have had more children may be at a higher risk of developing adenomyosis as well. Again, this is a very difficult disease to diagnose because the definitive diagnosis is with hysterectomy. But like I said before, there are signs on imaging that can suggest adenomyosis. If adenomyosis is left untreated, you will have to deal with the symptoms which can be a huge quality of life issue for women. There's also been suggestions that it might decrease fertility or that it might increase complications of pregnancy.

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