Many individuals are unfamiliar with adenomyosis, a chronic condition that impacts the uterus, but it affects as many as one in five women. Adenomyosis can lead to symptoms like irregular and heavy menstrual bleeding, pelvic pain, and can also impact fertility, leading to an increased risk of miscarriage and other complications for pregnant women. Despite the prevalence of this condition, there is still much to learn about its causes, diagnosis, and treatment.
The cause of adenomyosis involves endometrium-like cells found in the myometrium, which is distinct from but often coexists with endometriosis. Detecting adenomyosis has historically been challenging, requiring pathology assessment post-hysterectomy, but new imaging technologies like MRI and detailed pelvic ultrasound have led to increased diagnoses without surgical intervention. However, a standardized non-surgical diagnosis method is still being developed.
Adenomyosis presents as either focal lesions or diffused tissue growth in the myometrium and can be categorized by the depth of endometrial-like tissue invasion. Despite ongoing research, the relationship between the type or depth of lesions and symptoms remains unclear. The prevalence of adenomyosis increases with age, and it is associated with damage to the region between the endometrium and myometrium, potentially triggered by natural processes, pregnancies, childbirth, or medical procedures.
Treatment options include hormonal and non-hormonal medications to manage symptoms and minimize bleeding, as well as surgical procedures when medical treatments are ineffective. However, the variability in treatment effectiveness suggests that there may be different types of adenomyosis that require tailored strategies.
Despite its impact on many women, adenomyosis lacks sufficient clinical and research attention, requiring a heightened focus on improving understanding, diagnosis, and treatment options. Specialists continue to strive for a non-invasive diagnostic method and ultimately a cure for this widespread yet relatively unknown disorder.
Jen Southcombe, Principal Investigator/Group Leader, Nuffield Department of Women’s and Reproductive Health, University of Oxford and Nura Fitnat Topbas Selcuki, PhD Candidate, Nuffield Department of Women’s and Reproductive Health, University of OxfordThis article is republished from The Conversation under a Creative Commons license. Read the original article.An earlier version of this article was published in May 2023.
