Painful, Heavy Periods? What You Need To Know About Adenomyosis

If your period has become uncomfortably heavy and painful, you might have a condition called adenomyosis. It’s not cancerous, but it may make you miserable for several days each cycle. Doctors can’t cure adenomyosis, but they can make you more comfortable.

What Is Adenomyosis?

Adenomyosis is a uterine issue. Your uterus — the pear-shaped organ where babies reside until they’re born — has three layers. The inside one, the endometrium, thickens every month, then sheds blood: that’s your period. If you have adenomyosis, some of the endometrium grows into the wall of muscle that surrounds it. It might even inflame that muscle. The wayward endometrium still thickens, then sheds blood, cyclically, only now menstruation becomes more uncomfortable.

A third of women with adenomyosis don’t even know it. Some have mild discomfort and ignore it.

But if after years of regular periods with the expected irritating aches and pains, you start to have a worse experience: more blood flowing, stronger cramps, longer spells of menstruation, it might be adenomyosis. You have ways to stop the pain.

There’s only one way to know for sure you have adenomyosis — a hysterectomy. Doctors need to examine your removed uterus to see for sure that your endometrium expanded into the muscle. Still, modern medicine allows for educated guesswork.

How Is Adenomyosis Diagnosed?

To figure out if this is your issue, your medical team may take several steps:

• Assess your age. Most women with adenomyosis are in the tail end of their childbearing years, i.e. in their 40s, although younger women occasionally get it, too.

• Look at risk factors. The busier your uterus has been, the higher your chances of developing adenomyosis. That includes multiple pregnancies, along with procedures such as dilation and curettage (D&C) and Caesarean sections.

• Examine the pain. Adenomyosis patients often feel pain from the back shoot into the leg and vagina like a bolt.

• Consider infertility. If you’re struggling to conceive, adenomyosis could be the cause.

• Get imaging. Vaginal ultrasounds and pelvic MRIs have improved to the point where they can help diagnoses. Your team might measure the thickness of the zone between the endometrium and muscle, see the adenomyosis in a fibroid, spot cysts inside the muscle or even notice suspicious changes in the muscle lining.

How To Treat and Manage Adenomyosis Symptoms

Although the only cure for adenomyosis is removing the uterus, you can talk to your doctor to see if you are a candidate for these alternative treatment options.

• Embrace medication. There is no drug on the market that is FDA-approved and labeled for treatment of adenomyosis, but some drugs meant for other issues might suppress your symptoms. Talk to your doctor about repurposing drugs designed for endometriosis and fibroids to see if they might help you.

• Visit the pharmacy. Nonhormonal prescription medications like tranexamic acid can curtail bleeding.

• Maintain fertility. If you may want to get pregnant in the future, safe choices that can suppress symptoms include progesterone hormonal IUDs, oral progesterone, some birth control pills and GNRH-based medications.

• Buy over-the-counter. If your symptoms are mild, try over-the-counter anti-inflammatory products like ibuprofen.

• Ask about ablation. Some people have success with newly emerging radiofrequency ablations, where a special machine essentially burns the affected areas of the uterine muscle.

• Have your uterus removed. If you’re done with pregnancy and can’t treat your symptoms, consider having a hysterectomy.

Potential Complications and Impact on Pregnancy

Nobody talks about adenomyosis, yet so many people have it. While most are only uncomfortable, severe adenomyosis can have an impact on fertility and increase the risk of miscarriage. It can up your chances of preeclampsia during pregnancy and post-partum hemorrhage afterward. It has been associated with pre-term labor, pre-term birth, and the placenta separating from the uterus.

If you’re bleeding heavily, for too long or with too much discomfort, ask your OB-GYN if adenomyosis might be the cause. It’s a benign issue but you need to know it’s there so you can keep it under control.

This content is not AI generated.