Adenomyosis — what you should know

Adenomyosis is a condition in which the endometrium (the lining of the uterus) grows into the wall of the uterus.  In worst cases it can even grow all they way through the wall. Adenomyosis can cause heavy bleeding and may also cause severe cramping. 

Adenomyosis is often confused with fibroids.  This can be a serious  error, as the treatment may be quite different. 

On ultrasound examination adenomyosis will often appear as diffuse thickening of the wall, while fibroids are seen as  round areas with a discrete border.  Unfortunately adenomyosis is frequently confused with fibroids on ultrasound unless the examiner is looking for it.   Adenomyosis is usually a diffuse process, and rarely can be removed without taking out the uterus.  Since fibroids can be removed by myomectomy, it is essential to differentiate between the two conditions before planning treatment.  It is also common to have adenomyosis and fibroids in the same uterus.

Endometrial ablation and adenomyosis

Most methods of endometrial ablation treat the lining of the uterus and superficial muscle layers to a depth of about 5 mm (1/4 inch).  Adenomyosis that is deeper than this will not be treated.  This can cause regrowth of the endometrium, resulting in return of heavy bleeding and cramping.

Endometrial ablation is rarely successful in women with severe adenomyosis, so it is important that any woman considering ablation be evaluated for adenomyosis.

 

©2003, Paul Indman, MD. All Rights Reserved
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The medical information presented in this website represents the opinion of Dr. Indman,  and is based on his knowledge and experience. It is not applicable to all patients or physicians. Anyone visiting this or other related medical sites should discuss symptoms, findings, and alternatives with their personal gynecologist.