Angela Onwuzoo
Maternal health experts have said women experiencing regular pain and heavy bleeding during each menstrual cycle should be investigated for adenomyosis.
The gynaecologists said though endometriosis and adenomyosis could co-exist in a woman and share similar features, they are, however, different conditions.
The physicians said a lot of women battling with adenomyosis mistake it for fibroid, while also clarifying that the condition is different from fibroid despite having similar symptoms such as heavy menstrual bleeding and fertility challenges.
The maternal health specialists advised women to seek medical assistance if they experience symptoms such as heavy menstrual bleeding, severely painful cramps, or painful intercourse.
According to the Mayo Clinic, adenomyosis occurs when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus.
The displaced tissue the clinic says will continue to act normally — thickening, breaking down, and bleeding — during each menstrual cycle, leading to heavy and painful periods.
The gynaecologists said adenomyosis affects the quality of life of women battling with the condition due to the severe pain they experience regularly.
According to them, Magnetic resonance imaging popularly known as MRI could be effectively used to diagnose adenomyosis, adding that the cause of the condition is unknown.
They, however, assured of available treatment options for adenomyosis which women diagnosed with the condition could adopt especially, High-Intensity Focused Ultrasound – HIFU, to put an end to the constant pain.
HIFU is a non-invasive method of treating adenomyosis.
Speaking at an awareness webinar on adenomyosis, a consultant gynaecologist and fertility expert, Dr Abayomi Ajayi, expressed concern that despite the improvement of diagnostic equipment, the awareness of the condition is still very low among women and clinicians.
Ajayi, who is the Medical Director and Chief Executive Officer of Nordica Fertility Centre, Lagos, said pain is a major concern in adenomyosis, stressing that pain affects the quality.
He also pointed out that although adenomyosis is not a life-threatening condition on its own, it can cause severe discomfort and lead to complications if left untreated.
The gynaecologists noted that the condition is more common in women who have had children, adding however, that women who have never been pregnant could also develop it.
Although the statistics on the number of women battling with adenomyosis are scanty, the physician said women seen at the fertility clinics are presenting with the condition, disclosing that the condition could affect fertility and IVF.
Ajayi said, “Adenomyosis is a uterine disorder where the cells that normally form a lining inside the uterus, also grow in the muscle wall of the uterus.
“It is a condition that causes the uterus to thicken and enlarge. It occurs when the endometrial tissue grows into the outer muscular walls of the uterus, causing the uterus to enlarge in size and leading to abnormal uterine bleeding and painful periods.
“The displaced tissue continues to act normally every month which means thickening, breaking down, and bleeding during each menstrual cycle. This eventually causes the related symptoms and makes the uterine walls grow thicker.
“It is necessary to be aware that adenomyosis and endometriosis are different. Both are disorders that involve the endometrial tissue and both conditions can be painful.”
Adenomyosis, the fertility specialist noted is more likely to cause heavy menstrual bleeding, than endometriosis.
“The endometrial tissue grows into the muscle of the uterus in adenomyosis, while for endometriosis, it grows outside the uterus and may involve the ovaries, fallopian tubes, pelvic side walls, or bowel. You should consult your doctor if you suspect either adenomyosis or endometriosis.
“The true cause of adenomyosis remains unknown. But it is established that its growth depends on estrogen which is why it is seen in women in their reproductive years.
“The main symptom is mild to severe pain, but you may not experience pain at all. Other symptoms may include prolonged menstrual cramps, heavy menstrual bleeding, or pain during sexual intercourse”, he said.
Commenting on treatment, Ajayi said HIFU is a non-invasive method of treating adenomyosis, adding that certain hormonal medications could be used as well.
He, however, noted that drugs should not be used on women who want to get pregnant in order not to affect ovulation.
He urged women to talk to their healthcare provider about ways to ease symptoms.
In a 2019 study published in PubMed Central journal titled, “Recent advances in understanding and managing adenomyosis”, the researchers said
over the last decade, adenomyosis has also become a condition identified in young fertile-age women while attributing it to recent advancements in imaging techniques,
PMC journal is a biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine.
The researchers, however, said despite the improvement of diagnostic tools, the awareness of the condition is still poor.
“in some patients, adenomyosis coexists with other gynaecological conditions, such as endometriosis and uterine fibroids.
“The development of imaging techniques, such as MRI and transvaginal ultrasonography (TVUS), has allowed clinicians to make a non-invasive diagnosis of adenomyosis in women”, the researchers said.
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