More Than A Painful Period
What can feel like painful menstrual cramps can actually be adenomyosis. A woman’s uterus has a thin outer lining called the endometrium. Right beneath the lining is the sub-endometrium, a junctional zone before the myometrium. In some women, this area thickens unexpectedly. Cells from the endometrium penetrate the junction and even the myometrium. This is called adenomyosis. Adenomyosis causes heavy bleeding and intense pelvic pain during menstruation.
Diagnosing and treating adenomyosis
Doctors often misdiagnose adenomyosis since there are similar symptoms to other issues like fibroids. An MRI, rather than an ultrasound, can help with adequately confirming adenomyosis. A woman with a sub-endometrium of at least 12mm is said to have adenomyosis. In many cases, the woman can also have endometriosis. Treatment options include NSAIDs and, in some patients, hormone therapy. Surgery is a more effective treatment, including endometrial ablation, uterine artery embolization, or a hysterectomy.
Does the condition affect fertility?
Studies on the relationship between adenomyosis and fertility are limited. Doctors are not entirely sure but believe there is evidence linking the two. A thickened sub-endometrial lining can block sperm from reaching the egg and embryos from reaching the uterus. Women with the condition also have a higher inflammatory response, which can increase the risk of miscarriages. And since many of these women also have endometriosis, fertility is affected. Furthermore, statistics show that adenomyosis mostly happens in middle-aged women. This group naturally has lower pregnancy rates. So with the condition, the chances of pregnancy drop further.
Getting the right fertility treatment
Unfortunately, non-surgical treatment options are temporary. Hormonal medication helps with reducing estrogen levels, which may improve the uterine lining. That may help improve the chances of a natural pregnancy. Women with uterine artery embolization can also become pregnant. Surgical options like ablation or hysterectomy, however, stop natural pregnancies altogether. Therefore, some family planning must take place beforehand. In vitro fertilization (IVF) may be helpful in this case. Fertility clinics can extract eggs from the ovaries for future use. However, the best case would be surrogacy.
Research goes on
Scientists continue to learn the ins and outs of adenomyosis and the relation with fertility. Since many women with adenomyosis also have endometriosis, experts struggle with pinpointing adenomyosis as the cause of fertility issues. In the interim, hormonal therapy may help with natural pregnancies, but IVF is useful. Speak with a doctor about pain, heavy bleeding, and discomfort today. A healthcare provider can provide diagnosis and treatment options.