New Delhi, India

Adenomyosis is a chronic uterine illness that affects around one in five women, yet not many people are aware of it. Adenomyosis can cause symptoms such as irregular and excessive menstrual flow and pelvic discomfort. Patients differ in the degree of their symptoms; up to one-third of women with adenomyosis may experience none at all or very mild symptoms.

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Fertility may also be affected by the condition. When adenomyosis-afflicted women do get pregnant, their chances of miscarrying, giving birth before term, developing pre-eclampsia, and bleeding after delivery are higher.

What causes adenomyosis?

The uterus has two main layers. Embryos implant in the endometrium, which is the inner layer. If there is no pregnancy, this layer sheds during your period. The myometrium is the uterus' muscular layer. It expands during pregnancy and causes contractions. Endometrium-like cells are detected in the myometrium place in adenomyosis patients.

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It is believed that either medical operations or the normal processes of the menstrual cycle, pregnancy, and delivery, cause damage to the area between the endometrium and myometrium.

When endometrial tissue layer injury is not properly repaired in certain women, aberrant growth and penetration of endometrial-like cells into the myometrium occurs. They cause discomfort and bleeding by interfering with the myometrium's regular processes. There could be several contributing pathways and no single common disease-causing cause for adenomyosis.

How to diagnose adenomyosis?

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Adenomyosis is a difficult condition to diagnose. Historically, the presence of endometrium-like cells in the myometrium could only be verified by pathology assessment where the myometrium is examined under a microscope after a hysterectomy (surgery to remove the uterus).

Recent years have seen increased diagnoses with the development of imaging technologies such as MRI and detailed pelvic ultrasound. Although adenomyosis is now commonly identified without the need for a hysterectomy, doctors are still working towards developing a standardized method for non-surgical diagnosis.

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As a result, it remains uncertain exactly how many women have adenomyosis. Although we know that around 20 per cent of women having hysterectomies for reasons other than suspected adenomyosis are found to have evidence of the condition on pathology assessment.

Adenomyosis is a tough disorder to detect. Because of this, the precise number of women who have adenomyosis is yet unknown. Although data indicates that the condition is more common in older women, the exact cause of adenomyosis remains unknown.

How can you treat adenomyosis?

Hormonal treatments include progesterone-containing tablets and oral contraceptives. Tranexamic acid is one of several non-hormonal therapies. The goal of these therapies is to reduce menstrual bleeding. Nonsteroidal anti-inflammatory medications are commonly used to relieve pain. If medication therapies do not provide significant relief from symptoms, surgical alternatives include excision of the focal lesions or a hysterectomy.

(With inputs from agencies)