MRI (photo NIH file)
Adenomyosis is a condition where the lining of the uterus (also called the endometrium) starts to grow into the actual wall or muscle of the uterus. Although the exact cause is unknown, because adenomyosis is uncommon among women who have never been pregnant many doctors believe that trauma caused by stretching of the uterus during pregnancy or surgery (such as a c-section or an abortion) may play a role.
Adenomyosis can only truly be diagnosed when a pathologist evaluates the uterus after a hysterectomy; however, an ultrasound or an MRI may suggest the presence of the condition.
While many gynecologists have long blamed adenomyosis as a cause of painful periods, pelvic pain, and/or heavy periods, Dr. Michelle Morrill, Chief of Urogynecology at Kaiser San Francisco, says a study published last year sheds new light on the condition and that “adenomyosis may not be the culprit we once thought it to be.” That study, published in the medical journal Fertility and Sterility evaluated hysterectomy specimens from 137 women - surprisingly almost 50% of women had adenomyosis. What was fascinating about this study was not how common adenomyosis was, but that it was no more common among women who had symptoms, such as pelvic pain or heavy menstrual bleeding, than it was among women who had no symptoms at all. The authors of this study concluded that adenomyosis “may not actually be a disease per se but rather a normal variant.”
While Dr. Morrill admits, “we shouldn’t necessarily change medical practice based on one study” she believes it may be time for researchers and doctors alike to rethink the role of adenomyosis in conditions such as pelvic pain and heavy periods.
For more info: on adenomyosis
Remember, this column does not represent individual medical advice
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