Adenomyosis and Endometriosis

Alright guys, some of you will have read our blog post on understanding the basics of endometriosis (if not, you’ve gotta check it out! Click here to read) but now it’s time to deepen our understanding of adenomyosis. Yep, it sounds scary but we’re here to break it down for you (who comes up with these names anyway). Adenomyosis was once considered the same condition as endo but there are clear differences between the two. 

What is adenomyosis and how is it different to endo?

First things first, adenomyosis is when you see the abnormal endometrial tissue developing within the muscle of the womb. The main difference between endometriosis and adenomyosis is where the endometrial tissue grows. 

With endometriosis the endometrial tissue grows outside of the uterus (pelvis, stomach, lungs, fallopian tubes, ovaries, bowel, anywhere really), whereas with adenomyosis, the endometrial tissue grows in the muscle of the uterus. 


Symptoms

Adenomyosis is more common in people who have had children. Typically, if you have adenomyosis you will have painful and heavy periods, a bulkier uterus (but I mean, who really measures the lining of their uterus. Not your typical Saturday night activity), irregular menstrual bleeding or maybe bleeding between periods and experience pain after sex (usually minutes and hours after).

For endo, you will experience painful periods that are not necessarily heavy and sex will be painful during sex not afterwards. Here is a bit of a breakdown to make it easier to understand:

Adenomyosis 

Endometriosis 

  • Painful periods 
  • Painful periods (or pain at anytime throughout the cycle)
  • Heavy periods
  • May or may not experience heavy periods 
  • Pain after sex
  • Pain during sex
  • Abnormal bleeding 
  • Abnormal bleeding 
  • Chronic pelvic pain
  • Pelvic or bowel pain
  • Enlarged uterus 
  • Fatigue, nausea or diarrhea during your period 

There’s a lot of overlap between the two conditions as some people may have both conditions but typically, adenomyosis will be seen in people who had endometriosis in their 30s or 40s rather than their teens or twenties. 


Diagnosis

Adenomyosis can be difficult to diagnose but usually healthcare professionals will perform one or more of the following tests:

  • Pelvic exam- usually the area will be tender to touch 
  • Ultrasound- these can be useful but can miss some forms of the condition
  • Imaging scans/MRI- this can show uterine enlargement and thickening of certain areas of the uterus which can indicate adenomyosis 
  • Biopsy- this can only be done after a hysterectomy (removal of the uterus) when the adenomyosis deposits are sent to a pathologist for further testing. 

Is there a cure?

Sadly, there’s no “cure” for adenomyosis. As you cannot remove adenomyosis deposits, a hysterectomy is the only surgical option to fully “cure” the condition. Treatment options such as pain killers or the Mirena coil have been recommended to manage symptoms. Lifestyle can cause an overlap between adenomyosis and IBS symptoms as both are inflammatory conditions and triggered by poor diet. Everything we consume that encourages inflammation is like starting a fire within our body. So what do we want to do? We want to reduce the number of fires we start meaning we must alter our diet. 

We all know the usual spiel about avoiding alcohol, excess caffeine, red meat, dairy, gluten (I mean honestly what’s left after that?), but for this condition, it’s important to take a personalised approach and understand what starts the fire in the first place. From there we can learn to manage or alter our diet to avoid or minimise those problematic foods. We don’t need to get rid of all joy from our life, yes I’m talking about that glass of wine on a Friday night, or coffee first thing in the morning - we need to survive, right?

Speaking with a dietician can really help as the more improvements you make to your diet and lifestyle, the more you’ll reduce your symptoms. Although some people find supplements as a saving grace, there have been no supplements that are scientifically proven to reduce symptoms. Everything is highly personal with this condition, and it’s all about finding what works for you. I mean, who knows our body better than us? 

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