Are your heavy periods due to adenomyosis?

Adenomyosis is a condition where small islands of tissue from the lining of the uterus (endometrium) get into the wall of the uterus (myometrium), causing the uterus to become enlarged. The condition can cause menstrual cramps, lower abdominal pressure, bloating before periods and heavy periods. It’s mostly diagnosed in middle-aged woman and women who have had children. Obstetrician and gynaecologist Mr Michael Booker tells us how to diagnose and treat adenomyosis.

How is adenomyosis diagnosed?

Adenomyosis can be suspected with a physical examination and can be measured with a transvaginal ultrasound. The most reliable diagnostic imaging procedure for adenomyosis is an MRI scan.

Although it is not a dangerous condition, it can cause heavy menstrual periods and pain. For some women these symptoms can be severe and distressing, sometimes necessitating emergency hospital treatment. Occasionally, a blood transfusion may be required. However, it is a benign condition, and there is no connection between adenomyosis and cancer.

Without treatment, the symptoms tend to progress, but the woman eventually obtains relief when she reaches menopause.

How is adenomyosis treated?

The treatment for adenomyosis is divided into non-surgical and surgical treatment. The non-surgical approach involves medical treatments. The combination of two medications called tranexamic acid and mefenamic acid at the time of periods can reduce both the heaviness of periods and the pain. Hormonal therapies are often tried, including the combined oral contraceptive pill, the progesterone only contraceptive pill, the injectable contraceptive Depo-Provera, and the Mirena IUS.

Adenomyosis can be associated with miscarriages and infertility. For women who wish to preserve their fertility, and for whom medical treatment has provided little relief, there is the option to carry out conservative surgery to remove the areas of adenomyosis. The doctor who devised and perfected the surgical technique is Dr Osada from Japan. Mr Booker has been performing the Osada operation on a regular basis since 2008 and has been pleased with the improvement in his patients.

For women who do not wish to preserve their fertility and who have obtained little relief from medical treatments, there is the option to perform a hysterectomy. The ovaries can be preserved, provided they are healthy.

For more information regarding adenomyosis, make an appointment with Mr Michael Booker.