What is adenomyosis, and how can it be managed?

In this article below, esteemed consultant gynaecologist, Mr Mahantesh Karoshi, describes what adenomyosis is, and how women suffering from the condition can best manage it.

What is adenomyosis?

Adenomyosis is a common gynaecological condition characterised by the presence of endometrial glands and stroma within the myometrium.

What are the associated symptoms?

It can cause a range of symptoms, including heavy menstrual bleeding, dysmenorrhea, and infertility.

How can adenomyosis be managed most effectively?

Recent advances in preconception management of adenomyosis have focused on improving fertility outcomes and reducing the risk of complications during pregnancy. It can be managed in the following ways:

1. Medical management: Gonadotropin-releasing hormone (GnRH) agonists have been used to suppress ovarian function and decrease the size of adenomyosis lesions prior to conception.
2. Surgical management: Hysteroscopic resection of adenomyosis lesions has been shown to improve pregnancy rates in women with adenomyosis.
3. Imaging techniques: Magnetic resonance imaging (MRI) has been used to accurately diagnose adenomyosis and assess the extent and severity of the disease.
4. Personalised treatment: Personalised treatment based on the individual characteristics of adenomyosis lesions has been proposed as a potential approach to improve preconception management. In a study by Zhang et al., women with adenomyosis were classified into two subtypes based on the MRI characteristics of their lesions. Women in one subtype had a higher likelihood of pregnancy success with IVF, while women in the other subtype had a higher risk of miscarriage.

What are the suggested dietary modifications for women with adenomyosis?

Women with adenomyosis should focus on the following dietary recommendations:

• Increase intake of fruits, vegetables, and whole grains: a vegan diet is typically high in plant-based foods, which are excellent sources of antioxidants, fiber, and essential nutrients that may help reduce inflammation and pain associated with adenomyosis.
• Incorporate omega-3 fatty acids: since vegans don't consume fish, it's important to obtain omega-3 fatty acids from other sources such as flaxseeds, chia seeds, hemp seeds, and walnuts.
• Include soy products: soy products such as tofu, tempeh, and soy milk contain phytoestrogens that may help regulate hormone levels and reduce symptoms of adenomyosis.
• Avoid processed foods: Processed foods are often high in saturated fats and additives that can exacerbate inflammation and pain. Stick to whole, unprocessed foods as much as possible.
• Consider supplements: If it's challenging to get enough nutrients from diet alone, consider taking supplements such as vitamin D, omega-3 fatty acids, and magnesium, as they may help alleviate symptoms of adenomyosis.

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