What is Adenomyosis?
Adenomyosis is a condition that affects up to 1 in 10 women yet is rarely spoken about. It occurs when cells similar to those that line the uterus (womb) grow into the muscle wall of the uterus. The extra tissue can cause the uterus to enlarge and with each menstrual cycle it thickens, breaks down and bleeds which can lead to cramping, pain, and heavy periods. Adenomyosis most commonly occurs in women aged 35-50 years who have had children, although it can occur in young women and teenagers as well. The cause of adenomyosis is largely unknown, although it is believed that childbirth or previous surgeries can increase the risk of developing it.
Adenomyosis differs from endometriosis (another common pelvic pain condition), although many women have both adenomyosis and endometriosis. Endometriosis occurs where cells similar to those that line the uterus grow on other parts of the body, commonly the fallopian tubes, ovaries, bladder and bowel
Adenomyosis can vary greatly from woman to woman. For some women, symptoms can be severe and extremely debilitating. However, up to 30% of women with adenomyosis experience no symptoms at all. The correlation between the severity of symptoms and the amount of adenomyosis is also poor so it is difficult to predict who will experience symptoms.
Symptoms of adenomyosis can vary between women but may include:
- Heavy, painful periods
- Menstrual cramping
- Pain in lower limb and lumbar spine
- Pressure in pelvis and/or bloating
- Chronic pelvic pain
- Pain with sexual intercourse
How is it diagnosed?
Adenomyosis can be difficult to diagnose. If a medical practitioner suspects you have adenomyosis they will likely refer you for a transvaginal (internal) pelvic ultrasound.
MRI is also a useful tool for diagnosing adenomyosis and is non-invasive.
How is it treated?
There are medical, surgical, and conservative management strategies. Although the only definitive cure is hysterectomy, there are many lifestyle and medical interventions that can decrease pain and improve quality of life.
The good news is physiotherapy can help! Physiotherapy management may include lifestyle modification advice and pain management strategies including heat, ice, pacing and gentle movement. Physiotherapy management may also include; soft tissue release, pelvic floor muscle down-training, biofeedback, and retraining good bladder and bowel habits. Your pelvic health physiotherapist will conduct a comprehensive assessment and work together with you to identify your goals and create a tailored management plan.
Exercise is an important part of managing any persistent pain condition and working with an exercise physiologist who specialises in managing pelvic pain conditions is a great way to incorporate regular movement and activity into your daily routine.
- Pain management and analgesia
- Hormonal therapies. These may be either oral medications or an intrauterine device can help such as the Mirena.
- High intensity ultrasound
- uterine artery embolization
- Endometrial ablation
If you experience any of the above symptoms, get in touch today to discuss the role of Pelvic Floor Physiotherapy and Exercise Physiology.
Blog by Claire De Vos (Physiotherapist)