Adenomyosis

Adenomyosis is a condition in which the tissue that usually lines the uterus grows into the muscular wall of the uterus. While the exact cause is unclear, it is thought to result from a combination of hormonal changes and inflammation. This can lead to an enlarged and painful uterus, heavy menstrual bleeding and discomfort. It is important to consult a gynaecologist if you are experiencing symptoms like prolonged or heavy periods, pelvic pain or pressure. They can provide an accurate diagnosis and recommend suitable treatments to alleviate your symptoms and improve your overall well-being.

Symptoms of adenomyosis include:

• Heavy or prolonged periods
• Severe menstrual cramps
• Pelvic pain or discomfort
• Painful intercourse
• Enlarged uterus
• Bloating or abdominal pressure
• Irregular menstrual cycles
• Blood clots during menstruation

While adenomyosis can affect anyone with a uterus, certain factors may increase the risk in Singapore. Your risk may be elevated if you have had uterine surgery, such as a caesarean section. Additionally, if you are in your 40s and 50s, you could be at a higher risk, as adenomyosis tends to develop in this age range. Having multiple pregnancies may also be a risk factor. However, it is important to note that the condition’s exact cause is not fully understood.

Adenomyosis can be identified through a thorough review of your medical history and a pelvic examination that reveals an enlarged uterus. A pelvic ultrasound typically displays thicker muscular walls within the uterus. 

If you have concerns or symptoms related to adenomyosis, it is advisable to consult your gynaecologist for a proper assessment and guidance tailored to your situation.

• Non-hormonal medications: alleviate menstrual pain and excessive bleeding (such as pain relievers and tranexamic acid). These do not cause adenomyosis to shrink or disappear.
• Hormonal treatments: such as birth control pills or intrauterine devices. Mirena IUD is a possibility if you have moderately enlarged uteruses. These do not cause adenomyosis reduction or disappearance.

• Hysterectomy: hysterectomy is the surgical removal of the uterus. This is suitable if you do not want to preserve your uterus. Depending on womb size, this procedure can be minimally invasive or open. After the procedure, menstruation will stop, and you will no longer be able to conceive children. The decision to remove ovaries may vary.