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Adenomyosis

adenomyosis

What is adenomyosis?

Adenomyosis is when tissue from the inner lining of your uterus grows into the muscular wall of the uterus itself. These tissues react to hormonal shifts and persistently bleed within the uterine wall during menstrual cycles, causing the uterus to become enlarged. While the precise cause of adenomyosis is not fully understood, it generally manifests in women between 30 and 50 years old.

adenomyosis
Adenomyosis occurs when the tissue of the uterus's inner lining grows into the uterus wall.

What causes 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.

What are the symptoms of adenomyosis?

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
pelvic pain
Pelvic pain is a common symptom of adenomyosis.

Is adenomyosis painful?

Yes, adenomyosis can cause pain and discomfort. The condition involves the abnormal growth of uterine lining tissue into the muscular wall of the uterus. This can lead to a larger and swollen uterus, causing pain during menstrual periods and sometimes between periods. The pain may be sharp, cramp-like, or heavy. The severity of pain varies among individuals and can impact daily activities.

Who is at risk of adenomyosis in Singapore?

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.

How is adenomyosis diagnosed?

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.

adenomyosis
An ultrasound may be used in diagnosing adenomyosis.

What are the available treatment options for adenomyosis in Singapore?

Adenomyosis may be asymptomatic in certain instances and, therefore, not require treatment. For individuals experiencing symptoms, those who cannot tolerate or have not benefited from medical interventions might require surgical options.

Medical treatments 

  • 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.

Surgical treatment 

  • 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.

Frequently asked questions

Can adenomyosis cause infertility?

Adenomyosis can contribute to fertility issues, but not all individuals with the condition will experience infertility. If you are concerned, consult your gynaecologist.

Can adenomyosis be cured?

Adenomyosis can be managed and its symptoms alleviated, but a cure through medical treatment alone is generally not guaranteed. 

Is there a link between adenomyosis and cancer?

Adenomyosis is generally not linked to an increased risk of cancer. 

Let's talk to
Dr. Ng Kai Lyn



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