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Adenomyosis is a benign (non-cancerous) condition. It is the presence of endometrial tissue (tissue that makes up the lining of the uterine cavity) in the myometrium (the muscle of the uterus). Adenomyosis can spread throughout the myometrium or can form nodules called adenomyomas. It is a common disorder. The gynecologic surgeons in our Minimally Invasive Gynecologic Surgery (MIGS) program can provide patients with screenings and treatment for adenomyosis.

Symptoms of adenomyosis

Symptoms typically occur in women between 40 and 50 years of age. The most common symptoms are abnormal uterine bleeding (most often heavy periods) and dysmenorrhea (painful periods). Upon a physical exam, the gynecologist will find the uterus is often enlarged and boggy (spongy to the touch and inadequately contracted). About one-third of women with adenomyosis will have no symptoms.

Diagnosis of adenomyosis

Adenomyosis is difficult to diagnose. Symptoms such as heavy bleeding and painful periods, combined with a physical examination revealing an enlarged, boggy uterus, can suggest the condition.

To diagnose this condition, your doctor will need to perform a minor procedure to obtain sample tissue. The sample will then be evaluated in the lab. Ultrasound and MRI can also sometimes be helpful in diagnosing adenomyosis. Adenomyosis commonly co-exists with other gynecologic problems, such as endometriosis, fibroids and endometrial polyps.

Treatment options for adenomyosis

Effective treatment options for adenomyosis are limited. Most women are treated with hysterectomy or endometrial ablation, although some alternative therapies may have limited benefit.

  • Hormone treatments including birth control pills, progestins (oral, injection or IUD) or GnRH-analogs such as Lupron
  • Endometrial ablation
  • Uterine artery embolization
  • Hysterectomy