Heavy periods and painful sex? It could be Adenomyosis. Know signs and treatment options

From early warning signs to the health complications and treatment options, know all about adenomyosis from the expert here.

Adenomyosis is a uterine condition where the tissues lining the uterus grows into the muscular wall of the uterus, leading to prolonged menstrual bleeding, menstrual cramps and pelvic pain during sexual intercourse. In an interview with HT Lifestyle, Dr Dhatchayani S, consultant - obstetrics and gynaecology, Manipal Hospital, Sarjapur Road said, “Adenomyosis is a chronic painful condition affecting about 20-65% of adult women. The condition is caused due to the invasion of the endometrial glands and stroma into the myometrium (uterine muscle).”

Adenomyosis can lead to prolonged menstrual bleeding, menstrual cramps and pelvic pain during sexual intercourse.(Shutterstock)

The gynecologist further added that while this is a common condition, often it is mistaken for endometriosis due to overlapping symptoms.

Early symptoms of adenomyosis:

“Although pain is one of the defining symptoms of adenomyosis, about one-third of the affected women experience may remain asymptomatic and are diagnosed incidentally during gynaecological or pelvic scans for other conditions,” Dr Dhatchayani S added. Know the symptoms:

• Severe period pain (especially on the second day)
• Painful intercourse (dyspareunia)
• Chronic pelvic pain
• Abnormal vaginal bleeding
• Infertility – adenomyosis is known to reduce chances of implantation thereby reducing pregnancy rates, it also increases the risk of miscarriage. However, with pre-pregnancy hormonal treatment the pregnancy outcomes may improve.

Who is at risk of adenomyosis?

• Women over 35 years of age
• Those who have given birth (multiparous women)
• History of Caesarean section or uterine surgeries
• Co-existence with conditions like endometriosis or fibroids

Adenomyosis can cause severe health complications.(Shutterstock)

Complications caused by adenomyosis:

Adenomyosis is more than just a period problem, added Dr Dhatchayani S. The doctor further noted down the complications it can cause:

• 22-25% of cases lead to infertility
• Pregnancy risks: preterm labor, premature rupture of membranes, low birth weight, and miscarriage
• Common age groups affected are women under 40 and women aged 40-50

Treatment options:

“The treatment of adenomyosis includes medical management (primarily directed at symptom control) and surgical management,” the gynecologist explained.

Medical managament:

• First-line therapy: GnRH agonists
• Other drugs: Oral contraceptives (OCPs) and progesterone, Dienogest (progestin)
• Levonorgestrel intrauterine system (LNG IUS) – For those who have completed their families but wish to retain the uterus

Surgical management:

• Conservative options for fertility preservation include endometrial microablation, hysteroscopic adenomyoma resection and laparoscopic adenomyomectomy.
• Hysterectomy is recommended for women over 40 who have completed their families and for cases where medical treatment has failed.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.