Unfortunately, both are considered surgical diagnoses. Adenomyosis is a problem with the anatomy, so definitive treatment is via hysterectomy. That being said, there is no danger in avoiding this final solution altogether if you are willing to treat the discomfort conservatively with pain medication usually non-steroidal anti-inflammatories, or NSAIDs or hormonally to suppress the period altogether.
This is especially important if you desire pregnancy. The connection between adenomyosis and infertility is very vague at best, and many women with adenomyosis are able to successfully get pregnant and deliver normally. Endometriosis may be successfully treated with removal of the sites of its implantation.
At the same time, the scarring that has resulted can be freed up to improve the chance for fertility. Both adenomyosis and endometriosis involve glandular cells that are abnormally present in areas other than the endometrium. Each have similar as well as different symptoms, and each have definitive diagnosis via surgery.
What a Difference a Word Makes! Normally the endometrium loosens and falls away into the inside of your uterus when the normally fluctuating and cycling hormones of your cycle are at their lowest.
And again, normally, its exit is naturally through your cervix, then vagina, and then to the outside world for discarding as part of typical menstrual hygeine. This would explain how endometriosis can be found in some women in the nose monthly nosebleeds , the lungs monthly coughing up blood , or even the brain monthly ministrokes.
Adenomyosis: Glandular Invasion into Your Uterus Adenomyosis is when endometrial tissue not endometrial- like , but actual endometrial glandular cells invade the layer that overlies that innermost endometrium layer.
Broadly speaking, abnormal bleeding, pelvic pain and infertility are the three symptoms that women with adenomyosis might present to their care provider. Heavy menstrual bleeding does not seem to be highly predictive for all forms of adenomyosis, although with more severe forms of adenomyosis, heavy bleeding is more likely to be a major symptom 1. Dysmenorrhea and other forms of pelvic pain are often present in women with adenomyosis, although there is nothing about the pain that differentiates adenomyosis from other conditions such as endometriosis or leiomyomas that may also cause pain, so describing the pattern, frequency, location and severity of pain remains important for your health care provider but does require additional information to make the diagnosis 12, 14, There is still no universal classification system for adenomyosis, although the terms focal localized , diffuse generalized , adenomyoma a concentration of adenomyotic cells that may mimic a fibroid but grows within the muscle rather than pushing it apart and specific disease location are commonly used when describing this disease.
The principle problem of not having a classification system is that comparison of disease and possible treatments for women are thwarted.
The treatment of adenomyosis will depend on the presence of specific symptoms such as pain, AUB or infertility. Treatment options will also vary according to these presenting symptoms and fall into medical treatments, surgical options, radiologic or sonographic interventions or combinations of these choices. Medical treatment. Medical options with simple medications are often used first line in the treatment of adenomyosis and anti-inflammatory medications and the combined oral contraceptive pill are commonly used for both the issues associated with bleeding and pain, although there are limited data from studies to demonstrate effectiveness specific for adenomyosis.
Drugs such as zoladex, danazol, and aromatase inhibitors anti-oestrogens used for women with breast cancer are also reported to be helpful for women with adenomyosis , although the side effects of these medications and the limited time that they may be used limit their applicability.
Generally, these medications should be used by specialists in the area of adenomyosis and pelvic pain such as an endometriosis specialist. Surgical Treatment. Surgical options are available and have been described and are grouped as this that are conservative - with the intent of maintaining fertility and keeping the uterus, conservative with no intent of fertility such as endometrial ablation after which pregnancy is contra-indicated , or non-conservative where the entire uterus is removed.
Hysterectomy in any form offers the advantage of freedom from bleeding and no chance of recurrence and is considered the gold standard treatment for women who have no desire for future fertility since it eliminated disease by removing the uterine musculature.
Clearly it is not a suitable treatment for many women with adenomyosis! The most challenging of the surgical treatment options is conservative treatment with the view of maintaining perhaps even enhancing fertility. There are few well-conducted studies in this area, since it is very difficult to recruit to studies such as these.
A high degree of surgical skill is required for such fertility sparing procedures and whilst there are any techniques described for removal of adenomyosis, there is no universally accepted approach with individual techniques being promoted as successful. Non-surgical Interventions as treatment.
The use of high intensity ultrasound beamed into the body from outside under X ray or MRI guidance and techniques such as uterine artery occlusion where the blood supply to the uterus is blocked with tiny plastic particles have been reported as treatment options for women with adenomyosis and again reported as successful, however the science behind these studies is of variable quality.
No single technique appears to be universally acceptable and all report a decrease in symptoms such as bleeding and pain and improvement in fertility although it is essential that more research is undertaken to evaluate the long term benefits and risks of these as for other interventions such as surgery and the effects on fertility in particular.
Infertility and Reproduction. For women with adenomyosis who wish to retain their fertility, there are potential impacts of the disease on spontaneous pregnancy without treatment, on any form of assisted reproduction such as IVF and pregnancy outcomes following any procedural interventions such as surgery. Roughly the same figure is estimated to have adenomyosis , states the NHS. Both are disorders of the endometrial tissue, both can be incredibly difficult to diagnose the average diagnosis time for endometriosis is currently over seven years , and both can result in a decreased quality of life.
Despite these similarities, they do have their differences. As Healthline reports, endometriosis occurs when cells similar to those which line the uterus grow outside of it — around the ovaries, the fallopian tubes, and even the bowel, bladder, and intestines.
Adenomyosis is characterised by the growth of similar cells. However, with this condition, these cells grow inside the walls of the uterus. No matter where they are, these cells follow the menstrual cycle pattern, usually resulting in painful symptoms. It is also common for people to have both endometriosis and adenomyosis , as demonstrated by a study published in the Fertility and Sterility journal. An analysis of people concluded that 42 percent of participants with adenomyosis also had endometriosis.
The symptoms can be vastly similar. Endometriosis is commonly characterised by painful, heavy, or abnormal periods or pain when having sex or going to the toilet. People may also experience nausea and fatigue, especially during their period. Adenomyosis symptoms tend to be the same minus the tiredness and sick feelings. Some symptoms can mimic those caused by other conditions, such as ovarian cysts or uterine fibroids.
But researchers have identified likely mechanisms and risk factors. Theories include the following:. Studies of an adenomyosis association with smoking and ectopic pregnancy have mixed results.
If you have symptoms, such as pelvic pain, your doctor will take your medical history and ask you about your symptoms:. To rule out other possible causes of pelvic pain, your doctor may order a urine test, pregnancy test, Pap test , or vaginal swabs. Adenomyosis is difficult to diagnose. In the past, it was diagnosed only by examining tissue samples, for example after uterine surgery.
Adenomyosis causes the uterus to become enlarged, so your doctor will perform a physical exam to feel whether your uterus is swollen or tender. In some cases where a more precise image is required, sonohysterography may be used.
This involves an injection of saline solution into the uterine cavity before a sonogram. Your doctor will take your medical history. Your doctor will examine your pelvic area to feel for cysts or other abnormalities. The sonogram may be done with a wand type of scanner across your abdomen or inserted into your vagina.
Your doctor may also use laparoscopic surgery to look for endometrial tissue outside of the uterus. Research is ongoing into noninvasive ways to diagnose endometriosis using blood tests.
But so far, no accurate biomarker indicator that you have the condition has been found. Treatment for both conditions ranges from minimal over-the-counter medications to more invasive hysterectomy. Treatment options in between these extremes vary. This is because of the differences in where the misplaced endometrial tissue is located. If your symptoms are mild, your doctor may recommend using over-the-counter anti-inflammatory drugs just before and during your period.
For more severe symptom management, there are other options. Hormones are used to help control increased estrogen levels that contribute to symptoms.
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