Causes & Treatment

An MD shares the latest guidance on adenomyosis

Jessie Day  |   25 Apr 2023


Adenomyosis – the disease in which endometrial tissue grows into the muscular wall of your uterus, thickens, breaks down and sheds during each cycle – affects around one in ten of us. Today, Laurel Fertility Care answer top-searched questions about adeno, its similarity (but crucial differences) to endometriosis, and how it can impact our daily lives, and fertility. 

Looking into adenomyosis fertility treatment in California? Dr. Collin Smikle and team are our state go-to for carefully-tailored protocols and impeccable patient care. For a plan which puts you at the center, and builds out depending on your holistic needs, connect with Laurel Fertility Care and bring them up to speed. 

From adenomyosis treatment to fertility after a cancer diagnosis, or treatment, PCOS, endo and more, their integrative team is prepped to support. 

Let’s take a step back, and look at what causes adenomyosis – and how it shows up in our body. Starting with the basics (in a not-so basic disease), over to Dr. Smikle

Laurel-Fertility-Care-Adenomyosis-fertility-treatment

 What is adenomyosis?

Adenomyosis – ‘adeno ‘ for short – is a condition that causes your endometrium (uterine lining) to burrow into the muscular wall of the uterus. It’s not life-threatening, but it can have a serious impact on your day-to-day life and activities – and, if you’re trying to conceive (TTC), fertility. So getting support, whether it’s for pain, discomfort or fertility goals, is super-important.

Symptoms & causes

This is not ‘just a bad period’, as suggested by some of the more outdated thinking. 

Adenomyosis symptoms can include: 

  • heavy, long periods (lasting more than seven days)
  • severe pain
  • a feeling of pressure in your stomach, and bloating or distension
  • pain during sex, and/or bowel movements
  • fertility problems (particularly miscarriage and premature birth)

Around a third of people with adenomyosis have no symptoms at all – this is sometimes known as ‘silent adenomyosis’, and can lead to even further delay in diagnosis, and treatment. 

We don’t yet know the exact cause(s) of adenomyosis. Research suggests it’s more likely that people with adeno may have an increased risk factor due to genes, hormones or immunology, but more work is needed in this area. 

It’s also more common in women who’ve had multiple pregnancies and c-sections, and/or who are over 40 years old, as well as women who started their periods at a young age – under 12 years old, usually – and/or who have shorter menstrual cycles, maybe 27-24 days or less.

Diagnosis

Unfortunately, it’s very common for adenomyosis to go undiagnosed for years, rather than months. Symptoms can be similar to those which come with other conditions – including endometriosis, fibroids and polyp growth in the uterine lining, leading to missed adenomyosis, or confused diagnosis. 

Added to this, there’s a lack of research and attention in general to this area of women’s healthcare – endometriosis is also sadly under-serviced by modern medicine. 

Alongside careful monitoring of the key signs and symptoms of adenomyosis, ask your clinician to look into the following, to rule out – or help diagnose – possible adenomyosis: 

  • pelvic exam
  • ultrasound imaging 
  • magnetic resonance imaging (MRI) 

As a baseline, MRI-based studies show that a general myometrium thickness exceeding 12mm seems to be highly predictive of adenomyosis. 

A note on hysterectomy

The established science says that the only way to diagnose adenomyosis for sure is to examine the uterus after hysterectomy. 

How you decide to approach your own treatment will depend on your unique situation and condition, as well as your plans and future fertility goals. Working as I do to help women who are trying to conceive (TTC) at Laurel Fertility Care, I 100% aim to do everything I can with my team to support women with their symptoms, trying different things to help. 

We’re all about treating to improve and manage – whether it’s adenomyosis, endometriosis, fibroids or something else – empowering you to continue your TTC journey, if that’s where you’re at. 

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Adenomyosis stages

Adenomyosis is a progressive disease, so it often gets worse over time – especially if left to develop untreated. It’s powered by estrogen, which – as an important sex hormone – shows up in every normal menstrual cycle. 

Even mild or early-stage adenomyosis can begin causing symptoms that impact on your daily life. Aside from pain and heavy periods, bloating and other discomfort mentioned above, you may also begin to see iron deficiency – anemia – due to heavier bleeding, 

Advanced-stage adenomyosis can lead to fertility problems – particularly implantation issues, miscarriage and premature birth – as well as problems like pelvic organ prolapse. 

Women may find that they’ve had very few (or mild) symptoms of the disease – or none at all – and only suspect it once it’s already pretty established.

Adenomyosis and endometriosis

These two conditions are similar, but separate. Very often, they show up with the same symptoms, but they actually affect different parts of the body. 

What’s the difference?

Adenomyosis occurs when the same type of cells that line your uterus grow deep into its muscular wall, causing it to thicken. A tell-tale symptomatic difference to watch out for (with your clinician) is this thickening and enlarging of the uterus, which doesn’t usually occur with endometriosis. 

Endometriosis is where these cells grow outside the uterus – often spreading to nearby organs like your ovaries and fallopian tubes, and even your upper legs and bladder. So it goes beyond the uterus, whereas adenomyosis deepens within the uterus itself.  

Can I have both?

It’s absolutely possible to have endometriosis and adenomyosis at the same time – in fact, it’s thought that around a third of patients with endometriosis also have adenomyosis. If this is the case for you – or you suspect it may be one or other, or both, we are prepped to help – do get in touch to chat through your symptoms and situation. The team here are very experienced in supporting a number of conditions at once. 

Research also suggests that patients with adenomyosis are more likely to have deep or advanced endometriosis, so careful management is required, to improve quality of life for all, as quickly as possible, and fertility outcomes.

Adenomyosis and fibroids

Aside from endometriosis, adenomyosis is also regularly confused for other conditions, including pelvic infections and other pelvic issues, IBS, and fibroids. 

Fibroids and adenomyosis are not the same. They may share symptoms, but fibroids are actually noncancerous tumors which grow from the muscle layers of the uterus. 

It’s really difficult, as you can see, to self-diagnose and rule out all of these potential conditions at home, or battle for a diagnosis with a clinician who isn’t up for doing a proper investigation. Whether it’s with a specialist fertility clinic – like the team here at Laurel Fertility Care – or an expert in the field of adenomyosis, don’t ignore your symptoms. Push for the care you deserve. 

How does adenomyosis affect fertility?

Adenomyosis can be treated successfully. However, it can also make getting pregnant more difficult, impacting crucial aspects of conception such as implantation. Quite often, we may see pregnancies which start but don’t continue normally, due to adenomyosis blocking blood supply to the uterus, for example. Very sadly, this can lead to miscarriage.

Depending on how it’s managed, over 60 per cent of patients go on to conceive, in spite of their diagnosis.

Laurel-Fertility-Care-Adenomyosis stages-fertility-expert-support

Laurel Fertility Care are the only clinic in the US right now offering every patient a personalized Univfy PreIVF report, allowing you to make smarter decisions, based on your probability of success. 

Connect with the team today for your tailored report and next steps, factoring in adeno diagnosis, possible endo, fibroids and anything else you’re concerned about.

You’re never alone. Read these adenomyosis stories next.

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