adenomyosis - Profile (original) (raw)

on 19 December 2005 (#9060197)

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About
This community was designed for women out there of all ages who
is currently experiencing or has experienced Adenomyosis. Its a
place to vent, share stories, share tips, talk, complain, and whatever else
may come out of the group and its members. It is a very moderated
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of girls who are in need of support and a new friend, people to relate too.
If the above interests you, apply to become a member.

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Adenomyosis
endometriosis interna, uterine endometriosis, internal endometriosis

It Is
Adenomyosis is the presence of endometrial glands and supporting tissues in the muscle of the uterus where it would not occur normally. When the gland tissue grows during the menstrual cycle and then at menses tries to slough, the old tissue and blood cannot escape the uterine muscle and flow out of the cervix as part of normal menses. This trapping of the blood and tissue causes uterine pain in the form of monthly menstrual cramps. It also produces abnormal uterine bleeding when some of the blood finally escapes the muscle resulting in prolonged spotting. It more often occurs in the posterior wall of the uterus.

Is it Common
The background incidence of adenomyosis in all women either with or without symptoms is not known precisely because only in recent years has MRI imaging been able to diagnose adenomyosis without doing a hysterectomy. In studies of chronic pelvic pain in which women had hysterectomies, the incidence of adenomyosis is about 15% to 25% (1, 2). It seems to be about the same incidence in hysterectomy specimens from women without pain as from women with pain so it is possible that this represents the background incidence.

Differentiating Features
Cyclic, cramping uterine pain beginning later in reproductive life (generally after age 35) and often associated with prolonged and heavy menses is the classic presentation. It is difficult to differentiate from endometriosis if there is no abnormal bleeding and if it occurs earlier than age 40. Endometriosis tends to present earlier (20-40) and if there is abnormal bleeding it tends to be premenstrual spotting rather than heavy and prolonged nenses. The abnormal bleeding pattern of adenomyosis is similar to that found in perimenopause due to dysfunctional ovulatory problems.
On pelvic exam there may be uterine enlargement from about 6-10 weeks pregnancy size.

Patterns of adenomyosis as recognized by MRI seem to either be diffusely spread throughout the uterus (about 66%) or focal lesions (33%) that only occur in one or two places (3). On T2-weighted magnetic resonance images, diffuse adenomyosis usually appears as diffuse thickening of the endometrial-myometrial junctional zone (7-37 mm; mean, 16 mm) with homogeneous low signal intensity. Focal adenomyosis appears on both T2-weighted and contrast-enhanced T1-weighted MR images as a localized, low-signal-intensity round or oval mass with a diameter of 2-7 cm (mean, 3.8 cm) and usually has ill-defined margins.

Other Features
The uterus can feel soft and boggy on pelvic exam. Sometimes adenomyosis is associated with uterine fibroids (leiomyomata) (4 ). For an in depth discussion on pre surgical ultrasound imaging and diagnosis of adenomyosis, see (The Presurgical Diagnosis of Diffuse Adenomyosis by Helen Bickerstaff, MB, BChir.

Cause
Cause is basically unknown although there seems to be an increased incidence associated with any child birth (5), pregnancy terminations (6), Cesarean sections 7) and and even tubal ligations (8). It would appear that any trauma to the uterus may increase the chance that endometrial tissue becomes relocated from the uterine lining.

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