If you are wondering if it is normal and not a big issue to have painful cramps and heavy bleeding? Well, it’s time to rethink again cause adenomyosis can be the primary reason behind your infertility issues with heavy and painful menstruation. It is definitely an issue most women face which can cause a lot of emotional and psychological problems in their personal life due to reproductive issues.

What is adenomyosis? It is a condition where cells of the endometrium – which lines the uterus (womb) are found in the myometrium (is the muscle of the womb). It is the most common in every 1 out of 10 women even including women of 30s and 40s.

CAUSES:

The cause is still debatable but one theory that when the lining of the womb tries to heal itself during certain conditions, the endometrium tissue re-grows inwards instead and the endometrium lining spreads into the muscle wall of the uterus which causes disruption in the endometrial-myometrial junction. Inflammation is the main cause of it. Other causes include any trauma to the uterus or surgery during childbirth such as cesarean section and even the women with multiple pregnancies were associated with cases of adenomyosis.

RISK FACTORS:

• Middle age women
• Pregnancy
• Uterine surgery
• Trauma to the pelvis

SYMPTOMS:

• Painful cramps during periods.
• Heavy bleeding during periods.
• Pelvic pain or discomfort in the pelvic area.
• Pain during sexual intercourse.
• Pain during the bowel movement.
• Heaviness or pain the bladder area
• Enlarged uterus area.

DIAGNOSIS:

• The doctor will take the physical examination of the pelvic area with the medical history to check any tenderness or enlargement.
• INTERNAL TRANSVAGINAL ULTRASOUND SCAN
• MRI
• ENDOMETRIAL BIOPSY

TREATMENT:

• ANTI-INFLAMMATORY MEDICATIONS: like ibuprofen for reducing the inflammation which is causing pain.


• HORMONAL TREATMENT: oral contraceptive pills and Depo-Provera injections.


• If you are trying to have a baby or are near menopause, it’s better to do nothing because symptoms will stop itself during such times.


• NON- HORMONAL MEDICATION: like tranexamic and mefenamic acid will help I reducing the heavy bleeding and pain during periods.


• GnRH injections to create false menopause can be a short term solution.


• SURGERY: Hysterectomy, where there is the removal of the womb, can be an option for women who do not want to get pregnant.


• UTERINE ARTERY EMBOLIZATION: It helps in preserving fertility and is a better option than surgery. It injects small particles into the area affected by adenomyosis by placing the catheter in the groin area. It stops the blood supply to the affected area and helps in removing the symptoms.