Last year, BBC presenter Naga Munchetty shared her experience of enduring severe pain due to a lesser-known uterine condition, adenomyosis, in an effort to raise awareness. Adenomyosis, a chronic condition affecting the uterus, is estimated to impact one in 4 women yet remains relatively unfamiliar to many.
Common symptoms include irregular and heavy menstrual bleeding, along with pelvic pain. The severity of these symptoms varies, with up to one-third of affected women experiencing minimal or no discomfort.
Apart from its impact on menstrual health, adenomyosis can also influence fertility. Women with the condition who become pregnant face an elevated risk of miscarriage, pre-term delivery, pre-eclampsia, and post-delivery bleeding.
Despite its prevalence, much remains unknown about the causes, diagnosis, and treatment of adenomyosis. The condition poses challenges for affected individuals, and understanding and addressing it are crucial steps toward better management and support. Naga Munchetty's openness about her struggle serves as a call for increased awareness and a deeper exploration of this often-overlooked health issue.
What is adenomyosis?
According to Johns Hopkins University, adenomyosis is a gynecologic condition that causes endometrial tissue in the lining of the uterus to grow into the muscular wall of the uterus. It enlarges the uterus and may lead to very heavy menstrual bleeding.
"The tissue that lines the uterus (endometrium) is a special type of glandular tissue that responds to hormones," says Mildred Chernofsky, MD, a fellowship-trained gynecologic oncologist at Johns Hopkins' Sibley Memorial Hospital.
Each month, it prepares for a pregnancy by getting thicker. If pregnancy doesn't happen, the endometrial tissue sloughs off during your menstrual period.
But in adenomyosis, some of this tissue grows into the myometrium, which is the muscular inner wall of the uterus. The tissue still behaves as it would if it lined the uterus, so it thickens and bleeds with a woman's monthly hormone cycle.
What causes adenomyosis?
Experts aren't exactly sure what causes adenomyosis, but risk factors may include:
Age: Most women with adenomyosis are in their later childbearing years, between 35 and 50. The major symptoms of adenomyosis go away after menopause.
Childbirth: Many women with adenomyosis have given birth to more than one child. Endometrial tissue could invade the myometrium when an embryo implants in the uterine wall. However, more research is needed to confirm this.
Previous surgeries: Studies suggest that prior uterine surgeries, such as caesarean section or dilation and curettage (D&C), could make adenomyosis more likely. Research is ongoing about this risk factor.
Adenomyosis Symptoms
Adenomyosis symptoms may include:
- Enlarged uterus
- Feelings of abdominal bloating, fullness, or heaviness
- Heavy bleeding during periods (menorrhagia)
- Pain during sex (dyspareunia)
- Pelvic pain
- Severe cramps during periods (dysmenorrhea)
