This is part three in a series on the causes of heavy menstrual bleeding.  You can find Part 1 and Part  2 here.

 

 

In the previous post we described the uterus as having 2 main layers.  The first is the muscular layer called the myometrium.  The second layer is the internal lining of the uterus called the endometrium.  The lining of the uterus is the tissue which bleeds monthly during the menstrual period.

 

Normally these layers are separate from each other.  The muscle forms a sac and the lining covers the inner portion of that sac. In the illness we will speak about today this relationship between the layers is disrupted

 

A Hidden Problem

Adenomyosis is an abnormal  condition in which cells from the lining of the uterus (endometrium) are buried within the muscular wall of the uterus.  This tissue is exactly the same as the endometrial tissue inside the uterus.  It responds to hormones the same way.  And that is the problem.  The adenomyosis cause micro “periods” in the muscular wall of the uterus leading to a situation which creates bothersome symptoms in women with the disease.

 

Symptoms of Adenomyosis

The most common symptoms of adenomyosis are:

• heavy bleeding
• pain, mostly around the time of the period but may occur at any time
• painful periods

Although these are the most common symptoms, some women have no symptoms at all.

 

Do I Have Adenomyosis?

This condition is very difficult to diagnose.  It takes a physician or other medical provider familiar with the treatment of heavy bleeding to sort this one out.  What your doctor may find is an enlarged uterus on physical exam.  An ultrasound may suggest the diagnosis, but the findings may not be specific enough to make the diagnosis.  MRI is more specific, but it is very expensive.  Most doctors will provide treatment for this condition on the probability of adenomyosis based on all of the findings and symptoms of the patient.