Adenomyosis is a uterine condition that may affect fertility and pregnancy. If you’re planning to get pregnant or are already pregnant, you may wonder if this condition could affect you or your baby. Read on to learn more about adenomyosis and pregnancy complications.
What is adenomyosis?
Adenomyosis is a condition in the uterus that makes it get thicker. Adenomyosis causes the tissue that lines the uterus to grow into the surrounding tissues.
Normally, the inside of your uterus is lined with endometrial tissue. During your period, this tissue is shed by your body. If you have adenomyosis, this tissue doesn’t remain inside your uterus. Instead, it grows into the muscular wall of the uterus (the myometrium), which makes it thicker. Even though the tissue is growing in the wrong place, it continues to respond to the cycles of your hormones. During each menstrual cycle, it thickens, sheds, and bleeds.
This condition is similar to endometriosis. In endometriosis, the endometrial tissue grows outside of the uterus. It may grow on the ovaries or fallopian tissues. It’s possible to have both adenomyosis and endometriosis at the same time.
How common is adenomyosis?
Adenomyosis doesn’t get as much attention as endometriosis, but it’s not a rare condition. It may affect up to 65 percent of women.
The exact number of women who have adenomyosis isn’t known, but it’s estimated that between 20 and 65 percent of women have the condition in some form.
What are the symptoms of adenomyosis?
The symptoms of adenomyosis can vary from one woman to another. Some women don’t have any symptoms at all, while others experience only mild discomfort.
Other women can experience more severe symptoms. These may include prolonged, heavy bleeding during menstruation. During your period, you could also have severe cramps or a sharp, stabbing pain in your pelvic area. Some women experience chronic pelvic pain.
If you have adenomyosis, your uterus may grow to two to three times its normal size. This could cause symptoms like pelvic pressure or tenderness in your lower abdomen.
How to diagnose adenomyosis
Adenomyosis can be difficult for doctors to diagnose. Many other uterine conditions cause similar symptoms. Your doctor may perform various tests to diagnose you with adenomyosis.
Heavy periods, severe period cramps, and other symptoms can be associated with many uterine conditions, not just adenomyosis. These conditions include endometrial polyps, which are growths in the lining of the uterus, and endometriosis, which refers to uterine cells growing in other tissues.
If your doctor notices an enlarged, tender uterus during your pelvic exam, they may suspect adenomyosis. Imaging tests, such as ultrasounds and MRIs, can also help your doctor detect signs of the condition. To rule out serious conditions, they may recommend a biopsy (tissue sample) of your uterine tissue. However, a biopsy doesn’t help diagnose adenomyosis. The only surefire way to diagnose the condition is to examine the uterus after a hysterectomy (surgical removal of the uterus).
Does adenomyosis affect pregnancy?
Few studies have examined the effects of adenomyosis on pregnancy. However, some studies have reported a higher rate of pregnancy complications in women with adenomyosis.
A recent study published in the journal Fertility and Sterility reported pregnancy complications experienced by pregnant women with adenomyosis. The most common complication, preterm delivery, affected nearly one-quarter of women. This means their babies were born before 37 weeks of pregnancy. Preterm birth can be concerning because babies’ brains, lungs, and livers fully develop during the last weeks of pregnancy.
Other studies have reported that pregnant women with adenomyosis have a greater risk of miscarriages or infections in the uterus. Fetal growth restriction, when babies are smaller than they should be, is another complication that’s been linked to adenomyosis.
Can adenomyosis cause infertility?
If you’re trying to conceive, you may worry about the effect of adenomyosis on your fertility. Some studies have suggested that in vitro fertilization (IVF) is less effective in women with adenomyosis.
Recently, the journal Reproductive Biomedicine Online published a study that examined pregnancy outcomes in women with adenomyosis. While 34.55 percent of the control group got pregnant through IVF, only 23.44 percent of women with adenomyosis did. This suggests that it may be harder for women with this condition to get pregnant.
How to treat adenomyosis
Many treatments are available for adenomyosis. The condition frequently goes away by itself after menopause. If you choose treatment, your doctor may recommend home remedies, medications, or surgery.
While adenomyosis often goes away during menopause, there are many treatments that can be used in the reproductive years. Home remedies, such as heating pads and warm baths, can provide some relief. Your doctor may also recommend medications. Taking anti-inflammatory medications (like ibuprofen) a couple of days before your period starts can help control the pain. Hormonal medications like oral contraceptives can help reduce bleeding and pain.
If other treatments don’t work, your doctor may recommend a hysterectomy. Since this procedure involves the removal of the uterus, it’s not a good option for women who want to preserve their fertility.
Adenomyosis may make it harder for you to get pregnant, and it may increase the risk of some pregnancy complications. If you think you have this condition, talk to your doctor for advice and treatment.