Alternate Names: Endometriosis interna; Adenomyoma

Causes and Risks:

The diagnosis of adenomyosis can only be made after a pathologist examines uterine wall samples. The cause is unknown.Sometimes a focal area of adenomyosis appears to cause a mass or growth within the uterus, which is called an adenomyoma.The disease usually occurs in women over 30 years old who have borne children, and rarely occurs in women who have not carried a pregnancy to term.

Prevention: Prevention is unknown.

Symptoms:

• Prolonged or heavy menstrual bleeding (50% of patients)
• Menstruation, painful
  • New onset of menstrual cramping
  • Becomes increasingly worse (20% of patients)

Note: In many cases, the woman may not have any symptoms.

Signs and Tests:

Pelvic examination may reveal an enlarged, slightly softened uterus, a uterine mass, or uterine tenderness.

• An abdominal X-ray that is taken after ingestion of contrast (a dye-like material that is visible on X-ray) may be diagnostic.
• An ultrasound of the uterus may be helpful in differentiating between adenomyosis and other uterine tumors.
• An abdominal MRI is also useful in this respect, but its cost precludes its routine use.

Treatment:

Usually no treatment is initiated, other than recommending or prescribing pain medication (analgesics). A hysterectomy may be necessary in women with severe symptoms who are not approaching menopause soon. Most treatment attempts with hormonal supplements have been unsuccessful.

Prognosis:

Symptoms usually resolve after menstruation ceases. A hysterectomy completely resolves symptoms.

Complications:

Oral contraceptives may aggravate symptoms of heavy bleeding or pain.

Call for an appointment with your health care provider if symptoms suggestive of adenomyosis occur.