Affecting Nearly 1 in 5 Women! Severe Dysmenorrhea and Heavy Menstrual Bleeding May Be Warning Signs

In outpatient work, Dr. Jia found that many people have a certain understanding of many common gynecological diseases, such as uterine fibroids, endometrial polyps, etc., but every time they mention adenomyosis, many people are still confused and say it’s the first time they’ve heard of it.

However, this disease is quite common. According to the latest Meta-analysis,
the prevalence of adenomyosis in women of childbearing age in our country is about 19.5%(data from 2023), that is to say, one out of every five women may have adenomyosis, but the actual diagnosis rate is far lower than the prevalence! It can also cause dysmenorrhea, infertility, excessive menstrual bleeding and other various problems.

So today, let’s get to know this common gynecological disease with ten questions and ten answers.

Question 1: What is adenomyosis?

Imagine the endometrium ( glands and stroma) is supposed to stay quietly in the uterine cavity, but some endometrial cells are a bit rebellious and sneak into the uterine muscle layer (scientific name “myometrium”), leading to adenomyosis.

These lost endometrial tissues, like the normal endometrium, will continue to proliferate and bleed with hormonal changes, but cannot be expelled like a normal menstruation, causing the uterine myometrium to gradually expand like a balloon, causing dysmenorrhea, excessive menstrual bleeding and other problems.

Question 2: Why do endometrial cells “get lost”?

The medical community has not yet figured out the cause of adenomyosis, but the following situations may cause endometrial cells to “deviate”:

Question 3:

What’s the difference between adenomyosis and endometriosis?

Both are endometrium “running away from home”, but addresses are different:

✅ Common points: Dysmenorrhea, infertility;

❎ Differences: Adenomyosis is more likely to cause heavy bleeding, while endometriosis often comes with pelvic adhesions.

Question 4: Is adenomyosis common?

The latest Meta-analysis shows that the prevalence of adenomyosis in women of childbearing age in our country is about 19.5% (data from 2023), that is to say, one out of every five women may have adenomyosis, but the actual diagnosis rate is far lower than the prevalence!

There are three reasons:

Question 5: Who is more likely to be affected?

Question 6: What impact may it have on the body?

The degree can be “barely able to go to work” or “unable to get out of bed”, and it may also cause chronic pelvic pain, dyspareunia.

Bleeding half a tank of blood in a month, pale complexion, dizziness, and fatigue.

The difficulty of embryo implantation increases, the miscarriage rate rises.

The uterus graduallyenlarges and stiffens, possibly accompanied by a feeling of lower abdominal distension.

Question 7: Can adenomyosis become cancerous?

No. Adenomyosis itself does not lead to cancer or transform into cancer.

Question 8: How can I know if I have adenomyosis?

For example, menstrual pain worsening over the years, increasing menstrual volume over the years, lower abdominal pain during intercourse and other are signals that need to be vigilant.

Palpation:
Bimanual palpation feels an enlarged, hard uterus;

Ultrasound/MRI:
Seeing the uterine myometrium thickening, uneven or localized adenomyoma lesions, etc.

Question 9: Treatment plan PK,

which one is more suitable?

The appropriate treatment plan needs to consider age, severity of symptoms, future fertility plans and so on, usually the first choice is the drug plan, to improve pain and/or excessive menstruation symptoms.

Existing evidence suggests that Mirena(IUD)is the most effective in controlling the symptoms of adenomyosis, with a symptom relief rate of 82%, and very good safety, recommended as first-line treatment.

If drug treatment cannot control your symptoms, and you no longer plan to have children, your healthcare provider may suggest surgical treatment.

The most radical surgical treatment is hysterectomy (hysterectomy).

Question 10: How long will adenomyosis bother me?

Most women who experience bothersome symptoms due to adenomyosis can get better with treatment, and after menopause, the symptoms of adenomyosis usually disappear as well.

Conclusion

Although adenomyosis is annoying, it is by no means a disaster. Scientific and standardized treatment can control the symptoms of most women. Remember, your pain is never trivial, and we always have the right to seek professional support!