Endometriosis ('endo') is not the only reason a woman may have painful and/or heavy periods. There can be a few other reasons as well. Adenomyosis and fibroids are two such conditions. If you undergo a pelvic ultrasound and any other imaging and everything comes back unremarkable with no cysts, fibroids, nodules, or growths than it can merely be a case of increased estrogen and/or low progesterone contributing to the increased bleeding or pain. These hormone shifts can occur due to increased stress hormone ‘cortisol’ production, insulin dysregulation, gut dysbiosis, mold exposure, or something else.
Since April is Adenomyosis Awareness Month [1] and because the symptoms can be similar to endometriosis, which you have just read about or can read about in the previous post, let’s take a deeper dive into adenomyosis Often, a clinician will include both adenomyosis and endometriosis in their work-up when a woman is complaining of heavy and painful periods.
What Is Adenomyosis?
Adenomyosis is the growth of endometrial cells/tissue which pushes into the muscle layer (myometrium) of the uterus [1]. To recap, endometriosis is the growth of endometrial tissue outside of the uterus. Since adenomyosis is constrained to the uterus, if a partial hysterectomy is performed to remove the uterus, the condition will be “cured” as it isn’t found outside of the uterus. In endometriosis, a partial hysterectomy will not resolve the issue if there is endometrial tissue outside of the uterus such as in the abdomen. This extra-uterine endometrial tissue will still respond to estrogen unless that tissue is surgically removed in that localized spot.
Symptoms & Diagnosis
Symptoms:
- Heavy bleeding
- Passing of large clots
- Severe, stabbing pain in the pelvic area during your period
- Abdominal pressure or bloating
Diagnosis:
Once the history taking process is complete and the patient presents with the symptoms above, a transvaginal ultrasound and/or MRI [1] will be ordered which can diagnose adenomyosis. This makes the condition quicker and easier to diagnose than 'endo'.
Treatment Options
Since the symptoms of both adenomyosis and 'endo' are similar, conventional medical management for adenomyosis often involves the same which is Tylenol or NSAIDs like ibuprofen to deal with the pain. Since it is a condition that can arise from estrogen dominance, often the oral hormone pill will be recommended to help "balance the hormones out". To learn more about what the oral hormone contraceptive pill does, read this.
From a naturopathic approach, there are herbs and supplements to help modulate estrogen levels and support increasing progesterone if needed. We do have natural anti-inflammatory herbs to help with reducing inflammation and pain. We will always do a thorough history to identify any triggers that are leading to inflammation like autoimmunity, poor gut health, etc and work on improving those areas. Acupuncture treatments can also be integrated into your naturopathic care plan to support pain relief.
Do you have painful periods and are struggling to figure out what is going on behind your excruciating menstrual symptoms?
Thinking if your period symptoms may be related to adenomyosis?
Hesitant to go on the pill as your doctor recommended and want to just get another opinion or try a different approach first?
Book an initial assessment or even a quick alignment session with me. Open to residents of Ontario and Alberta!
Reference:
[4] The Endometriosis Network Canada (2022). “Adenomyosis vs Endometriosis: What you need to know”. Retrieved on April 4 2022 from https://endometriosisnetwork.com/blog/april-is-adenomyosis-awareness-month
