One of the most common conditions women complain of is heavy vaginal bleeding and pain during their menstruation cycle. Adenomyosis, or uterine endometriosis, is one of the most prevalent conditions causing these symptoms.
Adenomyosis occurs when the lining of the uterus penetrates the muscle of the uterus and causes the uterus to act as a sponge. As a woman gets closer to having her period, the uterus becomes full of blood and congested and when the period starts, the bleeding pours out of the endometrial lining and the uterus, as if a sponge is being squeezed. The congestion causes fullness and pressure in the lower abdomen and once the bleeding starts, the large amount of blood trying to exit the uterus causes cramping and pressure that can be very severe.
How is the diagnosis made?
An ultrasound examination in the office can easily identify the many causes of pain and bleeding. We use transvaginal or trans-abdominal ultrasound as needed and with the advanced technology in our ultrasound system, we can use 3D options to further evaluate the uterus and the ovaries. We also utilize Doppler to evaluate the blood flow.
In situations when the problem is hormonal or due to an enlarged uterus as a result of adenomyosis, identified treatment is usually hormonal. We use natural progesterone creams or pills, low dose hormonal birth control, or hormonal IUD as the first line of therapy. The hormone progesterone in these treatments helps decrease the congestion of the uterus and is usually extremely effective in resolving pain and heavy bleeding. Minimally invasive surgical options such as uterine artery embolization and endometrial ablation are also very effective in treating the more severe cases which do not respond well to conservative measures.