In her recent memoir, actress Gabrielle Union has opened up about her fertility challenges revealing that she had “eight or nine miscarriages” and countless rounds of in vitro fertilization (IVF). She also revealed that she has been diagnosed with adenomyosis, a form of endometriosis that often negatively affects a woman’s fertility. The diagnosis finally provided her with “answers”.

What is adenomyosis?

Adenomyosis occurs when tissue that normally lines the inside of the uterus is found outside the uterus — specifically in the muscle layers around it. The tissue is affected by hormones and acts like it normally would thickening at the start of the menstrual cycle and breaking down and bleeding at the end of the cycle. As a result, the uterus becomes swollen and enlarged, typically causing painful, heavy periods.

Why does adenomyosis occur?

While the cause of adenomyosis is not fully understood, damage to the inner wall of the uterus during pregnancy, labor, cesarean delivery, any surgical procedure in the lower abdomen, and/or postpartum bleeding provide an opportunity for healthy cells to invade the muscle of the otherwise healthy uterus causing the condition. Another theory is that in young baby girls, the tissues simply migrate abnormally.

Who gets adenomyosis?

Although a woman can experience adenomyosis at any time during her life cycle, symptoms usually  develop in the 40s to mid-50s typically beyond childbearing years and still menstruating regularly. Interestingly, there do not seem to be any risk factors or family history connections.

What are the symptoms?

A third of the women with the condition have no symptoms at all, but long, heavy and painful periods is the most common symptom. The pain can range from severe cramping to sharp, knife-like pain. Because the abnormally located tissue is composed of normally functioning cells, the regular menstrual cycle can cause bloating, uncomfortable pelvic pain, and unusual spotting. Other symptoms include:

• Low back pain
• Frequent urination and
• Painful intercourse
• Pelvic heaviness/tenderness

How is adenomyosis diagnosed?

There are a number of ways to diagnose this condition and a diagnosis is often difficult because it mimics other conditions that have similar signs and symptoms. If you’re experiencing symptoms, your gynecologist may identify adenomyosis during a pelvic exam. You may also have a vaginal ultrasound and magnetic resonance imaging (MRI), non-invasive procedures that more precisely identify where and how much adenomyosis is in the uterus, to confirm or diagnose this condition. A uterine biopsy, is another more invasive way to diagnose adenomyosis. Because the symptoms are similar to those experienced with fibroids, it’s important to accurately diagnose adenomyosis so you receive the appropriate treatment. 

How is adenomyosis treated?

If you aren’t experiencing symptoms, or if your symptoms are mild, you may elect to forgo treatment. However, if you’re experiencing symptoms, your gynecologist may prescribe anti-inflammatory drugs (like ibuprofen), conventional hormone-based treatment such as combined estrogen-progestin birth control pills, vaginal rings, a progesterone-only intrauterine device (IUD), or patches which may help lessen the heavy menstrual bleeding and pelvic pain. Some women may opt for hysterectomy or removal of the uterus, as this is the only way to completely cure the condition. Your gynecologist may also suggest a hysterectomy to remove your uterus. Typically your ovaries would not need to be removed so you’d maintain hormonal function.

On a more positive note, the consistent employ of traditional treatment modalities like vaginal steaming, acupuncture, thai yoga massage, and herbal therapy efficiently and effectively address the underlying cause of the condition for lifelong healing.