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Definition:

Adenomyosis is uterine thickening that occurs when endometrial tissue, which normally lines the uterus, moves into the outer muscular walls of the uterus.



Alternative Names:

Endometriosis interna; Adenomyoma



Causes, incidence, and risk factors:

The cause is unknown. Sometimes adenomyosis may cause a mass or growth within the uterus, which is called an adenomyoma.

The disease usually occurs in women older than 30 who have had children. It usually occurs in women who have not carried a pregnancy to term.

It is more likely in women with previous cesarean section or other uterine surgery.



Symptoms:

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



Signs and tests:

During a pelvic exam, the doctor may find an soft and slightly enlarged uterus. The exam may also reveal a uterine mass or uterine tenderness.

An ultrasound of the uterus may help tell the difference between adenomyosis and other uterine tumors. MRI can be helpful when ultrasound does not give definite results.



Treatment:

Most women have some adenomyosis as they near menopause but few women have symptoms, and most women don’t require any treatment.

In some cases, pain medicine may be needed. Birth control pills and a progesterone-containing intrauterine device (IUD) can help decrease heavy bleeding.

A hysterectomy may be necessary in younger women with severe symptoms.



Support Groups:



Expectations (prognosis):

Symptoms usually go away after menopause. A hysterectomy completely relieves symptoms.



Calling your health care provider:

Call for an appointment with your health care provider if you develop symptoms of adenomyosis.



Prevention:



References:

Katz VL. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 18.

Speroff L, Fritz MA. Dysfunction uterine bleeding. In. Speroff L, Fritz MA, eds. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Philadelphia, Pa: Lippincott Williams and Wilkins; 2005:chap 15.




Review Date: 10/28/2008
Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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