Adenomyoma: Description, Causes and Risk Factors:An adenomyoma is an abnormal growth within the muscle tissue lining of the uterus. It is formed when endometrial tissue, the cells that normally make up the innermost lining of the uterus, start growing spontaneously deep within the uterine walls. An adenomyoma is usually benign and does not cause symptoms, though an especially large growth may cause discomfort, tenderness, and heavy bleeding during menstrual periods.The exact causes of adenomyoma growth are unclear. The actual disorder that spurs the development of the mass is called adenomyosis, which is very similar to another type of uterine cell displacement called endometriosis. Adenomyosis does not always result in an adenomyoma. As endometrial cells start invading muscle tissue, they may spread uniformly and cause the tissue lining to thicken. Adenomyomas occur when clusters of cells protrude through the muscle layer.Regardless of how adenomyoma develops, its growth depends on the circulating estrogen in a woman's body. When estrogen production decreases at menopause, adenomyosis eventually goes away.Risk factors for adenomyoma include:Prior uterine surgery, such as a C-section or fibroid removal.
Most cases of adenomyosis, which depends on estrogen, are found in women in their 40s and 50s, with a low incidence after menopause. Finding adenomyosis in middle-aged women could relate to longer exposure to estrogen compared with that of younger women.
Symptoms:An adenomyoma may or may not cause symptoms. When symptoms are present, they may include heavy menstrual bleeding and spotting between periods. Adenomyomas can be tender and cause significant pain during menstruation and intercourse. Symptoms tend to worsen over time if they are not assessed and treated in the early stages of adenomyosis.Diagnosis: The diagnosis of adenomyomais suspected if the uterus feels enlarged and tender to the touch during the pelvic examination. However, the diagnosis of adenomyoma based on these findings is often inaccurate, and other causes-fibroids, endometriosis, or polyps-are often found as the cause for the bleeding or discomfort. The diagnosis may be suggested by the appearance of the uterus on a sonogram, although it is often difficult to tell the difference between adenomyoma and fibroids using sonography. MRI is better at detecting adenomyoma, but the test is very expensive and rarely used for this purpose. Unfortunately, the only way to establish the diagnosis of adenomyoma with certainty is with surgery. Once removed, the tissue can be examined under the microscope, and the uterine lining cells can be seen within the muscle wall.Treatment:The medications Lupron or Synarel can cause cessation of the periods and associated menstrual cramping and even lead to shrinkage of the swelling associated with adenomyosis. However, the effect is temporary-when the medication is discontinued, the symptoms return. At the present time, the only treatment for adenomyosis is surgery. In situations where the adenomyosis is confined to isolated areas in the muscle wall, an attempt may be made to surgically remove these areas and repair the rest of the uterus. In situations where the majority of the uterus is affected, hysterectomy may be the only cure.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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