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Endometriosis and adenomyosis 101

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Angharad Rose
Mum of 1

Endometriosis and adenomyosis are two very similar but different conditions that are a major cause of pelvic pain. With a stigma still surrounding reproductive and menstrual health, there is a lot of generalised and incorrect information out there, so let’s clear things up with a quick lesson on these two conditions.

Endometriosis 101

Endometriosis is a chronic inflammatory condition in which tissue similar to (but different from) the lining of the uterus (the endometrium) is found outside the uterus and in other areas of the body.

This most commonly includes the ovaries, fallopian tubes, the bowels, and bladder. But it can even extend to the lungs, diaphragm, and kidneys. In fact, endometriosis has been found in every organ of the human body.

Endometriosis cells have an inflammatory reaction, which causes a range of symptoms in patients depending on the severity and location. Adhesions, which are thick bands of tissue that bind organs together, can also develop in areas that endometriosis affects.

The symptoms of endometriosis include (but are not limited to):

  • Chronic pain
  • Painful periods and ovulation
  • Extreme bloating
  • Painful sex
  • Pain with bowel movements

A common myth is that endometriosis is a reproductive condition that manifests just as painful periods. But endometriosis is different and, in fact, you don’t even need a period or a uterus to have endometriosis. Endometriosis affects people of all identities and genders, and there have even been cases of endometriosis found in cis males.

Unfortunately, there is no cure for endometriosis. Hormonal therapies can help manage symptoms, however the gold standard treatment is to receive excision surgery (an operation that involves cutting out all visible endometriosis) by an endometriosis specialist, as well as multidisciplinary care with pelvic floor therapy, pain management, and reducing inflammation. These specialists come few and far between, and receiving this treatment is often seen as a postcode lottery.

Adenomyosis 101

Adenomyosis is often referred to as ‘Endo’s sister’, and is far less known than endometriosis. In fact, it is so unknown that an iPhone keyboard doesn’t recognise it as a real word in the dictionary.

Adenomyosis is a condition where the endometrium (the tissue that lines the uterus) grows into the uterine muscular wall. The displaced cells continue to behave as usual in the menstrual cycle, thickening, breaking down, and bleeding.

Symptoms can include (but are not limited to):

  • Pelvic pain
  • Heavy and prolonged bleeding
  • Lower back pain
  • Extreme bloating
  • Bladder and bowel issues
  • Infertility

The symptoms of endometriosis and adenomyosis overlap, however the diagnosis for adenomyosis can be a trickier one. With endometriosis, a laparoscopic surgery (an operation where a small telescope is inserted in the abdomen) can be performed to see the presence of it, whereas adenomyosis can only be officially diagnosed through a histology report after a hysterectomy (as the uterus needs to be removed in order to test for adenomyosis). A clinical diagnosis can be given based on symptoms, or using transvaginal ultrasounds or MRIs.

There is a cure for adenomyosis and that is to have a hysterectomy to remove the uterus. Other common treatments that can help manage symptoms include pelvic floor therapy, non-steroidal anti-inflammatory medications, and hormone therapy.

It might sound rather bleak if you’re experiencing these symptoms, but the positive takeaway is that you are not alone if you suffer from either or both of these debilitating conditions. Endometriosis and adenomyosis warriors have taken to social media to build a community and educate the public. So if you are suffering and need advice, just know that there is friendship to be found in the online community.