Endometriosis, Adenomyosis and Uterine Fibroids: What difference does it make?


When using the internet and/or groups of friends to help self-diagnose our symptoms, we tend to be presented with a dizzying number of possibilities under the something-is-wrong-down-there umbrella. Being as how the mom squad on the park bench or group of co-workers around the water cooler hasn’t been to medical school and has little to nothing in the way of diagnostic equipment, it isn’t just for fun that we, on this site, repeatedly recommend regular doctor visits.

Let’s take a look at three different conditions that have a lot of symptom overlap.

  • Fibroids are muscular tumors that grow in or from the wall of the uterus.
  • Endometriosis occurs when the endometrial cells (the lining of the uterus) grow outside of the uterus.
  • Adenomyosis happens when the inner lining of the uterus grows into the muscle wall of the uterus (myometrium).

While each of these conditions causes some similar symptoms, they are all separate issues, each with its own treatment options.

All three can cause heavy menstrual periods, painful menstruation, abdominal and/or back pain, fullness or pressure in the pelvic area, bloating and pain during intercourse and can cause fertility issues.

Symptoms particular to each of these three conditions include the following

  • Fibroids can cause frequent urination or constipation.
  • Endometriosis: Pain not only during intercourse but also afterward, pain while urinating or defecating during menstruation, blood in urine during menstruation and potentially, signs of depression.
  • Adenomyosis: The only different symptom particular to adenomyosis is that the severe cramping during menstruation can also take on a sharp, knifelike feeling, more acute than either fibroids or endometriosis.

To complicate matters further, even the causes behind these three maladies have quite a bit of overlap.

  • Fibroids can be triggered by the hormones estrogen and progesterone and by genetic changes on a cellular level. Risk factors toward developing fibroids include women with African heritage, other hereditary factors, early menarche, obesity, vitamin D deficiency, diet and alcohol usage.
  • Endometriosis is thought to also have a genetic factor as well as misdirected menstruation, immunity problems, and endometrium cells reaching parts of the body where they do not belong.
  • Adenomyosis is also possibly caused by hormonal issues including not only estrogen and progesterone but also prolactin and follicle stimulating hormone. It is suggested that women who have had prior uterine surgery may be more at risk for this condition.

Fortunately, technology has become a huge assistance in reaching an accurate diagnosis, as well as in avoiding surgical intervention as much as possible, preserving both fertility and hormonal function and avoiding the pain, risk and recovery from surgery.

  • Fibroids are generally diagnosed via ultrasound.
  • Endometriosis is confirmed through laparoscopy but can sometimes be detected via ultrasound.
  • Adenomyosis was until very recently diagnosed only following a hysterectomy but more recently, ultrasound and MRI have been used to reach a diagnosis.

Finally, treatment. None of the array of symptoms caused by any of these conditions could be classified as pleasant. Women experiencing bleeding, various pains and other symptoms causing a decline in quality of life want and deserve relief and a return to a healthy, productive and comfortable life.

  • Fibroids Options for the treatment of uterine fibroids have thankfully expanded over the years. While once, the only options on the table were hysterectomy or suffer in silence, options now include myomectomy and uterine artery embolization as well as a number of pharmaceutical options.
  • Endometriosis was once only treated via hysterectomy which then expanded to include the less invasive laparoscopy, though now pharmaceutical options also exist for the treatment of endometriosis.
  • Adenomyosis is treated similarly to its cousins mentioned above, whereby hysterectomy was the original “cure” and has since been joined by endometrial ablation, uterine artery embolization as well as pharmaceutical options.

So, while different maladies have somewhat similar treatments, all of the above involve the intervention of competent, experienced medical professionals toward a return to regular activity and the happy, fulfilling comfortable life that you deserve.

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