The OTHER ENDO

Adenomyosis is sometimes called "the other endo," but it is not the same disease.

If you have endometriosis, chances are, during one of your many internet searches hoping to self diagnose, you probably stumbled upon the word adenomyosis.

What is Adenomyosis?

According to the Mayo Clinic's website, adenomyosis occurs when tissue similar to the uterine lining grows into the uterus's muscular wall. This tissue still reacts to hormonal fluctuations throughout the menstrual cycle, potentially causing the uterus to enlarge (sometimes to two or three times its usual size) and resulting in pain and heavy bleeding.

Endometriosis, conversely, is characterized by endometrial-like tissue growing outside the uterus. This condition often involves the presence of such tissue on the bowel, bladder, appendix, ovaries, fallopian tubes, and, in some uncommon instances, the liver, lungs, and, very rarely, the brain.

The two conditions are different, but they can occur together — which can make an already complicated diagnosis even more complicated.

What are the symptoms of Adenomyosis?

• Heavy or prolonged periods

• Severe menstrual cramps

• Pelvic pain

• Pain during sex

• Abdominal pressure or tenderness

How is it diagnosed?

Doctors may use a transvaginal ultrasound or MRI to look for signs of adenomyosis. But diagnosis isn't always straightforward because its symptoms can overlap with endometriosis and fibroids. Historically, the only way to definitively confirm adenomyosis is through examination of the uterus after a hysterectomy.

My personal experience

It took approximately ten years for me to be diagnosed with endometriosis, and another eleven years before a surgeon suspected I might also have adenomyosis. During my third surgery for endometriosis, I underwent a hysterectomy, which confirmed the diagnosis. My surgeon could essentially tell just by examining the exterior of my uterus that he would find adenomyosis. I was never diagnosed using an ultrasound or MRI. The only conditions I ever had diagnosed purely using an ultrasound were fibroids and ovarian cysts. Never endometriosis or adenomyosis.

Adenomyosis and fertility

Research suggests adenomyosis may make pregnancy more difficult and may increase miscarriage risk, particularly among people undergoing fertility treatment. However, researchers are still working to determine exactly how much adenomyosis itself contributes to infertility, since it frequently occurs alongside endometriosis, according to the National Library of Medicine.

Treatment options

• Anti-inflammatory drugs: Your doctor might recommend an anti-inflammatory medicine, such as ibuprofen (Advil, Motrin IB, others). You may start taking the medicine 1 to 2 days before your period begins and continue taking it during your period. This can lessen menstrual blood flow and help relieve pain.

• Hormonal birth control: Combined estrogen-progestin birth control pills or hormone-containing patches or vaginal rings might ease heavy bleeding and pain. Progestin-only contraception, such as an intrauterine device (my top choice), or continuous-use birth control pills causing amenorrhea (when menstrual periods stop) which might provide some relief.

• Hysterectomy: If you have a lot of pain and heavy bleeding with periods, and no other treatments have worked, your doctor might suggest surgery to remove the uterus. Removing the ovaries isn't needed for adenomyosis. (I kept mine to avoid an early menopause).

Having both ENDOMETRIOSIS and ADENOMYOSIS

Can you have both? Yes. Adenomyosis and endometriosis can occur together, and their overlapping symptoms can make both conditions harder to diagnose.

That's why understanding the difference matters. Treating endometriosis doesn't necessarily mean adenomyosis isn't contributing to someone's pain or heavy bleeding.

To learn more, view The Endo Report: Episode six "The Other Endo" by clicking here.