Adenomyosis: another big name for another not-so-fancy condition. Of all women’s health conditions, this is probably one of the most understudied, misunderstood and misdiagnosed. Oftentimes a conclusive diagnosis of adenomyosis is only made after a hysterectomy! ( removal of uterus).
So what is Adenomyosis?
Adenomyosis is a non-cancerous gynaecological condition where the endometrial tissue grows into the outer muscular walls surrounding the endometrium ( myometrium). This often leads to a diffusely enlarged uterus commonly referred to as an adeno-belly. During a woman's cycle, when the estrogen levels rise, this endometrial tissue also begins to thicken and during menstruation, it attempts to shed off like the rest of the endometrium causing extremely painful periods and heavy bleeding. (Many women report passing out due to the severity of the pain.)
Adenomyosis is a close cousin of the more famous endometriosis. The difference is that in Adno the endometrial tissue grows in the wall of the uterus, while in Edno, the tissue grows outside the uterus and onto other organs like the ovaries, fallopian tubes , bowles etc. Oftentimes women who suffer from adenomyosis also suffer from endometriosis, since in both cases the origin of the problem is endometrial tissue going rogue, the difference is where this tissue decides to settle and grow.
Adenomyosis is often called the ‘hidden disease’ because unlike endo, it cannot be seen on laparoscopic surgery because it is hidden within the muscle. It tends to get missed on imaging tests and can’t be found unless you cut into the uterus at the exact spot where it is growing. Hence why it is most commonly found after a hysterectomy ( removal of uterus).
What causes Adenomyosis?
Adenomyosis is ONLY found in women during their reproductive years and this is because the condition is oestrogen-dependent - it needs estrogen to grow. For these reason, adenomyosis always clears upon menopause. 80% of the time it is found in women in their fortieth and fiftieth decades.
While there hasn’t yet been a conclusive answer on what exactly causes adenomyosis, there are a few clues on what leads to this debilitating condition:
Oestrogen Dominance- is a suspected cause of adenomyosis, this is where the intricate balance between oestrogen and progesterone is not so balanced. Oestrogen levels could either be too high or progesterone levels too low.
Inflammation - a wealth of research has been done on chronic inflammation and its connection to endometriosis. This same pathogenesis is linked to adenomyosis. Following childbirth and uterine surgery, the uterine lining is also naturally inflamed and the uterus may heal inward toward the muscle, instead of outward. This could also be why Ando is also more common in women who have already had children.
Blood Stagnation - In TCM, The main patterns associated with both endometriosis and adenomyosis are caused by stagnation (obstruction) of either the Qi (energy) and Xue (blood) or cold.
Impaired Immunity - When immunity is down, the reproductive organs also become susceptible to attack and the natural inflammatory process within the uterus may lead to abnormal growth in the endometrial tissue
Symptoms of Adenomyosis?
Painful menstrual cramps (dysmenorrhea).
Heavy menstrual bleeding (menorrhagia). Can lead to symptoms of anaemia like tiredness and dizziness.
Abdominal pressure and bloating
Bladder issues: (urge frequency, incontinence)
Chronic pelvic & back pain.
Painful intercourse (dyspareunia).
Enlarged uterus- on vaginal examination, the uterus feels enlarged and is often tender to touch
Bleeding in between periods - intermenstrual bleeding
IBS like symptoms - pain with bowel movements
Mental and emotional disturbances (depression, premenstrual dysphoric disorder)
Poor quality of life
Tips on managing Adenomyosis?
Sadly, conventional medicine offers several band-aid-like solutions to manage adenomyosis symptoms. These include hysterectomy and synthetic hormone treatments e.g the pill. TCM however looks at the problem holistically and aims to get to the root of the condition and help the body heal itself inside out.
For starters, TCM treatment aims to restore microcirculation, anti-inflammatory activity and regulation of the endocrine and immune systems. It uses some of the following methods:
Chinese herbs - A variety of herbs are used. Some are blood breakers (to invigorate the blood and move obstruction), others are warming spicy herbs (to warm the uterus and expel cold) and tonic herbs ( to help with pain and improve flow of the qi & blood.)
Acupuncture - Acupuncture therapy releases blocked qi in the body, evoking the body’s natural healing response through various physiological systems. Modern research has demonstrated acupuncture’s effects on the nervous system, endocrine and immune systems, cardiovascular system, and digestive system.
Get hormone testing done - Dried urine testing can tell how your body breaks down key hormones that aggravate your symptoms of adenomyosis and allows your health practitioner to create a better-suited healing protocol.
Avoid Endocrine Disruptors - Chemicals from everyday products like plastics, personal care products, cleaning products, and even non-organic produce contain endocrine disruptors that mess with your hormones. These synthetic hormones affect the normal hormonal balance aggravating symptoms of adenomyosis.
Get a handle on stress - Stress elevates cortisol, the stress hormone. When cortisol is elevated your body goes into survival mode and as a result switches off sex hormone production throwing things further out of whack!
DIET, DIET, DIET - Eating a whole foods, fibre-rich, anti-inflammatory diet that includes organic, colourful vegetables, seasonal fruits, raw nuts, seeds and beans is great for your femme health. Hormones are built from the fats we eat, so getting in some healthy fats like olive oil, avocados and other natural oils is beneficial for endocrine health. Removal of all inflammatory foods like processed, refined foods, dairy, coffee, sugar, gluten and alcohol is also essential as these foods trigger an inflammatory response from the body, messing with your cortisol production and throwing off your blood sugar levels.
Supplementation with magnesium - Magnesium is a muscle relaxant that offers a soothing effect for period pain. Soaking in a warm bath with Epsom salts ( naturally rich in magnesium) helps relieve pelvic congestion.
Applying heat: TCM affirms that cold is not good for the body and is a pathway to disease. Staying warm by heating our homes, wearing socks & booties as well as drinking warm liquids is a great way to dispel cold from the body. Use a heating pad, hot water bottle or castor oil pack on your abdomen to reduce pain symptoms during your period.
Exercise - Simply put a moving body is a happy body. Many women report a decrease in menstrual symptoms in months that they have been physically active. So go get your move on girl!
In conclusion, consider Adenomyosis as a sign that your body uses to tell you that things are out of balance and you need to take time for some self care. By taking time to feed your body right, manage stress, exercise and get sufficient sleep, you are taking giant steps towards reducing your symptoms and importantly improving your quality of life.