Adenomyosis: a condition that affects one in five women, but it is almost unknown

He pain during menstruation has long been considered a mixture of taboo and hype. “It won’t be so bad.” Fortunately, over time, this is beginning to be given more importance. In some countries, such as Spain, sick leave For this reason and in general, research has expanded to some conditions that increase this pain. One of them, the most famous, is endometriosis. Although awareness and research on this issue has increased, in many cases diagnosis is still delayed too long. But things are even worse with adenomyosisanother condition associated with menstrual pain that is much less known and more difficult to diagnose.

In the case of endometriosis, this occurs when the tissue lining the uterus, called the endometrium, develops. in other regions outside this body. As a result, there are very painful periods and heavy bleeding. In addition, ectopic pregnancies, in which the embryo implants outside the uterus, and spontaneous abortions are more common when pregnant. On the other hand, with adenomyosis, what happens is that this endometrial tissue develops in the uterus, but in the wrong layer. Instead of the endometrium, in the outer muscle layer called myometrium.

As explained in the article for Talk researchers from Oxford University Jen Southcombe and Noura Fitnat Topbas SeltsukiAdenomyosis is thought to affect 1 in 5 women. However, diagnosing it is difficult, which coupled with the unknown nature of the disease means that many of these women are unaware of what is happening to them. Therefore, the first step to changing this situation is to reveal its existence.

What is adenomyosis?

The endometrium is the layer that it thickens as the menstrual cycle progresses, to accommodate the embryo in case of fertilization. If this does not happen, the endometrium is shed during menstruation, causing its characteristic bleeding.

As for the myometrium, it is a muscle layer that primarily performs two functions. On the one hand, this facilitates the stretching of the uterus in the event of pregnancy. On the other hand, to provoke uterine contractions. They are produced during childbirth and also during menstruation to facilitate the release of desquamated endometrium.

Each layer has its own function and they cannot be mixed. However, this is exactly what happens in people with adenomyosis. Areas of the endometrium that grow within the myometrium. they also thicken during the menstrual cycle, causing pain and increasing menstrual bleeding. In addition, the proper functioning of the muscle layer is disrupted, which causes pain and problems during pregnancy, if it occurs. These problems may be spontaneous abortionsbut also complications during childbirth, such as premature birth, preeclampsia or bleeding.

Very difficult to diagnose

It is estimated that approximately one third of people with adenomyosis they have no symptoms or have very mild symptoms. However, in other cases, all the symptoms already mentioned actually occur.

The taboo of menstruation and the normalization of pain lead to the fact that many patients do not seek help. This is the first reason why adenomyosis is so difficult to diagnose. But that is not all. Previously, the only way to detect endometrial tissue in the myometrium was to analyze the tissue after hysterectomy. That is, after the uterus was removed, it was submitted for analysis. This, logically, is a last resort option. Currently this can be done using MRI or ultrasoundalthough in some cases this is not enough, which is why it is so difficult.

In any case, if this condition is suspected, birth control or other treatments are usually prescribed. hormonal drugs, such as tranexamic acid. This keeps bleeding to a minimum, but if there is pain you usually have to add a little anti-inflammatory agent.

This, along with adequate monitoring, is usually the most common and effective option. But as we’ve already seen, the first step is to ask for help. Because pain during menstruation, no matter what we are told, is not normal and complaining about it is not an exaggeration. Would adenomyosis be so unknown if every fifth man had it? It’s worth thinking about.