I have recently read some online articles about adenomyosis and endometriosis and have noticed quite a few misconceptions about these disorders. Since I recently wrote a book on adenomyosis after months of research into clinical studies, I feel it is necessary to write a myth vs. fact blog on these disorders.
Many misconceptions come from old information. Some of these inaccuracies are a result of a failure of medical professionals to update their current knowledge. I hope the following information will clarify the facts on these two disorders.
Myth: Adenomyosis and endometriosis are the same disorder.
False. Adenomyosis and endometriosis are similar, but they are not the same disorder. Both involved misplaced endometrial tissue (the tissue that is shed each month in the form of a menstrual period). In endometriosis, these endometrial implants are found outside the uterus on organs such as the bowel, bladder, and ovaries. Endometrial implants have even been found as far away as the brain. In adenomyosis, the misplaced endometrial tissue invades the uterine muscle and is confined to this area. It is important to note that many women suffer from both disorders at the same time.
Myth: Adenomyosis only affects women in their 40s – 50s.
False. This myth is rampant online. This used to be thought, but in recent years, this disorder is being recognized in much younger women. According to a 2013 study by Taran et al., “the clinical age at presentation of adenomyosis may be significantly earlier than previously thought and that early-stage adenomyosis might present a different clinical phenotype compared to late-stage disease.”¹ The reason for this change is due to the discovery of the difference in width of the junctional zone within the uterine wall (will be discussed later).
Myth: Pregnancy will cure both adenomyosis and endometriosis.
False. Pregnancy will only subdue symptoms due to fluctuations in hormone levels. Once the pregnancy is over, symptoms will return, sometimes worse than ever. Pregnancy is NOT an effective “treatment” for these disorders.
Myth: Adenomyosis/endometriosis is due to some kind of physical trauma earlier in the woman’s life.
False. This is a very antiquated belief that is completely false. Both disorders can now be seen clearly on imaging tests if the physician/radiologist is knowledgeable about the disorders. Bowel resections have been done on patients where the endometriosis has progressed through the bowel wall. Both adenomyosis and endometriosis can clearly be pathologically proven, so the idea that the disorders are linked to some kind of abuse has been proven to be false.
Myth: Adenomyosis can’t be diagnosed until hysterectomy.
False. If you go to a physician who is well-versed in adenomyosis diagnosis and treatment, he/she should be able to obtain a diagnosis prior to hysterectomy. As mentioned earlier, it has been found that the width of the junctional zone can indicate the presence of adenomyosis. The width of the junctional zone, visualized on MRI, varies throughout a woman’s cycle but in general, a normal width is 5-8 mm. Studies now show that a junctional zone width of 12 mm. or more indicates the presence of adenomyosis. In a 2011 study by Novellas et al., it was determined a thickness of the junctional zone of greater that 12 mm. indicates adenomyosis with an accuracy of 85 percent and a specificity of 96 percent.² A study by Dueholm et al. states that the use of transvaginal sonography and MRI together gives the most accurate results in the diagnosis of adenomyosis.³
Myth: Adenomyosis and endometriosis can be cured through hysterectomy.
This is only partly true – false for endometriosis and true for adenomyosis. Since adenomyosis involves only the uterus, removing the uterus will cure the condition. Since endometrial implants are found outside the uterus in endometriosis, removing the uterus will not cure the condition. Many adenomyosis sufferers become very confused when their symptoms do not resolve after having a hysterectomy, which is understandable. An important thing to remember is that in a lot of women, both adenomyosis and endometriosis are present. If your symptoms persist after having a hysterectomy for adenomyosis, you have probably been suffering from both adenomyosis and endometriosis.
For more in-depth information, including the results of recent research, please check out my book, Adenomyosis: A Significantly Neglected and Misunderstood Uterine Disorder by Maria Yeager. It is available on Amazon in both paperback and Kindle formats.
¹Taran, F.A., Stewart, E. A., & Brucker, S. (2013). Adenomyosis: Epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy. Geburtshilfe Frauernheilkd, 73(9), 924-931. doi: 10.1055/s-0033-1350840
²Novellas, s., Chassang, M., Delotte, J., Toullalan, O., Cheallier, A., Bouasis, J. & Chevallier, P. (2011). MRI characteristics of the uterine junctional zone: From normal to the diagnosis of adenomyosis. American Journal of Roentgenology, 196(5). doi: 10.2214/AJR.10.4877
³Dueholm, M., Lundorf, E., Hansen, E. S., Sorensen, J. S., Ledertoug, S., & Olesen, F. (2001). Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis. Fertility and Sterility, 76, 588-594. doi: http://dx.doi.org/10.1016/Soo15-0282(01)01962-8