Adenomyosis and endometriosis are two common conditions that affect women's reproductive health. People often get confused between adenomyosis and endometriosis as the symptoms of the two conditions can be very similar. Both conditions involve the growth of endometrial tissue outside of its usual location in the uterus, and both can cause heavy menstrual bleeding, severe menstrual cramps, chronic pelvic pain, and pain during sex. In addition, both conditions can be difficult to diagnose because the symptoms often mimic other gynaecological conditions.Dr. Priyanka Suhag, Consultant - Obstetrics & Gynaecology, CK Birla Hospital (R), Delhi says, “Adenomyosis and endometriosis can sometimes occur together. Studies have shown that up to 50% of women with endometriosis may also have adenomyosis. When these two conditions occur together, the treatment can be challenging. However, there are a few differences between the two that can help people to distinguish the two conditions.”
Location of tissue growth
The main difference between adenomyosis and endometriosis is the location of abnormal growth of tissue. Adenomyosis occurs when endometrial tissue grows inside the muscular wall of the uterus, while endometriosis occurs when endometrial tissue grows outside of the uterus, such as on the ovaries, fallopian tubes, or other organs in the pelvic area.
Age and childbearing history
Adenomyosis and endometriosis also tend to affect women at different stages in their reproductive lives. Adenomyosis is more common in women over the age of 30 who have had children or multiple pregnancies, while endometriosis is more common in women in their 20s and 30s who have not had children.
Symptoms
According to Dr. Suhag, the symptoms of adenomyosis and endometriosis can be similar, there are some differences in the way they manifest. Adenomyosis causes more heavy and prolonged menstrual bleeding, while endometriosis may cause more pain during sex, painful bowel movements or urination during periods, and in some cases infertility.
Diagnosis
Diagnosing adenomyosis and endometriosis can involve different procedures. Adenomyosis is detected through imaging tests such as ultrasound or MRI, while a biopsy of the uterine tissue may be needed to confirm the diagnosis. On the other hand, endometriosis may be diagnosed through a laparoscopy, which is a minimally invasive surgical procedure that allows doctors to visualize the tissue from outside the uterus.
Treatment
The treatment options for adenomyosis and endometriosis can also differ. Hormonal birth control may be effective for managing symptoms of both conditions, however, adenomyosis may require more aggressive treatments such as uterine artery embolization or even hysterectomy in severe cases. Surgery to remove endometrial tissue or scar tissue may be recommended for women with endometriosis and assisted reproductive technologies may be needed for those experiencing infertility.“While adenomyosis and endometriosis share some similarities in terms of symptoms and causes, there are important differences between the two conditions that require proper diagnosis and treatment. If someone is experiencing symptoms of either condition, it's important to consult a doctor to get an accurate diagnosis and discuss the most appropriate treatment options for the condition with their gynaecologists,” says Dr. Suhag.
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