Adenomyosis Treatment Singapore - Dr Ma Li Clinic

about Endometriosis

What is adenomyosis?

Adenomyosis is a common medical condition in Singapore characterised by tissues from the inner lining of the uterus (endometrial-like tissue) growing into the muscle walls of the uterus. As the uterine lining thickens, breaks down and bleeds during menstruation, so do these foreign tissues. This, in turn, causes the uterus to double, or triple in size, causing severe period cramps and heavy menstrual bleeding. Although adenomyosis is not a life-threatening condition, it can greatly impact your quality of life and cause complications, such as miscarriages.

Adenomyosis is a medical condition where tissues from the inner lining of the uterus grow into the muscle walls, and can either be sporadic or focal.

What are the common causes of adenomyosis in Singapore?

Whilst the exact cause is not definitive, some theories include;

Endometrial cells are accidentally ‘implanted’ into the uterine muscles during uterine surgical procedures.
Congenital abnormalities such as the presence of tissues in the uterine wall grow as you age.
The boundaries that separate cells in the lining of the uterus and the muscle wall deteriorate due to uterine inflammation, which could have occurred after childbirth.
Stem cells are ‘transported’ to the uterine muscle wall which then develops into abnormal tissues.

What are some of the symptoms of adenomyosis?

1 in 3 women with adenomyosis tend to be asymptomatic while others may experience some of the following symptoms:

An enlarged uterus.
Bloated belly.
Blood clots during period bleeding.
Heavy, or prolonged period bleeding (menorrhagia).
Infertility.
Irregular periods.
Painful sexual intercourse (dyspareunia).
Painful period cramps (dysmenorrhea).
Pelvic pain, accompanied by severe camping, or without.

Severe period cramps are a common symptom of adenomyosis.

What are some of the risk factors of adenomyosis?

While any woman can be at risk of adenomyosis, certain factors increase the risk of developing the condition;

Age: women who are in their 30s, or 40s are more likely to be diagnosed with adenomyosis. Meanwhile, women who are in their adolescent years, or are in their 50s pose a smaller risk of developing the condition.
Breast cancer treatment: a breast cancer drug called, tamoxifen, leads to a higher risk of developing adenomyosis.
Mental health conditions: being diagnosed with depression, or having a history of antidepressant use can increase your risk of getting adenomyosis.
Previous uterine surgery: if you had previously undergone uterine surgery, like a caesarean delivery or surgery to remove fibroids, then you stand a higher chance of being diagnosed with adenomyosis.
Smoking: although studies are limited, smoking has been associated with stimulating the development of adenomyosis.

If you think you are at risk of having adenomyosis, then we implore you to book a consultation with Dr. Ma Li.

How is adenomyosis diagnosed in Singapore?

It is possible to misdiagnose adenomyosis because the symptoms are similar to those of other gynaecological conditions such as endometriosis and uterine fibroids. As such, our doctors will conduct the following diagnostic procedures to investigate if your symptoms are caused by adenomyosis:

Imaging tests: by using imaging machines, or equipment such as magnetic resonance imaging (MRI), or a transvaginal ultrasound, our doctors will be able to confirm the presence of an enlarged uterus or to detect thickening is present in the uterus.
Pelvic exam: another indicator of an enlarged uterus is that your lower abdomen feels tender and painful when palpitated.
Biopsy: although a biopsy does not necessarily confirm an adenomyosis diagnosis, it does help doctors rule out other more serious conditions, such as uterine cancer.

How is adenomyosis treated in Singapore?

The first action plan to treat adenomyosis is to alleviate the symptoms. Generally, doctors will opt for one of the following fertility-safe medications to reduce the symptoms:

Birth control pills: birth control pills are known to help lighten the menstrual flow which helps to reduce pain and discomfort during menstruation.
Danazol: danazol is a medication that suppresses the pituitary gland’s ability to create certain hormones, like follicle-stimulating hormone (FSH), to reduce pelvic pain and reduce menstrual flow.
Gonadotropin-releasing hormone agonists: this refers to a group of medications that reduce pelvic pain and menstrual flow by halting the ovaries from producing hormones.
Hormone-containing intrauterine device (IUD): aids in shrinking the uterus to normal size by easing cramps and reducing menstrual blood flow.
Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs are often used to provide relief from menstrual cramps (pain).

Hysterectomy is often the last treatment option for adenomyosis, in the event all prior treatments were fruitless.

Additionally, doctors will only consider surgical procedures to treat adenomyosis if medicinal intervention if your condition does not improve. These surgical procedures include:

Adenomyomectomy: an adenomyomectomy is a surgical procedure that removes abnormal tissue growth from the uterine muscles.
Hysterectomy: if your adenomyosis symptoms are severe, then your medical provider may recommend completely removing your uterus. However, this recommendation is mostly reserved for older patients.
Uterine artery embolization: uterine artery embolization blocks the blood supply to the lining of the uterus, which results in lighter menstrual blood flow.

As there are no known causes of adenomyosis, it further emphasises the importance of regular gynaecological screening. Schedule an appointment with Dr. Ma Li today if you suspect you’re at risk of adenomyosis.

FAQs

Frequently asked questions

Is adenomyosis a common medical condition?

Adenomyosis is an arguably common condition that affects roughly 20%-35% of women globally. However, it is very common among women who are aged 40-50 years old (roughly 70%-80%).

Is adenomyosis the same as endometriosis?

No, adenomyosis is not the same as endometriosis whilst adenomyosis is a condition where endometrial-like tissue grows into the muscle of your uterus. Endometriosis, on the other hand, is the growth of endometrial tissue outside the uterus in places like ovaries and fallopian tubes.

How can I prevent adenomyosis?

Unfortunately, due to the lack of understanding surrounding the causes of adenomyosis, there is no way to prevent it. However, the next best course of action is to manage your risk factors.

Can adenomyosis affect my chances of getting pregnant?

Yes, adenomyosis can negatively affect your chances of getting pregnant and increase the risk of miscarriage.

What happens if adenomyosis is left untreated?

Adenomyosis if left untreated lead to infertility or miscarriage.

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