BBC presenter Naga Munchetty recently revealed that she suffers from adenomyosis, a chronic condition that affects the uterus. She spoke of how her pain can leave her unable to move and how a recent flare-up was so intense her husband had to call an ambulance.
Yet many people have never heard of this condition, despite it affecting as many as one in five women.
Adenomyosis can cause symptoms including irregular and heavy menstrual bleeding and pelvic pain. The severity of symptoms varies between patients – up to one-third of women with adenomyosis may have minimal or no symptoms at all.
The condition can also affect fertility. Women with adenomyosis who do become pregnant have an increased risk of miscarriage, pre-term delivery, pre-eclampsia and bleeding after delivery.
So what causes adenomyosis, and how is it diagnosed and treated? There’s still a lot we don’t understand about this condition, but here’s a bit about what we know so far.
There are two key layers in the uterus. The endometrium is the inner layer where embryos implant. If there is no pregnancy, this layer is shed during a period. The myometrium is the muscular layer of the uterus. It expands during pregnancy and is responsible for contractions. In people with adenomyosis, endometrium-like cells are found in the wrong place – the myometrium.
Although a large number of women with adenomyosis have endometriosis as well, adenomyosis is a distinct disease from endometriosis. In endometriosis, endometrium-like cells are also found in the wrong place, but in this case outside of the uterus, mainly in the pelvic cavity.
Thanks to research, public engagement and social media, awareness of endometriosis has increased in recent years. Yet adenomyosis is still relatively unheard of.
Adenomyosis is a difficult condition to diagnose. Historically, the presence of endometrium-like cells in the myometrium could only be verified by pathology assessment where the myometrium is examined under a microscope after a hysterectomy (surgery to remove the uterus).
Recent years have seen increased diagnoses with the development of imaging technologies such as MRI and detailed pelvic ultrasound. Although adenomyosis is now commonly identified without the need for a hysterectomy, doctors are still working towards developing a standardised method for non-surgical diagnosis.
As a result, it remains uncertain exactly how many women have adenomyosis. Although we know that around 20% of women having hysterectomies for reasons other than suspected adenomyosis are found to have evidence of the condition on pathology assessment.
The type of adenomyosis tissue growth in the myometrium can be either focal lesions (affecting a part of the uterus) or diffused (affecting a wide area of muscle). Adenomyosis can be further classified depending on the depth of endometrial-like tissue invasion into the myometrium. Scientists and doctors are still investigating whether the type or depth of the lesions relates to symptoms – the severity of symptoms and lesions don’t always tally.
We don’t yet understand why some women develop adenomyosis, though evidence shows there is an increasing prevalence with age.
It is thought that the region between the endometrium and myometrium becomes damaged, either by the natural processes of the menstrual cycle, pregnancies and childbirth, or medical procedures. In some women, damage to the endometrial tissue layer does not heal as it should and the endometrium-like cells enter and grow abnormally into the myometrium. These disrupt the normal functions of the myometrium leading to pain and bleeding.
It’s possible that a variety of mechanisms may contribute, and that there is not one common disease-causing factor behind adenomyosis.
Treatment strategies include hormonal medications such as oral contraceptives, progesterone-containing pills, the insertion of a progesterone-releasing coil (for example, Mirena), or a drug called GnRHa that stops the natural production of sex hormones. Non-hormonal treatments include tranexamic acid. These treatments aim to minimise menstrual bleeding. Pain is often treated with non-steroidal anti-inflammatory drugs.
Treatments that work for some women don’t for others, adding weight to the argument that there’s more than one type of adenomyosis. Treatment strategies should be tailored to patients, depending on their fertility wishes and symptoms.
If medical treatments are not providing adequate relief from symptoms, there are surgical options, namely removal of the focal lesions or a hysterectomy.
Although adenomyosis is a common disorder that affects many women, including those of reproductive age, it doesn’t receive enough clinical and research attention. There is also a lack of knowledge and awareness around adenomyosis among many healthcare professionals and the public. This needs to change so we can improve our understanding of the condition, diagnosis and treatment options.
Scientists and doctors who specialise in adenomyosis are still on the quest to find an accurate, non-invasive diagnostic method, and hopefully, one day, a cure.
Reuters
Sat May 27 2023
BBC presenter Naga Munchetty recently revealed that she suffers from adenomyosis, a chronic condition that affects the uterus. - INSTAGRAM/tvnaga
Pasaran getah ditutup tinggi disokong kenaikan harga minyak mentah
Pasaran getah Kuala Lumpur ditutup tinggi pada Isnin, disokong oleh kenaikan harga minyak mentah dan ringgit yang lemah berbanding dolar AS, kata seorang peniaga.
JPA perlu beri fleksibiliti kepada jabatan, agensi nilai prestasi penjawat awam - Pakar
Jabatan Perkhidmatan Awam (JPA) perlu memberi fleksibiliti kepada jabatan-jabatan dan agensi-agensi Kerajaan di semua peringkat untuk menilai prestasi penjawat awam.
Mohamed Khaled adakan lawatan rasmi ke Turkiye Jun ini
Menteri Pertahanan Datuk Seri Mohamed Khaled Nordin akan melakukan lawatan rasmi ke Turkiye pada Jun ini bagi meningkatkan lagi kerjasama strategik dari segi pertahanan antara kedua-dua negara.
81 peratus kes dilaporkan kepada IMFC selesai, percepat realisasi pelaburan - Tengku Zafrul
81 peratus daripada 464 kes yang dilaporkan kepada Pusat Memudah Cara Pelaburan Malaysia (IMFC) telah diselesaikan dan berjaya mempercepat proses realisasi pelaburan-pelaburan yang diumumkan.
Tumpuan Selasa - 07 Mei 2024
Ikuti rangkuman berita utama yang menjadi tumpuan di Astro AWANI.
Hamidin masih ada misi yang belum selesai sebagai Presiden FAM
Presiden Persatuan Bolasepak Malaysia (FAM) Datuk Hamidin Mohd Amin memberi bayangan untuk terus menerajui badan induk itu kerana terdapat misi yang masih perlu diselesaikan di bawah kepimpinannya.
Persidangan Antarabangsa Ketua-Ketua Agama tiada agenda pluralisme agama - Mohd Na'im
Menteri di Jabatan Perdana Menteri (Hal Ehwal Agama) Datuk Mohd Na'im Mokhtar menafikan Persidangan Antarabangsa Ketua-Ketua Agama 2024 esok ada kaitan dengan agenda pluralisme agama.
AWANI Tonight: 6 May 2024
#AWANITonight with @Hafiz_Marzukhi
1. Man arrested for attack on national football player remanded for two days - Police
2. Pay rise should be transparent & holistic - Economist
#AWANIEnglish #AWANINews
1. Man arrested for attack on national football player remanded for two days - Police
2. Pay rise should be transparent & holistic - Economist
#AWANIEnglish #AWANINews
Permohonan aktivis untuk cabar keputusan AG tak dakwa pendakwah ditolak
Panel tiga hakim membuat keputusan sebulat suara menolak permohonan yang dikemukakan oleh S. Sivakumar dan M. Rajasegaran.
Forum Putrajaya 2024: Perkuat diplomasi pertahanan, manfaatkan teknologi baharu
Menteri Pertahanan, Datuk Seri Mohamed Khaled Nordin, menekankan pentingnya meningkatkan diplomasi pertahanan dan memanfaatkan teknologi baharu untuk menangani ancaman bukan tradisional dan trend yang muncul.