WOMENS-HEALTH Messages for December, 1998: Re: adeno and exam

Re: adeno and exam

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Thu, 10 Dec 1998 18:21:12 -0600 (CST)

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In reply to: Ronna: "adeno and exam"

At Thu, 10 Dec 1998, Ronna wrote: >
>can a doctor make a dx of adenomyosis by doing a exam?

Although it's not possible to make an exact diagnosis of adenomyosis without either a uterine biopsy (difficult to do) or a hysterectomy specimen, it is possible to make an "educated guess" that the patient has this condition. First of all, adenomyosis occurs when the tissue lining the inside of the uterus, called the endometrium, grows in to the muscular, outer layer of the uterus. (A similar condition is endometriosis, where the lining tissue is found completely outside of the uterus, on other organs).

Most cases of adenomyosis likely cause no symptoms, but some women develop pelvic pain, heavy bleeding, or painful intercourse. When we feel the uterus, it usually is fairly firm, like, for instance, a firm pear or apple. Adenomyosis produces a "spongy" or "boggy" uterus, like a peach that's been sitting out for a few days. (O.k., you gynecologists reading this can give me a break on this one; I'm post-call with 2 hours of sleep last night, and I'm *really* trying to come up with a good example)! The uterus is typically enlarged, also. A vaginal ultrasound sometimes helps make the diagnosis, as does an MRI. However, neither are 100%, and the latter is very expensive.

Adenomyosis is usually treated surgically (hysterectomy), although some women find relief from powerful medications called GnRH agonists, which produce menopause for a month at a time (the menopause reverses once you are finished with the medication). This helps shrink the adenomyosis.

I hope this helps answer your questions.

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://home.mpinet.net/dahmd

The above is intended for general medical education, and is not for specific medical advice. I apologize, but I am unable to answer personal e-mail due to time constraints.

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