He menstruation pain has long been considered a mix of taboo and hype. “It won’t be that bad.” Fortunately, over time it is beginning to be given more importance. In some countries, such as Spain, the sick leave For this reason and, in general, research has increased into some of the conditions that worsen this pain. One of them, the best known, is the endometriosis. Even though awareness and research on it has increased, diagnoses continue to be delayed for too long on many occasions. But even worse is the case of the adenomyosisanother condition related to menstrual pain that is much less known and more difficult to diagnose.
In the case of endometriosis, this occurs when the tissue that lines the uterus, called the endometrium, develops in other regions outside this body. As a result, there are very painful menstruations and intense bleeding. Furthermore, in the case of pregnancy, ectopic pregnancies, in which the embryo implants outside the uterus, and spontaneous abortions are more common. On the other hand, with adenomyosis what happens is that this endometrial tissue develops in the uterus, but in the wrong layer. Instead of in the endometrium, in an outer muscular layer, called myometrium.
As explained in an article for The Conversation researchers from the University of Oxford Jen Southcombe and Nura Fitnat Topbas Selcukiit is estimated that adenomyosis affects 1 in 5 women. However, her diagnosis is complicated, which, together with the unknown nature of the disease, means that many of these women are not aware of what is happening to them. Therefore, the first step to change this situation is to disclose its existence.
What is adenomyosis?
The endometrium is the layer that it thickens as the menstrual cycle progresses to accommodate the embryo in case fertilization occurs. If this does not occur, the endometrium is shed during menstruation, giving rise to its characteristic bleeding.
As for the myometrium, it is a muscular layer that has mainly two functions. On the one hand, it makes it easier for the uterus to stretch if pregnancy occurs. And, on the other hand, provoke the uterine contractions. These are produced during childbirth, but also during menstruation, to facilitate the release of desquamated endometrium.
Each layer has its function and these should not be mixed. However, this is just what happens in people with adenomyosis. Patches of endometrium that grow in the myometrium they also thicken during the menstrual cycle, causing pain and increasing menstrual bleeding. In addition, the correct functioning of the muscle layer is hindered, causing pain and problems during pregnancy if it occurs. These problems can be spontaneous abortionsbut also complications during childbirth, such as premature births, preeclampsia or hemorrhages.
Very difficult to diagnose
It is estimated that approximately one third of people with adenomyosis they do not have symptoms or they have very mild symptoms. However, in other cases all the symptoms already mentioned do occur.
The taboo of periods and the normalization of pain lead many patients not to ask for help. That is the first reason why it is so difficult to diagnose adenomyosis. But that is not all. In the past, the only way to detect endometrial tissue in the myometrium was to analyze this tissue after a hysterectomy. That is, once the uterus was removed, it was analyzed. This, logically, is an extreme option. Currently it can be done by MRI or ultrasoundalthough in some cases it is not enough, which is why it is so complicated.
In any case, if this condition is suspected, treatments with contraceptives or other treatments are usually prescribed. hormonal drugs, such as tranexamic acid. In this way, bleeding is minimized, but for pain it is usually necessary to add some anti-inflammatory.
This, and adequate monitoring, is usually the most common and effective option. But, as we have already seen, the first step is to ask for help. Because period pain, no matter what they tell us, is not normal and complaining about it is not an exaggeration. Would adenomyosis be so unknown if it affected 1 in 5 men? It’s worth thinking about.