March 27, 2025 | 10:27 am
TEMPO.CO, Jakarta - Adenomyosis is often called a silent disease because many women experience mild symptoms or no symptoms at all and often go undetected through ultrasound. There are also those who experience symptoms but are misdiagnosed for years.
Dr. Natalya Danilyants, a gynecological surgeon and director of the Center for Innovative Gyn Care in the United States, said that many OB-GYN specialists and researchers are not aware of this condition or do not take it seriously.
"Common issues in men and women, such as cancer, diabetes, or hypertension, receive more attention, but not adenomyosis. Patients are not aware of it. OB-GYN doctors may be aware of it but cannot educate patients, which leads to delayed treatment and further diagnosis," Danilyants said as quoted from USA TODAY, March 24, 2025.
What Is Adenomyosis, Symptoms, and Causes?
Adenomyosis occurs when the tissue inside the uterus, called endometrial tissue, grows into the uterine wall. As a result, the size of the uterus can swell 2-3 times, causing severe menstrual cramps and heavy bleeding. Other symptoms include irregular menstruation, pelvic pain, bloating, pain during sexual intercourse, and infertility. Abnormal bleeding can cause anemia and fatigue.
Unfortunately, adenomyosis symptoms are often mistaken for endometriosis symptoms, which is the growth of endometrial tissue outside the uterine wall. MRI is more accurate in detecting adenomyosis compared to ultrasound, but health insurance does not always cover it, so patients can spend up to tens of millions of rupiah. Danilyants said that even if signs of adenomyosis are found, doctors do not always take it seriously.
"Sometimes, patients come with copies of ultrasound or MRI findings and other reports mentioning suspected adenomyosis, and the patient is not even aware of it because the OB-GYN never emphasized it as a significant finding," Danilyants explained.
The cause of adenomyosis is not yet known, but Danilyants said that risk factors include being in one's 40s, having a history of multiple cesarean sections, curettage, and endometriosis, according to the Cleveland Clinic. Medications can help control symptoms, but the only way to treat adenomyosis is through a hysterectomy, a surgical procedure to remove the uterus. Most insurances cover hysterectomy if it is medically necessary.
Surgery is indeed a major decision. However, Danilyants said that vaginal or laparoscopic hysterectomy by specialists is a minimally invasive procedure that only takes 45 minutes under total anesthesia. Danilyants said that within seven days, her patients can already return to work. Recovery processes may vary for each person, but it usually takes 2-4 weeks, shorter than abdominal hysterectomy, which requires 6-8 weeks of recovery, according to the Brigham and Women's Hospital as well as the Cleveland Clinic.
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