Adenomyosis: When period pain is more than it should be

This article is sponsored by The Center for Innovative GYN Care

If left untreated, some GYN conditions can lead to long-term damage. There are conditions that are not well understood by many physicians, and can be difficult to diagnose. Adenomyosis is a painful and complex gynecological condition that can be difficult to detect. An ultrasound is insufficient to detect the disease in the uterus. In many cases, an MRI can detect adenomyosis, but if it is small and diffuse, it may not appear on any imaging, and can only be diagnosed during surgery. The only cure is a hysterectomy.

There is a dearth of research on the condition itself, as well as lack of definitive research on treatments other than surgical removal of the uterus. Limited knowledge in the medical community about how to diagnose and treat adenomyosis often leaves women suffering unnecessarily.

The normalization of pain associated with a woman’s monthly cycle also creates barriers to treatment.

“Women who have adenomyosis often feel trapped each month,” said Natalya Danilyants, MD. “Between heavy menstrual cycles, or debilitating pelvic pain, and severe anemia, this condition can be disruptive to their lives. I hear too often from my patients that they thought menstrual pain was to be expected, and had no idea anything was wrong.”

There is a support group, Adenomyosis Advice Association with members on Facebook who have struggled with both the condition and even getting a diagnosis. This resource offers advice, support and information on adenomyosis.


Adenomyosis develops when cells from the endometrial lining of the uterus grow into the muscle of the uterus. These cells behave the same during a woman’s monthly menstrual cycle, but in the location, they become trapped. Inflammation leads to pain (sometimes debilitating), heavy bleeding, and enlargement of the uterus.


Adenomyosis is contained within the uterus. Endometriosis (cells similar to the those found in the endometrial lining of the uterus) can exist throughout the pelvis, and in rare occasions, it may be found in the lungs and even in the brain. Both can be very painful, cause severe monthly bleeding, and can mimic other conditions, making them hard to diagnose.


“After attempts at conservative management with medicine and minor temporizing procedures, if the symptoms continue and a woman has completed child bearing, then hysterectomy can be an option,” said Rupen Baxi, MD. “To date, hysterectomy is the only known cure for adenomyosis.”


“When it comes to lesser known GYN conditions like adenomyosis, women should seek a specialist for optimal care,” said Paul MacKoul, MD. “A minimally invasive hysterectomy should be performed by a skilled laparoscopic surgeon who is fellowship trained on advanced techniques to prevent damage to the delicate structures in the pelvic cavity.”

Standard laparoscopic or robotic hysterectomies have a higher risk of damage to ureters, bowel and blood vessels. The DualPortGYN technique for laparoscopic hysterectomy was developed to protect these structures and has been proven to minimize overall risk, reduce recovery time, and improve overall outcomes. The DualPortGYN technique uses only two 5 MM incisions and post-operative recovery is 1 week.

“DualPortGYN is truly innovative and different from other procedures because the incisions are tiny and there are only two of them,” said Dr. Baxi. “The incisions are located in the midline of the abdomen so you are sparing all the muscles, blood vessels and the nerves. This is very important as it reduces post-operative pain, bleeding or lingering nerve pain. It is also a reason why patients that undergo DualPortGYN procedures are able to move around immediately after surgery, are able to eat and drink, and go home in just a couple of hours after surgery.”

The DualPortGYN approach was developed by Paul MacKoul MD and Natalya Danilyants MD and has been applied to thousands of cases for hysterectomy, endometriosis, pelvic massesovarian cysts and prolapse procedures.

The Center for Innovative GYN Care is dedicated to providing information and materials for women to help navigate the complicated healthcare system. CIGC minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD developed advanced GYN surgical techniques using only two small incisions. Dr. Rupen Baxi, MD is a minimally invasive GYN specialist at CIGC with extensive fellowship training and a respected speaker and researcher.

If you are suffering with adenomyosis, talk to a minimally invasive GYN specialist for an evaluation. Book a consultation at The Center for Innovative GYN Care or call 888-787-4379.

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