Adenomyosis - CRASH! Medical Review Series

[@uttamkumar097]

i have no words to praise dr.paul bolin what he is doing for medical students its incredible...keep it up paul you are my real life hero...

[@cruzotto608]

I realize it is quite off topic but do anybody know of a good place to stream new series online?

[@melaniewhalen7122]

I had adenomyosis and fibroids. My symptoms were heavy bleeding and long periods (14 plus days), painful periods and pressure in lower abdomen. Had to get a hysterectomy and this is where the adenomyosis diagnosis came in as well. 3 fibroids but largest was the size of a small watermelon. Glad it's all gone.

[@lovelove326]

I was just diagnosed with adenomyosis, an enlarged uterus and an apple sized benign ovarian cyst. How was your recovery and did you have an open or laparoscopic robotic surgery?

[@michelleclawson4240]

I have been told by several obgyn that 10 pads a day is normal since I was 12 years old. Same with large blood clots. Same with a history of miscarriages early on. On a pain level it's more painful then birth. Can you imagine being told at 12 you will have this pain the rest of your life and it's normal? It wasn't until I gave birth that I had something compare it to and have a doctor believe that I was in pain during my period. Basically if you're in dry active back labor and can walk and talk, it's not normal. It's the same pain I have felt for 20 years of my life. The same pain I was told as as child is something I'd have to get used too. So I was used to it by the time I had my kids. Please be kind to your patients. Lots of us have been told for years it's in our heads. That we are not in pain. So I would take the late diagnosis age with a huge grain of salt. I wasn't diagnosed until I was 34. For 22 years doctors would not even offer additional testing.

[@MsPeabody1231]

It took until I was in my 40s until I was taken seriously. I've had the issues since I was a teen also. I was told as a teen to see a doctor over my period issues but wasn't listened to. So saying women present late is because we are not listened to.

[@itsalladream22]

I have felt this way since I was young as well. I am now 42yrs old but for my whole life I've had to go to extreme measures to find relief from the pain Ive had to endure. I've had 3 preterm births with each the gestation was longer. I'm now thinking this is why.

[@nadjapatricio3831]

i got diagnosed with PCOS 10yra ago however recently With Ademyosis.Thank you Dr.Paul very informative!

[@awaisawan663]

Thanks Dr paul for such a good video. Please keep giving more lectures videos on gynecology.

[@styx5565]

Only halfway through the video but I have to say something or I’ll forget. It used to be thought that adenomyosis was associated with older age and multiparity. This is no longer the case. Or at least on UpToDate it’s explains we don’t know. We’ve gotten better at diagnosing it with MRI but there are still no official diagnostic criteria agreed upon. Which is hindering studies. So the only “official” way to diagnose adenomyosis is after a hysterectomy. Who has the easiest time convincing a doctor to do a hysterectomy? Middle age women who have had multiple children. Young nulliparous women have a hard time getting a hysterectomy and therefore an official diagnosis. I do think there may be a factor of increased estrogen exposure, same as endometrial hyperplasia. So age may still be a risk factor just not as strong as once thought. 👍

[@nadia_manjate]

This is helping me currently having theee worst period experiences...it just started out of nowhere

[@vnagubandi11]

Thank you so much Dr.Bolin can't thank you enough...

[@alittlebitnat]

Not everyone can tolerate oral contraceptives and progestins unfortunately and many doctors seem to be reluctant to give a hysterectomy leaving many women to suffer more than they should.

[@HS-vb7nk]

I am 48 years old and I have been suffering with Adenomyosis since 2015. I still don’t want to remove my uterus; I also have anemia and I get transfusion and I have tried some of medicine. I had a UFE which it works for almost 2 years, but my menstrual bleeding is back. I don’t know what else to do. I get a lot of pain too. They have Dr in Europa, China, India, etc that do adenomyosis remover from the uterus, but they don't remove the Uterus like here in the USA. In the USA they only want to remove the Uterus and not bother helping the female to keep their Uterus which is sad. They should take classes from the others Dr who know how to remove the Adenomyosis

[@mengwu1113]

you are my onestop shop. thank you.

[@me9860]

Very good information and presentation. Thank you!

[@BeckysYarnEscape]

Thank you for this video. Very informative and has helped me to understand my condition and what I'm experiencing.

[@flow_dojo]

thank you.

[@Dancin4Joy2]

FYI: I have severe adeno, endo and PCOS. I didn't know what it was and almost bled to death a few months ago with it. I never have been pregnant, never had uterine surgery and never used those items or smoked. It still happens, most of the women I talk to who have it as well have the same chemical sensitivities as I do and other environmental issues so we're thinking that along with our friends who are growing tumors in other places who have that kind of condition, the uterus is opportunistic for some of us depending on what the exposures are. Many of the women in our groups have never had uterine surgery and some can't for other reasons. They only thing that helped my pain is an ibuprofen protocol taking 400-600mg w/food and then 2 hours later doing it again, and another 2 hours later one or two more, usually 3 to 5 pills works perfectly and stops the period flat (Unless it was allowed to go too long or I was asleep when it started.)

[@pommiebears]

Dancin4Joy2 I am suffering right now. I had a D&C two years ago.....but it’s worse now. Hurts so badly. They scanned me and said I had extra vascularisation. Bring on menopause.....who says that other than sufferers? 🤷🏼‍♀️

[@SuperNewMom1]

I had pcos when I was younger (got pregnant by surprise btw), and now I have adenomyosis. For the heavy bleeding I’ve been on tranexamic acid 650mg. For the extreme bleeding it may help. Ask your doc

[@farhashiakh5758]

@@SuperNewMom1 same here

[@isabelalaniz7928]

Thank you Dr.Bolin for this video.I am recovering now from a miomectomy and laparatomy.surprised to find out that I have adenomyosis. MRI or ultrasounds did not catch the disease until my surgery. Non stop bleeding for 6 months even with the depo provera. It did help a lot with the pain and ease the bleeding.lets see how it goes after I recover .a fibroid and tissue were removed.

[@amethystfaithdonato851]

Is it normal that I will still bleed even if I'm taking Progesterone daily ? I started taking progesterone last June 17, a day after I was diagnosed with adenomyosis. I was amazed that after 2 days my menstrual flow stopped instantly. I started bleeding again on July 13 up to this day. I noticed that I started spotting when I did some strenuous repotting of my plants and like carrying the heavy pots from one side of the garden to another. Could this be the cause of my bleeding again? With this condition, I didn't stop taking my medication. I'm experiencing mild pelvic cramps. Although I'm bleeding again, it doesn't bother me. It's not as much as I had before I was diagnosed . Before it could last 2 to 3 weeks, and really heavy. Thank you for this lecture, I'm glad that I come across your channel. I really wanted to know more and by sharing this experience, I hope I can also be of help to women of the golden age, who are confused and bothered. More power to you.

[@sidhedanu]

I use a menstrual cup & can say for a fact that before my ablation surgery I lost about 800 ml of blood every month. Horrible anemia. After, I'm still bleeding a significant amount. The pain feels like labor. It feels like my uterus is turning itself inside out. I don't want to remove it, though, because like the Vignette lady I'm 42 & could be nearing menopause. I was always anti-birth control because of how it messed with my hormones, but I am wondering if medication to suppress estrogen would be worth trying.

[@ihsaneboualaoui5335]

Great lecture! thank you very much!

[@tenishagrant3387]

I’m 22 years old and I’ve just been told today that I have adenomyosis I’m bleeding at the moment was bleeding a week ago and last month I was bleeding for a entire month honestly I feel light headed

[@gangotri4793]

Treat your estrogen dominance

[@DrDinooshDeLivera]

Thank you!

[@sidhedanu]

The more I watch this the more I am aware of my uterus and how much pain I am in, a week post bleeding.

[@carmen2259]

Just got this dx yesterday...I'm a bit perplexed and seeking answers.

[@geraldrufulenge3350]

This is the best! thank you a lot

[@slimfatty7742]

Ladies Motrin is antiflamatory it works well

[@somcana]

It also increases bleeeding

[@luvaubs]

Thank you so much!! So helpful!! One question though...Does having Adenomyosis put a woman at higher risk to also develop Endometriosis?

[@pwbmd]

Some studies have shown a higher prevalence of endometriosis in women with adenomyosis compared to the general population. However, most cases occur separately. It is important to know the differences. So if a woman comes in with chronic pelvic pain, after you've ruled out infectious causes/PID, you should know your basic physical exam findings. A tender uterus that's confluently enlarged is more consistent with adenomyosis, whilst a tender uterus that's nodular is more consistent with endometriosis. Some fibroids can be tender and that can make the differential between (focal) adenomyosis and fibroids tricky. In any case, if you suspect any of these, you want to refer these patients to an experienced gynecologist for transvaginal sono with doppler. The flow patterns tend to be different amongst the three (I discuss this in my lecture on Uterine Leiomyoma).

[@pwbmd]

ALWAYS rule out pregnancy too.... that should go without saying in any woman of child bearing age who has pelvic pain!! :)

[@coffeedrinker7575]

Paul Bolin, M.D. t

[@daviettasimbowoloquelli1762]

@@pwbmd is it possible for egg transplantation with a surrogate

[@daviettasimbowoloquelli1762]

How long does it take to do surgery?

[@ms.robinson8252]

I've been bleeding heavy for 15 days now. It's painful, I feel weak.

[@afenismama]

4 pads a day😂 try 22 extra heavy overnight pads and 10 depends underwear in 4 days… I went to the emergency room obv

[@SaiKrishna-ew2wr]

Smoking is anti-estrogenic, so how is it a risk factor for development of adenomyosis?

[@KatieDeGo]

How about you guys actually believe how painful it is when we tell you how painful our periods are and actually TEST FOR ABNORMALITIES instead of saying "periods are supposed to be painful"?

[@pwbmd]

I get where you're coming from. Some mild discomfort with periods is to be expected and does not warrant further workup. Debilitating pain (e.g., pain that keeps you home from work) is not normal and needs to be taken seriously. Generally, if I have a woman who says her periods are painful, I don't bother asking her whether it's debilitating because I don't think she'd be complaining if it weren't. A woman knows her own body best. Bear in mind that my videos are for board examination review purposes and not intended for a lay audience. They're designed to help doctors and medical students answer USMLE test questions correctly. They are certainly not intended to substitute for a doctor's recommendations for an individual patient.

[@mohiuddinalfarra5440]

thanks

[@SuperNewMom1]

Thank you Dr Bolin! I was just diagnosed today. I am 32 yrs old, so not in my 40’s. I am 7+ yrs post opp cesarean and 4 yrs post opp myomectomy, I be had a Mirena removed and reinserted multiple times, 3 times last years and was told that my uterus was tilted so it kept pushing the iud out and the NP said it was best to leave it out. I felt like there was some damage from there back and forth of inserting and removing the iud so many times (along with post coital bleeding) within the space of 2 months, now a year later they recommend I mirena as one of the options to relieve the unbearable pain from this adenomyosis. I am too young to face a hysterectomy!!! Are birth control , tranexamic acid and NSAIDS my only alternative to a hysterectomy??? I want to do more than just put a bandaid on this issue.

[@doctoruadialeherbal8136]

Have you tried herbal medication before? Doctor uadiale herbal on KZbin helped me cured mine he can help you too

[@lorih3666]

I’ve used an over the counter supplement called Slow Flow which helps. I’ve been bleeding for 5 months now. I am older and have given up on alternatives so seeking a hysterectomy.. Good luck to you!

[@r.girardi6253]

A woman who is at risk of another stroke after having one should not take oral contraception/progestins or any other HRT. Hysterectomy sucks as well, still leading to screwed hormones and empty body cavities for the rest of our organs to move and shift. Any brilliant ideas? Will women have to get "permission" from their spouse? (unconscionable).

[@ashavers3507]

Was diagnosed today an been in depo shot for years I feel like the depo brought this on idk that's just how I feel about it or in denial of being old turned 40 2 mo ago.

[@leyvamichelle]

Use Agbara Herbal Medication to cure Adenomyosis, Adenomyosis isn't life-threatening. Many treatments are available to help alleviate your symptoms. But Agbara Herbal Deep Root Cleanser is the only treatment that can eliminate them altogether. However, the condition often goes away on its own after menopause.But for you to get pregnant, Use Agbara Herbal Medication to treat this in time and get pregnant.

[@paradisegeography7536]

Where to buy that herbal?

[@hellomeme94]

thank u

[@moboda7233]

Thank you, Dr. Bolin. BTW, Midol never helped me and it is NOT an NSAID so please stop recommending it. (32:40)

[@bridgetburdick6791]

I have premature ovarian failure and post menopause. I was just diagnosed with Adenomyosis. How could that be?

[@babylegs1968]

Me too!!

[@anmolnotani6361]

Have you pregnent in such scenario mine is same too.

[@bridgetburdick6791]

The very same thing happened to me at age of 45. May I ask how old are you?

[@anmolnotani6361]

@@bridgetburdick6791 29 years.

[@fickleemu4life401]

Can you diagnose adenomyosis by biopsy? Sorry if it's a silly question. I am not a medical student. Thank you.

[@hyejihan98]

As I know we should diagnose adenomyosis "clinically" (diffuse uterine enlargement but not pregnant, and secondary dysmenorrhea), sono or MRI is not routine but the "additional" one that can help diagnosis. Pathologic review after total hysterectomy is the only way that we can "definitely" diagnose this disease. In short, we do not do local biopsy for diagnosing this, we use pathologic results only after TAH and can definitely diagnose adenomyosis!

[@SelenaFriend]

I’ve had adenomyosis for years and I’m 23, never had a child. Guess that’s weird 🤷🏻‍♀️

[@MsPeabody1231]

No. Unfortunately they don't look at younger woman but they have found adenomyosis in teenagers. Incidentally I've had the menstrual issues since I was a teen but only diagnosed with adenomyosis in my 40s. Mainly because I changed to a surgery with more female GP then.

[@try2justbe]

does cystic changes in uterine wall or myometrium mean the same thing as Adenomyosis? Note I was diagnosed with large fibroids a year ago which increased in number within 3 months and now recently after another MRI they saw cystic changes in the right upper-side of the uterine wall. Is that normal? I couldn't find much information online.

[@kristymeyers8415]

No that's not adenomysosis it looks like curtaining

[@shereehi5539]

Has anyone heard of periods changing from 4 pads a day to 2? Like, it can start one month heavy, and the next it only is 2 days long because the first two get super heavy? Happens to me it is so weird. I’m also bleeding when not on period anymore. I have anemia I suspect is due to menstruation.

[@doctoruadialeherbal8136]

Have you tried herbal medication before Doctor uadiale herbal on KZbin helped cured me completely

[@kavitham8098]

I have adenomyosis... If any affected fertility.. Not married sir

[@Sukira69]

i had severe pain and had heavy flow

[@megbuchanan1630]

I just found out I have this issue today. I was also on antidepressants for 4 years and just stopped taking them 3 months ago. It was called Effexor. Did this drug do this to me? Ive been having issues for 2 years.

[@kristymeyers8415]

Unlikely but was also on Effexor and ended with multiple issues

[@estherobeitor9176]

I was diagnosed of adenomyosis 7years ago. Then I was 33years. Before I got married 2017. That 4years ago. Since I got married I fund it difficult to conceive. But two months ago my Dr advice me to go for IVF. Please how save is iVF. With adenomyosis. With a very bulky uterus of 12.5cm

[@hildaefua6979]

Have you tried herbal medication before it worked for me with the help of Doctor Uadiale herbal he can help you too

[@anmolnotani6361]

Your ivf become success??

[@biancaj6344]

Im 31, have 1 child and want more kids, i have adenomyosis was diagnosed this week (may 2021)was told its heavy on the left hand which the doc saw on my mri scan. Will fertility be affected and why? What age should i try for for a baby? I have lower back pain since i was 14 years old could this be due to adenomyosis? Why? How can i holistic treat myself. Im a black woman is this more common in black women? Also, I got my mri pelvic scan for pain when i open my bowels and they found adenomyosis. Can this be why i get pain opening my bowels. I have bloating for 5 years is the adenomyosis or need to change my diet? The doc said they can see a small sac of fluid lower down and adhesions on the scan

[@hildaefua6979]

Have you tried herbal medication before it worked for me with the help of Doctor Uadiale herbal he can help you too

[@Smile-so8mj]

Can a person conceive with this?

[@MsPeabody1231]

Yes. Everyone is individual.

[@theacmouse]

DR. I want to ask after USgHIFU ~6-2015, my pain reduce alot n not in serious bleeding n no more clots, but uterus still growing to 11cm~ 5-2016, feeling urinary pressure, any suggestion I need to pay attention to. Thx 4 your reply. 8*9cm focal reduce to 3cm now. But. I dont understand why uterus enlarged.Would it be the problem of diffuse?What is the different measurement between. Transvaginal ultrasound n MRI. Data is different so confused😭

[@anaabby5097]

Painful pms and painful ovulation

[@Dr.Quratulain]

thanks for the amazing video, but i like it if you can add more details related this disease because i was diagnosed with this condition 5years ago at the age of 24, and so i joined OBGYN to learn at the depth of this condition so far studies published often says about women after pregnancy or abortion or miscarriages but i had none still was diagnosed with it, so probably hormones related like more estrogens less progesterones or metabolic conditions? if you have some more information please can you update about it, coz i am sure their must be alot of young girls in their 20s also get diagnosed with this condition, thanks

[@sahilsood4524]

vennetian blind sign 😀

[@jacquelinendekezi8446]

In French

[@psychiatrist123]

Does raloxifine help with regression of endometrial lesions ?

[@maksudahaque8740]

thankyou so much. very effctive presentation..but one question more what about treatment of adenomyosis with mirgfus.its not good?I'm the patient of adenomyosis.dont want to go through histerectomy.

[@theacmouse]

i hv finished Usghifu,(MRgfus)， it worked for me, pain release lot after 9 mon. focal shrink.

[@azubuikeifeoma8890]

@@theacmouse hi pls where was the procedure done for you.the pain is killing me.pls help.

[@Rachelprideaux]

I'm going through this right now . I just had the IUD put in , Not working so well .

[@marymcintosh4764]

There's a facebook group for Mirena and other IUD's, and Ablation. You can control heavy bleeding by taking Lysteda.