Hormone Imbalance, Hysterectomies & Adenomyosis

My Adenomyosis Story

When the doctor looked at my ultrasound and said I had a “bulky uterus” and had adenomyosis 8 years ago, I had no idea what she was talking about.  She did not exactly explain what it was or what I could do about it.  I was relieved though, that finally there was a name for the heavy bleeding, passing out in the bathroom from severe pelvic pain, and huge belly I had.  Maybe I could stop looking 4 months pregnant when I was not!  I learned that the only “cure” for adenomyosis is a hysterectomy.  I was desperate for relief, yet I associated a hysterectomy with giving up the fight to love my beautiful but scarred uterus. Through holistic hormone balancing, now my cramps are mild, I have a lot of energy, my “adeno belly” is gone, and I sleep well.

What is adenomyosis?

Adenomyosis is a pelvic condition where the endometrial layer of the uterus grows into the muscular myometriallayer and grows there.  The myometrial layer is what contracts when you have menstrual cramps. Estradiol(estrogen) stimulates adenomyosis to grow.  Endometriosis is a disorder where tissue that normally lines the uterus grows outside of the uterus.  A recent research study revealed that seventy eight percent of women with endometriosis also have adenomyosis.

What are the symptoms of adenomyosis?  

Adenomyosis can cause no symptoms at all in some women, and heavy bleeding (menorrhagia), severe pelvic pain (dysmenorrhea), spotting, enlarged, “bulky” uterus (e.g. adeno belly), frequent urination, bowel upset and bowel pain, infertility, and other symptoms in others.

What causes adenomyosis?  

It is unknown what exactly causes adenomyosis, though current research studies have given us a better idea about likely causes.  One cause could be multiple pregnancies or pelvic surgery that causes injury and inflammation to the tissues.  Inflammation increases proinflammatory cytokines (cytokines regulate responses to infection, immunity, and inflammation) and allows tissue from the endometrium to get into the myometrium.

Progesterone resistance in the endometrium, and over stimulation of estrogen (estrogen dominance) can allow tissue to migrate into the myometrium, appearing to cause adenomyosis.  According to adenomyosis researcher and well known author Maria Yaeger, other probable causes of adenomyosis include autoimmune factors, beta catenins, VEGF, expression of COX2, toxin exposure, an abnormal junctional zone, abnormal uterine contractions, HOX gene abnormalities, and elevated STIP-1.

Current research tells us adenomyosis is associated with increased platelet activation and hypercoagulation.  Platelets in our blood stop bleeding by clotting blood vessel injuries.  Inflammation and coagulation of our blood are two systems that work together.  Inflammation activates coagulation and coagulation modulates inflammation.

How many women have adenomyosis?

It is unknown how many women have adenomyosis.  Dr. Keith Isaacson writes, “400,000 women a year have an endometrial ablation for abnormal uterine bleeding.  All of those patients if they do not have fibroids essentially have abnormal bleeding from adenomyosis.”

Does adenomyosis affect the whole body or just the uterus?

Adenomyosis is a whole body condition.  Hysterectomy stops the heavy bleeding associated with the conditionand decreases pelvic pain, however it will not fix thehormone imbalance, autoimmune reactions, and gut issues related to the condition.  

When considering any pelvic surgery like a hysterectomy for adenomyosis, make sure to ask your medical team and do your own research on the long-term side effects.  According to specialists from the University of Hong Kong Department of Gynecology,   “Patients undergoing hysterectomy for adenomyosis should be advised of an increased risk of bladder injury (2.3% risk) and persistent pelvic pain.”   Persistent pelvic pain after a hysterectomy is often due to endometriosis, which is not cured by a hysterectomy.

The United States has the highest rate of hysterectomy in the world and often hysterectomies that are not medically necessary are performed.  Hysterectomies for the severe heavy bleeding and pain from adenomyosisare medically justified.  Many women find relief from heavy bleeding by using progesterone cream or Prometrium(natural progesterone capsules prescribed by a doctor) on days 14-28 of their cycle.

Most women who have had a partial or complete hysterectomy have a decline in progesterone levels after this surgery, and may experience depression, sleep problems, anxiety, and weight gain due to hormone imbalance.  Eating foods that promote optimal progesterone levels and/or supplementing with natural progesterone post hysterectomy can help ease these symptoms.

Why has no one heard of adenomyosis?

Little funding has gone into research for adenomyosis and there is a great need to increase awareness about this condition.

8 Best Secrets for Natural Adeno Relief:

First, it is essential to get to the bottom of the autoimmune and inflammatory responses associated with adeno.

1. Reduce inflammation

I love Inflammatone by Designs for Health because it contains so many anti inflammatory goodies like ginger, tumeric, enzymes that break up excess tissue, and boswellia.  Clinical studies from 2018 found that Boswellia, or Indian Frankincense, reduces heavy menstrual bleeding and inhibits an enzyme called 5-lipoxygenase which causes chronic inflammation.

Women with adenomyosis are often deficient in vitamin Aand research shows high doses of vitamin A can reduce heavy bleeding.  Cod liver fish oil is an excellent source of natural vitamin A, and it is safe while synthetic high dose vitamin A can be toxic.  It is almost impossible to find true high quality fish oil; there is only one I have found called Rosita Cod Liver Oil (capsules if you don’t like the taste like me) which is wild caught, unprocessed, and sustainably harvested in Norway.

2.  Say goodbye to toxins

Cleansing our pelvic area and liver of hormone disrupting toxins increases blood flow to our pelvis and womb and supports our liver in it’s natural job of getting rid of toxins. Our vaginal tissue is highly absorbent, and using tampons and pads that are not organic causes chemicals and toxins to be absorbed in our pelvic area.  This can make estrogen dominance worse.  Use organic tampons and pads!

Did you know that many beauty care products, cleaners, and other personal products contain chemicals that are hormone disruptors?  Start taking a look at the ingredients and labels on your products and cleaners and take baby steps to replace ones containing toxins with natural ones.  Some toxic ingredients to watch out for are: phenoxyethanol (toxic to skin and immune system- often used as a preservative in “natural” products), glyphosate(trade name is the herbicide Roundup- increases risk of many types of cancer), parabens (found in sunscreens), BHA (a food preservative), phthalates (plasticizers), and PCBs (from plastics).  

3.  Diet Makeover

Studies show the standard American diet is extremely high in omega 6 fatty acids compared to omega 3 fatty acids thatincrease inflammation.  To lower inflammation, start with eating more fat.  You heard that right, you need a lot of healthy fats like butter, ghee, avocados, tuna, nuts, and salmon to make enough of the right hormones.

If you are not lactose intolerant and eat dairy, switch to A2 protein dairy from Jersey Cows, sheep, or goats.  While A1 dairy increases inflammation, research shows A2 dairy does not cause inflammation or digestive upset.  

4.  Get your pelvic floor in tip-top shape with a pelvic PT  

If you have to pee at all during the night and are under 60 years old, or if you have any pain with sex, go see a pelvic PT.  We’ve all heard of doing Kegels to strengthen our pelvic muscles, but actually most women with adeno or endo actually need to release certain areas of their pelvic muscles.  A pelvic PT can help you learn how to do this safely at home, and this can significantly lower pelvic pain and reduce heavy bleeding.  There is a pelvic PT directory for the United States on https://pelvicguru.com.

5.  Improve your Gut Health

Bad bacteria in our gut can cause toxins from our GI tract to leak out into our body and wreak havoc on our immune system.  When these endotoxins combine with estrogen, they can make pelvic pain and adenomyosis worse.  I recommend taking RESTORE liquid created by Dr. Zach Bush’s team to tighten junctures in your gut lining and seal up any leaks in your gut.  It is best to start with just one drop a day and increase slowly, and drink a lot of water.  When my digestion is off and I’ve forgotten to take my RESTORE liquid, I notice immediate improvement when I remember it.  It is also important to work with a functional medicine doctor and health coach to check for low stomach acid.  Low stomach acid causes poor digestion, inability to digest protein, and adrenal dysfunction; it is extremely common.  Ways to increase stomach acid include reducing sugar, adding fermented food and drinks, eliminating processed foods, and taking digestive enzymes with meals.

6.  Mayan Abdominal Massage

Mayan abdominal massage www.arvigotherapy.comimproves blood flow to your pelvis, strengthens and tones the uterus, and helps place the uterus back in it’s proper position.  It is important whether you’ve had a hysterectomy or still have your uterus.  Women with adenoare more prone to uterine polyps and this massage helps prevent them.  I have been doing this massage myself at home since I had surgery to remove multiple uterine polyps years ago and have not had any since.  There are Mayan Abdominal Massage practitioners all over the world, and they can show you how to do the massage yourself at home.  For women who’ve had a hysterectomy, this massage improves circulation around the scar, preventing scar tissue from forming in the pelvis.

7.  Balance your hormones

According to the latest research, “Like endometriosis, adenomyosis is estrogen dependent.”  Balancing your ratio of estrogen to progesterone as well as other hormonesis necessary to achieve improvement of adenomyosissymptoms.  Testing sex hormones (e.g. estrogen, progesterone, testosterone) through blood or saliva is not accurate because levels change throughout the day and these tests do not measure available versus bound hormone levels.  The DUTCH test is the most accurate test because it measures your hormone levels throughout the day and gives an accurate read on free and available hormones, including those responsible for adrenal functioning.  You do the test at home by peeing on strips and send it in.  Ifyour levels are off, working with both a functional medicine doctor and a health coach is key to rebalancing your hormones.

8.  Fix your adrenals

Here is my final secret: period problems and pain start with our adrenals.  

Our adrenals make cortisol, aldosterone, DHEA, DHEA-S, adrenaline, and testosterone.  When our brain tells our body to make a lot of cortisol and adrenaline, stress hormones,they occupy progesterone receptors so we don’t have enough free progesterone available.  “Fight or flight” mode causes our digestion and reproductive functions to slow down so we don’t make enough of the right hormones.  Interestingly, if we also release enough DHEA-S along with cortisol, it has a beneficial effect on our body.  Producing DHEA-S along with cortisol happens when we see a potentially stressful situation as a challenge, rather than something to be anxious about.  Tell yourself, “I am excited about this challenging… new job, presentation, person, etc.” rather than “I am dreading it”.  Women are expected to do everything and be superwomen in our modern culture, even though our bodies are not made for this.  Listen to your body, slow down, say no, and give tasks on your to do list to others.

Questions-

What has your journey with adenomyosis been like?  What are your worst symptoms and what have you tried that helped?

What do you want to know about adenomyosis?

I offer free discovery calls to see if we would like to work together on a personalized, step-by-step plan to transformyour hormones and/or heavy and painful periods.  I help women find adenomyosis relief through hormone balancing coaching.  Find me on Instagram at https://www.instagram.com/sara_e_lopez/ or on Facebookat https://www.facebook.com/periodsloveandwayfinding/ .

Research and References:

Eshaghian, R. and Babaelan, M. (2018) The Effect of Frankincense (Boswellia Serrata) and Ginger on Heavy Menstrual Bleeding:  a Randomized, Placebo- controlled, Clinical Trial.  Retrieved from: sciencedirect.com

Isaacson, Keith, M.D., Adeno: What We Know and Don’t Know.  Retrieved from: http://endofound.org

Li, JJ.  BioMed Research International (2018) The Investigation and Management of Adenomyosis in Women Who Wish to Improve or Preserve Fertility.  Retrieved from: https://www.hindawi.com

Liu, X.  Corroborating evidence for platelet-induced epithelial-mesenchymal transition and fibroblast-t0-myofibroblast transdifferentiation in the development of adenomyosis.  Retrieved from: https://www.ncbi.nlm.nih.gov

McGonigal, Kelly. (2015). The Upside of Stress.  US: Avery.

Sun Wei Guo, Ph. D. Endometriosis and Adenomyosis are Procoagulant Diseases.  Retrieved from: http://seud-congress.com

Yeager, Maria.  (2018).  Why Can’t Anyone Help Me?  The Nightmare of Adenomyosis.  US:  Maria Yaeger

Zhu, B.  Anti Platelet Therapy Holds Promise for Adenomyosis.  Retrieved from: http://www.ncbi.nlm.nih.gov

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