Nollywood actress, Nse Ikpe-Etim recently opened up about her struggles to conceive and why, eventually, she had to remove her womb.

The award-winning actress spoke at an event called “Conversation With Nse” in Lagos and revealed that she would not be able to have a child because she has removed her womb.

She said she was diagnosed with Adenomyosis, a medical condition whereby the inner lining of the uterus breaks through the muscle wall of the uterus, three years ago.

Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy periods. The condition can be located throughout the entire uterus or localized in one spot.

Though adenomyosis is considered a benign (not life-threatening) condition, the frequent pain and heavy bleeding associated with it can have a negative impact on a woman's quality of life.

Studies estimate that 1 in 10 women have adenomyosis and that it is most common in women aged 40 to 50. Other risk factors include Prior uterine surgery, such as a C-section or fibroid removal and having given birth.

Although not harmful, the pain and excessive bleeding associated with adenomyosis can disrupt your lifestyle. You might avoid activities you've enjoyed in the past because you're in pain or you worry you might start bleeding.

If you often have prolonged, heavy bleeding during your periods, you can develop chronic anemia, which causes fatigue and other health problems.

Causes

The cause of adenomyosis isn't known but there are theories which include:

Invasive tissue growth- Some experts believe that adenomyosis results from the direct invasion of endometrial cells from the lining of the uterus into the muscle that forms the uterine walls. Uterine incisions made during an operation such as a cesarean section (C-section) might promote the direct invasion of the endometrial cells into the wall of the uterus.

Developmental origins- Other experts suspect that adenomyosis originates within the uterine muscle from endometrial tissue deposited there when the uterus first formed in the fetus.

Uterine inflammation related to childbirth- Another theory suggests a link between adenomyosis and childbirth. Inflammation of the uterine lining during the postpartum period might cause a break in the normal boundary of cells that line the uterus. Surgical procedures on the uterus can have a similar effect.

Stem cell origins- A recent theory proposes that bone marrow stem cells might invade the uterine muscle, causing adenomyosis.

Symptoms

Adenomyosis varies widely among people, including the extent of the condition and the severity of the symptoms.

Symptoms include:

  • heavy menstrual bleeding
  • very painful periods
  • pain during sex
  • bleeding between periods
  • worsening uterine cramps
  • an enlarged and tender uterus
  • general pain in the pelvic area
  • a feeling that there is pressure on the bladder and rectum
  • pain while having a bowel movement
Adenomyosis is when tissue that lines the uterus is present inside the muscular wall of the uterus [Credit: Faculty of Medicine- University of Queensland]

Diagnosis

If a doctor suspects adenomyosis, the first step is a physical exam. A pelvic exam may reveal an enlarged and tender uterus. An ultrasound can allow a doctor to see the uterus, its lining, and its muscular wall.

Additionally, an MRI can be used to confirm a diagnosis of adenomyosis in women with abnormal uterine bleeding.

Because the symptoms are so similar, adenomyosis is often misdiagnosed as uterine fibroids so, an accurate diagnosis is key in choosing the right treatment.

Treatment

If left untreated, adenomyosis can remain stagnant or the symptoms can worsen.

Treatment is not recommended if a woman has no symptoms, is not trying to get pregnant, or is nearing menopause, which is when most women are relieved of their symptoms.

However, there are many different treatment options available to women with this condition:

Anti-inflammatory medications- Medications such as ibuprofen can reduce pain and discomfort.

Hormonal medications- Some hormonal treatments, such as oral contraceptive pills, progestin IUD's, or injection (Depo-Provera), can help lessen the symptoms.

Injectable medications- These medications can induce false or temporary menopause. These are only used in the short-term and are not suitable for long-term use.

Uterine artery embolization- This involves placing a tube in a major artery in the groin and injecting small particles into the area affected by adenomyosis. This stops the blood supply reaching the affected area, which will shrink the adenomyosis and reduce symptoms.

Hysterectomy- The only definitive treatment for adenomyosis is complete removal of the uterus. It is not a good option for women who may still want to become pregnant.