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Why Does Adenomyosis Pain Persist After Menstruation?

Adenomyosis is a common gynecological condition characterized by the invasion of endometrial tissue into the muscular layer of the uterus, leading to a range of pain and discomfort symptoms. While many attribute menstrual pain solely to the period itself, some patients still experience abdominal discomfort after menstruation. What could be the reason behind this?


Postmenstrual pain in adenomyosis may be attributed to the following factors:

1. Symptoms caused by adenomyosis

In most cases, dysmenorrhea caused by adenomyosis will alleviate and disappear with the end of the menstrual cycle. Still, the pain in some patients is not related to the menstrual cycle and manifests as chronic pelvic pain, which may continue to be painful after the menstrual cycle is complete.

2. Inflammatory response

Ectopic endometrial tissue resulting from adenomyosis can lead to local chronic inflammatory reactions. This inflammatory response not only exists during menstruation but may also persist after the end of menstruation, leading to persistent abdominal pain and discomfort in patients.

3. Complications

Other gynecological diseases, such as uterine fibroids, endometriosis, pelvic inflammatory disease, etc, may accompany adenomyosis of the uterus. These diseases may also cause pain after the end of menstruation.

For example, if a patient fails to pay attention to personal hygiene during menstruation or fails to treat potential infections in a timely manner, bacteria may invade ectopic endometrial tissue, leading to pelvic inflammatory disease (PID). PID can cause the release of inflammatory factors, stimulate local nerves, and cause pain even after menstruation. The symptoms of PID include lower abdominal pain, lumbosacral soreness, etc. These symptoms may persist after menstruation.

4. Residual Edema from Lesions

Endometriotic lesions may exhibit edema and congestion during menstruation, which may not immediately resolve after menstruation ends. Persistent edema can continue stimulating surrounding tissues and nerves, resulting in ongoing pain postmenstrually. The presence of unresolved edema increases local pressure, thereby triggering chronic pain symptoms.

5. Elevated Estrogen Levels

The sites affected by adenomyosis are sensitive to estrogen levels. Elevated estrogen levels can induce edema and proliferation of these pathological tissues. Even after menstruation ceases, persistently high estrogen levels in the body can continue to cause edema and pain in these affected tissues. Elevated estrogen levels also prolong the duration of inflammation, leading to persistent pain beyond the menstrual period.

What to do if adenomyosis pain persists after menstruation?

In the face of persistent pain from adenomyosis, even after menstruation, patients need to adopt a comprehensive approach to treatment to alleviate pain and improve quality of life.

1. Medication: Patients can use non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics to alleviate pain. Additionally, for inflammation, patients need to take antibiotics or herbal medicine like Fuyan Pill. For patients with abnormal estrogen levels, hormone therapy may be recommended to regulate hormonal balance.

2. Physical Therapy: Physical therapy offers another effective avenue for relieving adenomyosis pain. Common physical therapy methods include heat therapy, massage, and acupuncture, which promote local blood circulation, alleviate muscle spasms, and thus relieve pain.

3. Surgical Treatment: Surgical intervention may be necessary for patients with severe symptoms that cannot be relieved by medication or physical therapy. Surgical options include hysterectomy and lesion excision.

4. Lifestyle Adjustments: Patients should maintain good sleep hygiene and ensure an adequate amount of rest. They should also avoid excessive fatigue and strenuous exercise to prevent exacerbating pain. Dietary adjustments, such as focusing on a healthy diet while avoiding spicy, irritating foods, excessive caffeine, and other stimulants, are crucial. Additionally, maintaining an optimistic attitude and avoiding excessive anxiety and tension is also an essential factor in pain relief.

Recommended Readings:

How Long Should I Take Short-acting Contraceptive Pills for Adenomyosis?

Can Drinking Lots of Hot Water Ease Painful Menstruation?

Frequent Pelvic Pain in Women? It May be Related to These 'Behind-the-Scenes' Culprits

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