From the Guidelines
Adenomyosis is associated with constipation due to the interplay between pelvic pain, inflammation, and bowel function, and managing adenomyosis symptoms can indirectly alleviate constipation. To manage constipation associated with adenomyosis, consider the following approaches:
- Dietary changes: increased fiber intake (25-30g daily), adequate hydration (at least 8 glasses of water daily), and regular physical activity
- Over-the-counter options: docusate sodium (100mg twice daily), polyethylene glycol (17g daily in water), or psyllium husk (1 tablespoon in water 1-2 times daily) can provide relief
- For adenomyosis pain management that may indirectly help constipation, consider NSAIDs like ibuprofen (400-600mg every 6-8 hours) or hormonal treatments such as combined oral contraceptives or a levonorgestrel IUD, which can reduce pelvic inflammation 1
- Pelvic floor physical therapy may also help by addressing muscle tension that contributes to both conditions The connection between adenomyosis and constipation stems from shared anatomical space in the pelvis, where inflammation from adenomyosis can affect nearby bowel function, and pain medications (particularly opioids) used for adenomyosis can worsen constipation. If symptoms persist despite these measures, consult a healthcare provider as more specialized treatment, such as uterine artery embolization (UAE), may be needed, which has been shown to improve symptom scores and quality of life in patients with adenomyosis and fibroids 1.
From the Research
Relationship Between Adenomyosis and Constipation
There is no direct evidence in the provided studies to suggest a relationship between adenomyosis and constipation.
- The studies primarily focus on the diagnosis, symptoms, and treatment of adenomyosis, with symptoms such as heavy menstrual bleeding, dysmenorrhea, and infertility being commonly discussed 2, 3, 4.
- None of the studies mention constipation as a symptom or a related condition to adenomyosis 2, 3, 4, 5, 6.
- The treatments discussed in the studies, including hormonal therapies, uterine artery embolization, and surgical options like hysterectomy or uterine-sparing procedures, do not address constipation as a concern 3, 5, 6.
Symptoms and Treatment of Adenomyosis
- Adenomyosis is characterized by the presence of endometrial glands in the myometrium of the uterus, leading to symptoms like heavy menstrual bleeding and pelvic pain 2, 4.
- Treatment options range from medical therapies aimed at suppressing symptoms to surgical interventions, including hysterectomy for severe cases 2, 3, 4.
- Recent approaches include uterine-sparing surgeries, such as laparoscopic uterine artery occlusion combined with partial adenomyomectomy, aiming to preserve fertility and reduce symptoms 6.
Diagnostic Approaches
- Diagnosis of adenomyosis often involves clinical suspicion followed by confirmation with imaging techniques like transvaginal ultrasonography and pelvic magnetic resonance imaging 2, 4.
- The choice of diagnostic method can depend on the patient's symptoms, age, and desire for future fertility, as well as the availability of imaging technologies 4.