Adenomyosis · Marrakech
Heavy, long and painful periods, a heavy abdomen before periods: adenomyosis is a common and often unrecognised cause of these symptoms. In Marrakech, Dr Oussama Rachid, an obstetrician-gynaecologist, listens, examines, requests the useful tests and explains the options according to your age and plans. This page is informational and does not replace a consultation.
Adenomyosis, sometimes called internal endometriosis, is a benign condition of the uterus. Tissue similar to the uterine lining (the endometrium) settles in the muscle of the uterus (the myometrium). At each cycle this tissue responds to hormones: the uterus becomes thicker, more sensitive and bleeds more.
It mainly affects women aged 35 to 50, but can also concern younger women. It is not cancer.
Adenomyosis can show as:
Some women have no symptoms and adenomyosis is found by chance on ultrasound.
These three conditions can look alike and coexist:
They are not always treated in the same way: an accurate diagnosis is therefore important.
After the history and clinical examination, a pelvic ultrasound, most often by the vaginal route, can show suggestive signs: enlarged uterus, thickened wall, small cysts in the muscle, blurred borders. When images are uncertain or for a localised form, a pelvic MRI clarifies the diagnosis.
A blood test looks for anaemia. Other causes of bleeding (polyp, fibroid, hormonal disorder) are looked for in parallel.
Treatment depends on how intense the symptoms are, your age and your plans for pregnancy:
Each option is explained with its benefits and limits, and the choice is made together.
Adenomyosis can be associated with reduced chances of pregnancy and certain risks during pregnancy. However, many women with adenomyosis conceive and carry a pregnancy without difficulty.
If you want a child, talk about it at the first consultation: the doctor assesses the situation, discusses the favourable timing and, if needed, proposes suitable follow-up.
Adenomyosis depends on hormones: its symptoms most often ease after menopause. In the meantime, treatments can relieve heavy and painful periods and prevent anaemia.
Consult if your periods are heavy (changing protection often, clots, prolonged duration), if they have become more painful, if you have bleeding between periods, pelvic pain or marked tiredness. Bleeding after menopause must always be explained.
The clinic offers a consultation with time to listen, targeted examination and imaging, and a personalised care plan. No procedure is offered without a clear indication, and a second opinion is welcome.
The doctor does not promise a definitive cure before menopause: adenomyosis is controlled and relieved. This page is informational.
The procedures and examinations linked to this care. Each is offered after a consultation, according to your situation.
Adenomyosis assessment
Ultrasound and, if needed, MRI for heavy and painful periods.
It is benign and is not cancer, but it can be very troublesome through bleeding and pain, and lead to anaemia.
Adenomyosis affects the muscular wall of the uterus, endometriosis affects organs outside the uterus. They can coexist.
Yes, many women do. Adenomyosis can however reduce the chances or complicate pregnancy: suitable follow-up is useful.
Its symptoms most often ease after menopause because the hormones that sustain it fall.
Not in most cases. It is considered only for severe symptoms resistant to other treatments, when plans for pregnancy are finished, after discussion.
A levonorgestrel hormonal IUD often reduces bleeding and pain. The doctor tells you whether it suits you.
Informational content: it does not replace a consultation. No outcome can be guaranteed.
