Due to many requests, I am currently working on publishing my book, “My Hormones Are Killing Me – My Struggle With Adenomyosis and Estrogen Dominance” as an e-book. I have to re-format the book for Kindle, so I am basically reading it as I re-format. It was originally published in 2012. This book is a re-cap of my seventeen year struggle with the disorder which finally ended in 2007 after my hysterectomy. Since writing this book, I have done a lot of research on the disorder and have recently published my second book which looks at all of the current knowledge and research. So, today I know much more about adenomyosis than I did back in 2012.
As I was re-formatting today, I read my ultrasound, sonohysterogram, and hysteroscopy notes that were done when I had a uterine polyp in the early 2000s. The ultrasound, which was done first, noted an endometrial thickness of 5 mm. Thickness of the endometrium varies throughout a woman’s cycle, but in general, this falls into the normal range. Please note, as I discuss in my current book, that it has now been found that it is of utmost importance to look at the thickness of the junctional zone, or JZ, in particular on MRI to identify adenomyosis. I’m quite sure that at that time, they didn’t look at the JZ.
My sonohysterogram report (done after the ultrasound) stated that my endometrium appeared normal with a thickness of 1-2 mm. A thickness of 1-2 mm usually is seen during menstruation, and I wasn’t menstruating – I was mid-cycle. That was a big red flag to me as I re-read the report. Other than the polyp, the report stated that everything appeared normal.
However, about a month after the sonohysterogram, I had a hysteroscopy to remove the polyp. The hysteroscopy report stated that I had a bicornuate uterus, and the surgeon was not able to accurately visualize the left horn of my uterus. The polyp was successfully removed but it begs the question: Why wasn’t the bicornuate uterus picked up by sonohysterogram? A sonohysterogram is touted for being about 90% accurate for picking up uterine abnormalities of all kinds, including a bicornuate uterus.
So….1-2 mm endometrial thickness and no mention of a bicornuate uterus? Hmmm. As you can see, I question everything. I have learned to do this not only because of my ordeal with adenomyosis, but also because I worked in the medical field for about twenty years. Although people in this field are quite diligent, we are all human. Mistakes are made in the medical field, and doctors and radiologists are not immune to this problem.
This also drives home the point that I have made in previous posts and on my website, Adenomyosis Fighters. The ability to be able to properly diagnose adenomyosis is entirely dependent on the skill of the doctor or radiologist. If the doctor who performed the sonohysterogram failed to pick up a bicornuate uterus, do you think he would be able to pick up adenomyosis? A bicornuate uterus is a rather large and much more obvious abnormality compared to adenomyosis.
It is imperative that doctors and radiologists update their current knowledge on adenomyosis. Even though I’ve said this over and over again, to this day, I STILL hear patients tell me that their doctors don’t know much about adenomyosis. In my most current book, I point out the following statement made by researchers Owalbi and Strickler:
“Adenomyosis is the addendum to textbook chapters on ectopic endometrium: it is a forgotten process and neglected diagnosis.”ª
To learn more, please visit http://www.adenomyosisfighters.com.
ªOwalbi, T. O. & Strickler, R. C. (1977). Adenomyosis: A Neglected Diagnosis. Obstetrice and Gynecology, 50(4), 424-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/904805