Women in the child-bearing age can normally get pregnant without a hitch, barring reproductive health problems. Some of the most common factors that affect fertility are age and weight, and certain conditions like endometriosis, polycystic ovarian syndrome and a lesser-known condition called adenomyosis.
In October 2017, Hollywood actress Gabrielle Union revealed in her book entitled We’re Going to Need More Wine that she and her husband, Miami Heat shooting guard Dwayne Wade, had been struggling to conceive for years and "had eight or nine miscarriages." The couple were married in 2014.
Gabrielle, 46, wrote, “For three years, my body has been a prisoner of trying to get pregnant — I’ve either been about to go into an IVF cycle, in the middle of an IVF cycle, or coming out of an IVF cycle.”
During a conference advocating women empowerment in August 2018, Gabrielle gave an update on her condition and shared that she was finally diagnosed with adenomyosis, which she thinks played a big factor in her ability to conceive.
"Towards the end of my fertility journey, I finally got some answers because everyone had just sort of chalked it up to, 'You're a career woman, you've prioritized your career, you waited too long, and now you're just too old to have a kid — and that's on you for wanting a career.' The reality is I actually have adenomyosis," Gabrielle said.
What is adenomyosis?
Adenomyosis is a uterine disorder where a woman's endometrial tissues, instead of just lining the uterus, move into the muscle wall of the uterus. It may cause bleeding and painful, heavy periods that last unusually longer than a regular menstrual cycle. (In endometriosis, endometrial tissues grows outside the uterus and attaches itself to the ovaries, fallopian tubes or the pelvic lining. It is possible to have both conditions.)
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Who are at risk?
Women in their 40s or 50s, those who have had prior surgery (like a C-section, for example), and those who have gone through childbirth, are most susceptible to having adenomyosis.
According to Healthline, adenomyosis is characterized by heavy and prolonged menstrual bleeding, chronic pain in the pelvic area, menstrual cramps, and pain during sex.
Adenomyosis can cause the uterus to become enlarged. Prolonged heavy bleeding can result to chronic anemia that causes fatigue.
Is there a treatment?
Adenomyosis can be treated with anti-inflammatory drugs prescribed by your doctor, hormone medications like pills, or surgically through hysterectomy. The condition also goes away on its own after menopause, reports Mayo Clinic.
How does adenomyosis affect a woman's fertility?
While a direct association between fertility and adenomyosis has not yet been fully established, a study led by Tasuku Harada, M.D. reports, "based on the available information, recent studies suggested that adenomyosis has a negative impact on female fertility." Furthermore, "several uncontrolled studies with limited data also suggested that treatment of adenomyosis may improve fertility," states the paper, which was published in the journal Obstetrical & Gynecological Survey in 2016.
In the case of Gabrielle, she said in her interview that she wished someone probed deeper into the problem when she was in her 20s. “The gag is I had it in my early 20s, and instead of someone diagnosing me they were like, ‘Oh, you have periods that last nine or 10 days and you’re bleeding through overnight pads? Not a mere inconvenience perhaps there’s something more there.'" Instead, "Every doctor I saw was like, ‘Let me put you on birth control,'” she added.
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She adds, "If you are on birth control for anything other than birth control, to address or treat any sort of period issue, you are not actually treating or addressing a period or reproductive issue. You are masking it. The Pill can mask all kinds of things. It is amazing at preventing pregnancy; not so great with addressing adenomyosis."
Gabrielle and Dwayne, through a surrogate, welcomed daughter Kaavia on November 7, 2018.
“The gag is I had it in my early 20s, and instead of someone diagnosing me they were like, ‘Oh, you have periods that last 9 or 10 days and you’re bleeding through overnight pads?'” she said. “Every doctor I saw was like, ‘Let me put you on birth control.'”