Everything to know about adenomyosis, the condition Gabrielle Union says compromised her fertility

Not long ago, talking openly about fertility-related issues—or really anything to do with the reproductive system, for that matter—just wasn’t really a thing. The oh-so prevalent conditions and situations under the topic’s umbrella were regarded as “shameful” and relegated to be dealt with in private. But over the past year or so, this has started to change. Certain celebrities, like Lena Dunham and Julianne Hough, have been pioneering voices to increase awareness about endometriosis, and their openness has made way for even more people to get real about other often-overlooked conditions, like adenomyosis.

After enduring multiple rounds of in-vitro fertilization (IVF) and “eight or nine” miscarriages, Gabrielle Union now knows the issue that might be precluding her from pregnancy. Even though she showed signs of the condition, which is similar to endometriosis, in her twenties when she was dealing with heavy periods that lasted up to 10 days, she just now—at 45 years old—is getting answers. “Everyone said ‘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.’ The reality is I actually have adenomyosis,” Union said at this year’s BlogHer conference, Essence reports.

Unlike some reproductive issues, adenomyosis isn’t as well-known or talked-about. According to Adeeti Gupta, MD, founder of Walk In GYN Care in New York City, it affects about 2 to 3 percent of women, making it generally uncommon, though she does see it in her practice. (Perhaps, like many other painful issues women face, adenomyosis is underdiagnosed.) While endometriosis involves the tissue that normally lines the uterus (AKA the endometrial cells) growing outside the uterus, adenomyosis occurs when those same cells grow into the uterine wall.

“Everyone said ‘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.’ The reality is I actually have adenomyosis.” —Gabrielle Union

Because those cells are still doing what they would normally do during the menstrual cycle—”thickening, breaking down, and bleeding,” the Mayo Clinic reports—the result is in an enlarged uterus (two to three times its normal size!), heavy periods, and a whole lot of pain and discomfort. “Painful periods, painful sex, and heavy periods are some of the main complaints I hear,” Dr. Gupta says. Unfortunately, she adds that the only surefire cure is undergoing a hysterectomy, but “birth control pills are some of the mainstay [solutions], and lifestyle and diet changes can help as well.”

While the condition typically dissipates after menopause due to it being estrogen-dependent, research suggests adenomyosis might affect a woman’s fertility during her child-birthing years—which could explain Union’s situation. In general, though, it’s often diagnosed later on—most often in a woman’s forties and fifties—so “the effect on fertility isn’t clearly predictable,” Gupta says. Consider this all the more reason for more research to take place so the world—and the affected women—can know more about the condition and how to deal.

Gabrielle Union isn’t just opening up about her infertility—she’s also talking about PTSD. Or, find out how to tone your glutes with her go-to abs exercise.