Patient education
Adenomyosis
Adenomyosis is a condition where endometrial tissue grows into the muscle of the uterus. It commonly causes heavy bleeding and painful periods, and can be difficult to diagnose without targeted imaging.
Start here
- What adenomyosis is (and how it differs from fibroids)
- Common symptoms
- How it’s diagnosed
- Bleeding, pain, and fertility considerations
- Treatment options
What is adenomyosis?
Adenomyosis occurs when tissue similar to the lining of the uterus (endometrium) is found within the muscular wall of the uterus (myometrium). This leads to thickening and inflammation of the muscle, which can cause pain and heavy or prolonged bleeding.
Unlike fibroids, adenomyosis does not form a discrete lump. Instead, it causes a more diffuse change in the uterine muscle, often resulting in a uniformly enlarged or “boggy” uterus.
Common symptoms
- Heavy or prolonged menstrual bleeding
- Severe period pain (dysmenorrhoea)
- Pelvic pain outside of periods
- Passing clots
- Pain with intercourse
- Fatigue or iron deficiency
How adenomyosis is diagnosed
Adenomyosis is diagnosed primarily with imaging. Blood tests do not diagnose adenomyosis, and endometrial biopsy does not detect it because it is a disease of the uterine muscle.
- Transvaginal ultrasound – first-line and often diagnostic
- MRI – useful when the diagnosis is uncertain or for treatment planning
Treatment options
Treatment depends on symptoms, severity, fertility goals, and whether adenomyosis is focal or diffuse.
- Anti-inflammatory medication for pain
- Hormonal treatments to reduce bleeding and pain
- Levonorgestrel-releasing IUD (Mirena)
- Surgical options in selected cases
- Hysterectomy as definitive treatment when appropriate
Adenomyosis is real, common, and treatable. If bleeding or pain is affecting your quality of life, a structured assessment helps clarify what’s going on and which options make sense for you.