PATIENT GUIDE
Heavy, painful periods can affect your energy, work and everyday life. If a scan suggests adenomyosis, I help you understand what the finding means, which symptoms it may explain and what treatment fits your priorities.
UNDERSTANDING THE CONDITION
Adenomyosis is a benign condition in which tissue similar to the womb lining is present within the muscle wall. It can cause heavy or prolonged periods, painful periods, pelvic aching or fullness, and pain with sex. Some people have no symptoms.
It can affect younger patients too, including those who have not had children. Heavy bleeding can cause iron deficiency and anaemia, contributing to tiredness or dizziness.
The exact cause is not fully understood. Changes where the lining meets the muscle may play a part, and the tissue responds to hormones. There is no single explanation for every person.
Endometriosis involves tissue outside the womb. It can coexist with adenomyosis, as can fibroids or pelvic-floor problems. A scan finding may not explain every symptom.
YOUR CONSULTATION
We discuss bleeding, pain, their effect on daily life, previous treatment and your priorities. Pregnancy plans and whether you want to keep your womb matter.
Vaginal ultrasound is usually the first scan when suitable and acceptable. If it is unsuitable or declined, abdominal ultrasound or MRI may help, with their limitations explained. MRI can clarify uncertain findings.
We consider the findings alongside your symptoms and choose a useful next step. You do not need a hysterectomy simply to diagnose adenomyosis; a scan cannot predict every symptom or fertility outcome.
A full blood count is part of heavy-bleeding assessment; iron stores may also need checking. New or unusual bleeding can require separate assessment of the womb lining. Bleeding after menopause needs prompt assessment, even with an existing adenomyosis diagnosis.
Tell me about difficult examinations or worries. We explain any proposed examination and ask for your consent; you can ask to pause or stop.
MEDICAL OPTIONS
There is no single best option for everyone. Your symptoms, health, previous treatment and pregnancy plans guide the choice.
We agree when to assess bleeding, pain, side effects and everyday function, and check the response of anaemia or iron deficiency where relevant. If treatment is not helping enough, we reconsider the options and other pain contributors.
YOUR PRIORITIES
Tell me whether you want to conceive now or later. Hormonal suppression is generally unsuitable while trying to conceive; not every hormonal medicine provides reliable contraception.
Adenomyosis can be associated with fertility and pregnancy difficulties, but this does not predict your individual outcome. I work with fertility specialists when their input would help.
This matters whether or not you want children. Medical treatment is one option. Selected specialist procedures, such as uterine artery embolisation or removal of a focal area, need careful assessment.
Evidence, risks and availability vary. Keeping the womb does not necessarily mean preserving fertility, and these procedures cannot promise better pregnancy outcomes.
WHEN SURGERY MAY HELP
Hysterectomy removes the womb and definitively treats adenomyosis within it. We may discuss it when symptoms remain troublesome or other options are unsuitable or not wanted. You do not have to try every medicine first.
It ends the possibility of carrying a pregnancy. Removing the ovaries is a separate decision. Pain from coexisting endometriosis, pelvic-floor muscles or other causes may remain.
Surgical care at Life Kingsbury Hospital. We discuss the operation, route, benefits, risks and recovery if surgery is being considered.
OPTIONAL SYMPTOM DIARY
Bring previous scan reports and a list of medicines and treatments tried, if available. This endometriosis and menstrual diary also helps record adenomyosis symptoms, bleeding, what helps and your priorities.
Use only the pages you find helpful. You can book without a confirmed diagnosis, complete records or a full cycle of diary entries.
Printable PDF · 8 pages · 41 KB
COMMON QUESTIONS
No. Symptoms and their effect on your life guide the decision. Observation may be suitable for mild or absent symptoms, with review if bleeding or pain changes.
No. Adenomyosis is benign. That does not mean every new symptom should be attributed to it: new, unusual or postmenopausal bleeding needs assessment.
Yes. They are different conditions that can coexist. Treatment should consider the whole symptom pattern. Read more about endometriosis and overlapping pain.
It may help selected patients with heavy bleeding. Ablation treats the lining; it does not remove adenomyosis throughout the muscle. Existing period pain increases the chance of an unsatisfactory result or later hysterectomy.
It is unsuitable if you want a future pregnancy, and reliable contraception remains necessary. We assess suitability individually. Read the endometrial ablation guide.
Not automatically. Your symptoms, priorities and the benefits and limits of other options guide the decision. See when hysterectomy may help.
That is useful information at review. We reassess other contributors, including endometriosis and pelvic-floor symptoms, and discuss further investigation, different treatment or physiotherapy when appropriate.
YOUR NEXT STEP
Consultations in Claremont, with additional appointments in Simon’s Town on selected Mondays. Reception will confirm your date, time and venue.
General information to support your consultation. Your assessment and treatment plan are individual.
Page updated: .
Sources & further reading: NHS: adenomyosis · NICE: heavy menstrual bleeding · RANZCOG: living guideline · SOGC: adenomyosis guideline · SOGC: endometrial ablation