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Conditions

Gynecology · Reproductive health

Adenomyosis

Understand adenomyosis, prepare for assessment and discuss options according to pain, bleeding and personal plans.

Editorial publication · Medical review pending.

Understand

Adenomyosis means tissue from the uterine lining is present within the uterine muscle. It may be localised or diffuse and can coexist with endometriosis, which affects tissue outside the uterus.

Possible symptoms

Heavy or painful periods, pelvic pressure, bloating and pain during sex may occur. Some people have no symptoms. These signs alone cannot establish a diagnosis.

Causes and associated factors

The causes remain poorly understood. Hormonal and genetic factors may play a part; they cannot predict every individual situation.

Diagnosis

The doctor reviews the pattern of periods and pain. An abdominal and, with your consent, pelvic examination may guide assessment.

Tests

Ultrasound is usually the first imaging test; MRI may add information. With heavy periods, a blood test may check for anaemia.

Course of the condition

Adenomyosis can cause no symptoms and may need no treatment. Symptoms usually ease after menopause.

Care options

Treatments can reduce bleeding, including a hormonal intrauterine system when appropriate. Benefits, contraindications and side effects need discussion. Hysterectomy may be considered for some troublesome cases after assessing alternatives. It removes the uterus and prevents any future pregnancy.

When to consult

Seek advice if periods disrupt daily life, pain persists or you bleed between periods or after sex. Mention tiredness and breathlessness.

Urgent help

Severe or worsening pelvic pain, fainting, breathing difficulty or heavy bleeding: seek immediate help. With fever, vomiting or possible pregnancy, seek urgent advice. Do not assume new pain is caused by adenomyosis.

Questions for your doctor

  • Which tests could explain my symptoms?
  • What alternatives to surgery are available?
  • What benefits and risks should I expect from treatment?
  • How can my pregnancy plans be preserved?
  • What follow-up and recovery time should I expect if an operation is chosen?

Continue reading

A procedure linked to a condition does not establish an indication for your individual situation.

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