About this condition
Adenomyosis describes endometrial-like tissue within the muscle of the uterus. It can be associated with pronounced period pain, heavy menstrual bleeding and a sensation of pelvic heaviness. Some people have few or no symptoms, and similar complaints occur with other gynecologic conditions.
Possible causes and features
A fibroid is a benign muscle nodule, whereas adenomyosis involves changes within the uterine muscle. Endometriosis outside the uterus is another condition, and these diseases can coexist. A symptom pattern alone is not enough to identify which one is present.
Warning features for an appointment include worsening period cramps, increasingly heavy bleeding, pelvic discomfort and pain during intercourse. Because bleeding can cause anaemia, tiredness or dizziness may also require evaluation.
Assessment and next steps
The gynecologist reviews cycle history, pain and bleeding and may recommend pelvic ultrasound. When pronounced pain and heavy bleeding suggest adenomyosis, transvaginal ultrasound is often considered first if acceptable to the patient. MRI is not routinely needed for everyone.
Management is individual and can involve pain relief, medicines to reduce bleeding, hormonal options or an operation in selected situations. The plan depends on symptoms, other diagnoses, contraindications and pregnancy goals. No single symptom proves that surgery is necessary.
Related topics: Uterine fibroids; Heavy periods; Painful periods.
Signs and symptoms
- Painful periods that may progressively worsen.
- Heavy or prolonged bleeding during menstruation.
- Pelvic pressure, discomfort or pain during intercourse; some people have no symptoms.
Diagnosis and tests
A gynecologist assesses the cycle, pain and bleeding and considers examination and pelvic ultrasound. Transvaginal ultrasound is often preferred when suitable; additional imaging or endometrial evaluation is selected when indicated. A blood count may be appropriate if anaemia is suspected.
Care and treatment approaches
Options may include clinician-selected pain relief, medicines to reduce blood loss, hormonal approaches and, for selected cases, surgical procedures. Risks, preferences and future pregnancy plans affect the choice of treatment.
When to seek urgent care
Seek prompt emergency help for sudden severe pelvic pain, very heavy bleeding, fainting or major weakness. Pain and bleeding when pregnancy is possible require urgent exclusion of pregnancy complications; call 103 or 112 in Ukraine for emergencies.
Frequently asked questions
How is adenomyosis different from fibroids?
Fibroids form benign muscle nodules; adenomyosis involves endometrial-like tissue within the uterine muscle. Both can coexist.
Can adenomyosis cause heavy periods?
Yes. Heavy bleeding and painful periods are possible manifestations, but other causes must also be considered.
What is the usual investigation?
The clinician may suggest pelvic ultrasound, often transvaginal when appropriate, with other methods reserved for selected situations.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
