Adenomyosis
Find out about adenomyosis, including symptoms, what to do if you think you have it and how it's treated.
Symptoms of adenomyosis usually affect women over the age of 35. It can affect anyone who has periods.
Some symptoms of adenomyosis affect your periods, such as:
- painful periods – the pain may be severe and stop you from doing your usual activities
- heavy bleeding during your period
Other symptoms can happen any time in your menstrual cycle, such as:
- pelvic pain (pain in the lower part of your tummy)
- bloating, heaviness or fullness in your tummy (abdomen)
- pain during or after sex
Some people with adenomyosis have no symptoms.
Adenomyosis can make it difficult to get pregnant and it can also increase your risk of miscarriage.
Endometriosis is a different condition where cells similar to the lining of the womb grow in other places, such as the ovaries or fallopian tubes.
You should get medical help if you have symptoms of adenomyosis, such as painful periods or severe pelvic pain.
Ask for an urgent GP appointment or get help from NHS 111 if:
- your pelvic pain or period pain is severe or worse than usual and painkillers have not helped
You can call 111 or get help from 111 online.
See a GP if:
- your periods become more painful, heavier or irregular
- you have pain during or after sex
- heavy periods are affecting your life or you've had them for some time
- you've been feeling bloated for a while (about 3 weeks)
- you bleed between periods or after sex
It can take a long time to diagnose adenomyosis. You might need several different tests to find out if you have it.
This is because adenomyosis symptoms can be similar to other conditions, such as:
- endometriosis
- fibroids
- polyps
- endometrial hyperplasia (when the womb lining becomes too thick)
What happens at your GP appointment
A GP will ask about your periods if you have symptoms of adenomyosis. They may feel your tummy to see if there’s any swelling or bloating.
They might also ask to do an internal examination to check your vagina and cervix (the opening between the vagina and the womb).
You can ask for a female GP when you book your appointment. You can also have a friend, family member or other member of staff in the room with you during your examination if you want.
Further tests
Sometimes further tests are needed to find out what’s causing your symptoms, or to rule out similar conditions such as endometriosis.
Tests you may have include:
- an ultrasound scan – this may be done on your tummy or inside your vagina
- an MRI scan
There are treatments that can help manage the symptoms of adenomyosis.
Treatment depends on things like your symptoms, age and if you want to become pregnant.
Treatments that can help ease your symptoms include:
- the IUS (intrauterine system, also called Mirena or hormonal coil), which thins the womb lining, making your periods lighter and less painful
- other types of hormonal contraception if you cannot, or do not, want to have an IUS, such as the progestogen-only pill, the combined pill or the contraceptive patch
- medicines to help with pain, such as anti-inflammatories (NSAIDs), or reduce heavy bleeding during periods, such as tranexamic acid
If these treatments do not work, other treatments include:
- a procedure to block the blood supply to the affected cells (uterine artery embolisation)
- surgery to remove your womb (a hysterectomy)
Your doctor will explain the benefits and risks of these treatments. Removing your womb is the only way to cure adenomyosis, but this means you will not be able to get pregnant.
There are things that can help with period pain or pelvic pain caused by adenomyosis.
Do
use a heat pad or hot water bottle wrapped in a tea towel on your tummy
try a TENS machine – a small device that uses mild electrical impulses to reduce pain
take painkillers like paracetamol or ibuprofen
It's not clear what causes adenomyosis.
You may be more likely to get it if you've given birth.
You also have a higher chance of getting adenomyosis if you have endometriosis.
