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What is adenomyosis?

Adenomyosis is a condition where the tissue that normally lines the uterus is abnormally positioned in the muscle of the uterus

The displaced tissue continues to act normally – thickening, breaking down and bleeding – during each menstrual cycle. This can lead to an enlarged uterus and painful, heavy periods.

Adenomyosis affects as many as one in ten women of reproductive age.

What are the symptoms of adenomyosis?

The most common symptoms are:

  • Heavy, painful or irregular periods
  • Pre-menstrual pelvic pain and feelings of heaviness/discomfort in the pelvis

Less common symptoms are:

  • Pain during sexual intercourse (dyspareunia)
  • Pain related to bowel movements

When should you speak to your doctor?

If you have any of these symptoms, or are concerned about a change in your periods, it is worth speaking to your GP.

Who is likely to get adenomyosis?

Most cases of adenomyosis are found in women in their 40s and women who have had children. However, with advances in how adenomyosis is diagnosed, women are being diagnosed at younger ages.

What happens when I speak to my GP?

A GP will ask you about your symptoms and may need to examine you.

Your doctor may organise a transvaginal ultrasound scan, in which a small ultrasound probe (about the size of a finger) is gently passed into the vagina and images are transmitted to a monitor. They may also organise an MRI scan to investigate your symptoms.

Adenomyosis can take years to diagnose. Symptoms can be non-specific and overlap with those caused by other conditions.

Before visiting a GP, it may help to keep track of your periods and your symptoms in a diary so that they can understand them better.

Will adenomyosis stop me from having a family?

Adenomyosis does not appear to decrease the chance of pregnancy, but some women may experience an increased risk of miscarriage and premature birth.

What treatments are available?

The right treatment option will be based on a variety of factors which your doctor should discuss with you.

Options include:

  • If symptoms are mild, you are trying for a baby or nearing menopause, you may choose to do nothing
  • Non-hormonal treatments, such as tranexamic acid, to help with heavy bleeding
  • Hormonal treatments, such as the oral conceptive pill or Mirena coil, help to reduce bleeding and pain
  • Removal of the uterus, also known as a hysterectomy, for women not wishing to preserve fertility
  • A procedure, known as a uterine artery embolization, where tiny particles are injected into blood vessels via a catheter in the groin aiming to block off the blood supply to the adenomyosis and cause it to shrink

For further information, visit the North Bristol NHS Trust and read the Women's Health Matters 2021 report on adenomyosis