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Understanding Adenomyosis

This information is for general education only and is not medical advice. It cannot replace a diagnosis or treatment plan from a qualified healthcare provider who knows your history. Always talk with your own doctor about your symptoms and options.

Adenomyosis occurs when the tissue that normally lines the uterus (endometrium) grows into the muscular wall of the uterus. This can cause the uterus to enlarge and lead to heavy, painful periods.

Adenomyosis illustration
20-35% Of women in imaging or hysterectomy studies, with higher rates in symptomatic populations
2x More likely with endometriosis

Adenomyosis is sometimes called the "sister condition" to endometriosis, and the two conditions can occur together. It is most commonly diagnosed in women in their 30s and 40s, though it can affect women of any age.

Recognize the signs

Do I have adenomyosis?

These conditions are often complex to diagnose and can look different in every patient. If several of these feel familiar, it's worth talking to a specialist.

Heavy menstrual bleeding

Prolonged or excessively heavy periods are the hallmark symptom.

Severe cramping

Intense menstrual cramps that worsen over time.

Enlarged uterus

The uterus may feel tender or enlarged during a pelvic exam.

Pain during intercourse

Deep pelvic pain during or after sex.

Find the right surgeon

1,800+ AAGL member surgeons list adenomyosis as a focus area

These surgeons have identified adenomyosis as an area of focus in their own listing. AAGL does not verify this information. Inclusion is not an endorsement.

Treatment options

How is adenomyosis treated?

Treatment depends on your symptoms, severity, and goals. Here are the most common approaches, with an emphasis on minimally invasive options.

Hormonal management

Birth control pills, hormonal IUDs (e.g., levonorgestrel IUD), or GnRH analogs can reduce bleeding and pain by suppressing the menstrual cycle.

Pain management

NSAIDs and individualized pain strategies can ease symptoms during the menstrual cycle.

Uterus-sparing surgery (limited)

Uterine-preserving surgical options for adenomyosis are emerging but remain limited and are not considered standard first-line treatment. Adenomyomectomy may be considered for select patients with focal disease who wish to preserve fertility, but outcomes vary, recurrence is possible, and obstetric risks — including uterine rupture in a subsequent pregnancy — must be discussed. Diffuse adenomyosis is generally not amenable to complete excision. Patients should be counseled by a surgeon experienced in the procedure.

Hysterectomy

Removal of the uterus is the only definitive cure for adenomyosis and may be appropriate for women with severe symptoms who have completed childbearing.

When to seek care urgently

This page is for education, not diagnosis. Some symptoms need prompt medical attention. Seek urgent care or call your local emergency number if you experience:

  • Severe or sudden pelvic or abdominal pain
  • Heavy vaginal bleeding that soaks through a pad or tampon every hour for two or more hours
  • Fever with pelvic pain
  • Fainting, dizziness, or a racing heart
  • Bleeding during pregnancy, or severe pain during pregnancy
  • Very heavy bleeding with weakness or dizziness needs urgent care.
Common questions

Frequently asked about adenomyosis

What is the difference between adenomyosis and endometriosis?

In endometriosis, tissue similar to the uterine lining grows outside the uterus. In adenomyosis, it grows into the muscular wall of the uterus. Both can cause pain and heavy bleeding, and they can occur together.

Can I still get pregnant with adenomyosis?

Many women with adenomyosis can conceive, though it may be associated with some pregnancy complications. Discuss your fertility goals with a specialist.

Medical Disclaimer

The information on this page is provided by Gynawareness, an educational initiative of the American Association of Gynecologic Laparoscopists (AAGL), for general informational and educational purposes only. It is not intended as, and should not be used as, a substitute for professional medical advice, diagnosis, or treatment.

Every patient is unique. Treatment options, risks, benefits, and outcomes depend on individual medical history, current health status, and clinical findings that can only be evaluated by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or treatment.

Do not delay seeking medical care, disregard professional medical advice, or stop a prescribed treatment because of information you have read on this site. If you believe you have a medical emergency, call your physician or 911 immediately.

Gynawareness and the AAGL do not endorse any specific test, product, procedure, opinion, surgeon, or other information that may be mentioned on this site.