What is Adenomyosis?

Adenomyosis is a gynaecological condition marked by the infiltration of endometrial tissue into the muscular uterine wall. This intrusion leads to thickened uterine walls and various symptoms. Typically affecting those in their reproductive years, adenomyosis often presents with intense menstrual pain, heavy bleeding, and pelvic discomfort, impacting sexual health. The precise causes of adenomyosis are unclear, but hormonal influences and uterine trauma are implicated. Treatment approaches vary. They include pain management and surgical interventions.

Who does it affect?

Adenomyosis is most prevalent in individuals aged 30 to 50. It has a higher occurrence in women who have experienced multiple pregnancies or undergone uterine surgeries like caesarean sections. It can affect women who have not given birth, and its frequency diminishes in those nearing menopause. It is due to hormonal changes, which alleviate the symptoms of this condition. It significantly influences the quality of life for individuals in their reproductive years, emphasising the importance of understanding and managing adenomyosis.


Causes of Adenomyosis

Understanding the causes of adenomyosis is pivotal for individuals and healthcare providers alike. The causes are:

  1. Immune System Dysfunction:An immune system that does not function optimally may be associated with the development of adenomyosis. A compromised immune response might fail to regulate the invasion of endometrial tissue into the muscular layers of the uterus.
  2. Stress and Lifestyle Factors:While not directly causative, chronic stress and certain lifestyle factors might exacerbate hormonal imbalances and inflammation, potentially influencing the development or progression of adenomyosis.
  3. Hormonal Influences:Fluctuations in hormonal levels, such as elevated oestrogen, are associated with the development of adenomyosis. This hormonal imbalance may encourage the invasion of endometrial tissue into the uterine muscle.
  4. Inflammation: Chronic inflammation within the uterine walls may facilitate the development of adenomyosis. Inflammatory processes can alter the tissue environment and encourage the infiltration of endometrial cells.

Symptoms of Adenomyosis

Adenomyosis manifests through a spectrum of symptoms that can significantly impact daily life. Recognizing these varied symptoms of adenomyosis is essential for early diagnosis and targeted management:


  1. Menstrual Pain:Intense and prolonged menstrual cramps, often worsening over time, are a hallmark symptom of adenomyosis. This pain can be more severe than typical menstrual discomfort.
  2. Heavy Menstrual Bleeding:Adenomyosis is frequently associated with heavy menstrual bleeding, leading to increased blood loss and potential anaemia if left untreated.
  3. Pelvic Discomfort:Individuals with adenomyosis may experience chronic pelvic pain or a sense of fullness and heaviness in the lower abdomen outside of the menstrual period.
  4. Painful Intercourse:Adenomyosis can contribute to pain during sexual intercourse, impacting individuals’ intimate relationships and overall quality of life.
  5. Back Pain:Some individuals may experience lower back pain as a result of adenomyosis, adding to the complexity of its symptomatology.
  6. Irregular Menstrual Cycles:Adenomyosis can contribute to irregularities in menstrual cycles. Women may experience variations in the duration and frequency of their periods.
  7. Abdominal Bloating:Some individuals with adenomyosis may notice persistent abdominal bloating, which can contribute to a feeling of fullness and discomfort.
  8. Painful Bowel Movements:The proximity of the uterus to the rectum in some cases of adenomyosis may lead to discomfort or pain during bowel movements during menstruation.
  9. Bladder Issues:It may cause pressure on the bladder and lead to an increased frequency of urination or a sense of urgency.
  10. Enlarged Uterus:Due to the thickening of the uterine walls, it can result in an enlarged uterus. This enlargement may be noticeable during a pelvic examination.

Adenomyosis Treatment

Effectively managing this condition involves a multifaceted approach, with adenomyosis treatment strategies tailored to individual needs:

  1. Pain Management:pain relievers can decrease menstrual and pelvic discomfort.
  2. Hormonal Therapies:Regulating hormones with contraceptives or progestin-releasing devices (mirena) controls symptoms and slows adenomyosis progression.
  3. Uterine Artery Embolization (UAE):This minimally invasive procedure reduces symptoms by blocking blood vessels supplying the uterus.
  4. Endometrial Ablation:Removing or destroying the uterine lining can provide relief in non-fertility cases.
  5. Hysterectomy:In severe cases or when fertility is not a concern, removing the uterus is a definitive treatment.
  6. Complementary Therapies:Lifestyle changes and therapies like acupuncture or physical therapy can offer additional symptom management.


Adenomyosis presents a complex landscape, necessitating a thorough understanding of its causes and diverse symptoms of adenomyosis. Understanding its treatment options can help you prepare for what is to come. By unravelling the intricacies of adenomyosis, individuals can make informed decisions about their health, and healthcare providers can offer targeted interventions that enhance the overall well-being of those affected by this condition. Fostering awareness, promoting open dialogue, and advancing research are essential steps in optimising care and empowering individuals living with adenomyosis.