Adenomyosis

Uterine adenomyosis, often called adenomyosis, is a health condition where the uterine lining grows into the muscle walls of the uterus. This usually leads to an enlarged uterus and can result in heavy, painful periods.

Adenomyosis requires medication or surgery to remedy.

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On this page 

• What Is Adenomyosis?
• What Are the Symptoms of Adenomyosis?
• How Do You Diagnose Adenomyosis ?
• How Do You Treat Adenomyosis? 

What Is Adenomyosis?

In most healthy women of childbearing age, the uterine lining builds inside the uterus each cycle. If an egg isn't fertilized in the uterus, the lining will shed and cause menstruation. A new uterine lining then begins to build up again for the next cycle.

But for people with uterine adenomyosis, the uterine lining instead begins growing into the muscle walls of the uterus, causing pain and discomfort. While not much is known about the condition, it can be treated with medications or a hysterectomy (removal of the uterus).

Without proper treatment, the symptoms of adenomyosis may worsen and hinder daily life.

How common is adenomyosis?

This condition has been historically under-reported and under-diagnosed, but current estimates point to adenomyosis affecting 20% to 35% of women.

What causes adenomyosis?

Doctors are still trying to learn more about this condition, but believe some factors are linked to uterine adenomyosis.

They may be:

• Injury to or inflammation of the uterus.
• Prolonged exposure to estrogen.
• Exposure to progesterone or prolactin.
• History of uterine surgery.

Currently, researchers aren’t certain how the cells lining the uterus enter the muscles. The condition usually goes away after menopause.

What are adenomyosis risk factors and complications? 

Adenomyosis risk factors

Uterine adenomyosis can happen to any person with a uterus. But you may be at a higher risk for adenomyosis if you:

• Are between age 35 and 50.
• Have given birth two or more times.
• Have had a cesarian section birth.
• Have had prolonged exposure to estrogen.
• Have had previous uterine surgery.
• Have endometriosis.
• Have had shorter menstrual periods (24 or fewer days between cycles).
• Have been diagnosed with infertility.
• Have taken birth control bills.

Complications of adenomyosis 

If left untreated, adenomyosis symptoms can worsen and begin to interfere with your daily life. Adenomyosis has been known to occur with endometriosis and fibroids, causing more complications if left undiagnosed.

How can I prevent adenomyosis?

Since doctors still don’t know much about why this condition occurs, there’s nothing you can do to prevent it. It’s always important to focus on your physical and mental health, especially if you're planning to get pregnant.

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What Are the Signs and Symptoms of Adenomyosis?

While some people with adenomyosis never experience symptoms, many people with this condition may have:

• Painful menstrual cycles and uterine cramps.
• Heavy menstrual bleeding that lasts longer than usual.
• Bleeding between periods.
• Pain during sex.
• Infertility.
• Pelvic pain.
• Pressure on the bladder or rectum.
• Pain during bowel movement.
• Bloating or fullness in the abdomen.

When should I see a doctor about my adenomyosis symptoms?

Make an appointment with your ob-gyn or women's health provider if you're experiencing adenomyosis symptoms. Your doctor can help diagnose your discomfort and discuss treatment plans.

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How Do You Diagnose Adenomyosis?

Your doctor will perform a physical exam to look for signs and symptoms of adenomyosis, such as an enlarged uterus. They'll also ask questions about your menstrual cycle and reproductive health.

Specifically, they'll want to know about:

• Previous pregnancies, miscarriages, terminations, and live births.
• Your menstrual cycle history, such as length between cycles, heaviness of bleeding, and length of cycle.

Tests to diagnose adenomyosis

Your doctor my order the following tests to help determine adenomyosis:

• Transvaginal ultrasound.
• MRI.

Your doctor may also insert a hysteroscope into your uterus through the vagina to look for evidence of uterine adenomyosis.

Adenomyosis can't be fully diagnosed unless you have a hysterectomy, and a pathologist examines the uterus under a microscope.

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How Do You Treat Adenomyosis?

If your adenomyosis isn't causing symptoms, or if you're not trying to get pregnant or are close to menopause, treatment isn't necessary.

But for people who need treatment, it will depend on the severity of symptoms and their history. Adenomyosis treatment options include medication and surgery.

Medicine to treat adenomyosis

If you have adenomyosis, your doctor may prescribe:

• Anti-inflammatory drugs, such as ibuprofen, which can help reduce swelling and pain.
• Oral contraceptive pills, injection contraception, and progestin intrauterine devices, which can ease symptoms.
• Gonadotropin-releasing hormone agonists or antagonists in short doses, if needed.

Surgery for adenomyosis

There are two main types of surgery for adenomyosis:

• Uterine artery embolization. This process places a tube in a major artery in the pelvic area to stop the blood flow, reducing symptoms.
• Hysterectomy. This surgery removes the complete uterus from the body. Hysterectomy is only an option for women who don't wish to become pregnant or who prioritize relieving symptoms over a possible pregnancy.

Is adenomyosis treatment right for me?

You can choose what treatment option works best for you based on your history with adenomyosis and your family plan. A hysterectomy is the best option for women who don't want to become pregnant in the future, while medications should be tried first if you're planning on becoming pregnant.

By UPMC Editorial Staff. Last reviewed on 2024-09-05.