Adenomyosis
Adenomyosis occurs when the tissue that lines the uterus grows into its muscular wall, often causing painful periods, heavy bleeding, or an enlarged uterus. Understanding the condition and available management options can help you make informed decisions about your care.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
The Uterus
The uterus is a hollow, muscular organ in the pelvis, made up of three layers: the innermost lining (endometrium), the muscle layer (myometrium), and the outer lining (serosa). Normally, the endometrium sits neatly inside the uterus and sheds each month during menstruation.
In adenomyosis, the endometrial tissue grows into the myometrium, the muscular wall of the uterus. This can cause the uterus to become thicker and heavier, and it may cause pain or tenderness, especially during periods.
Understanding Adenomyosis
Adenomyosis is a condition where the lining of the uterus grows into the muscular wall, which can affect how the uterus functions. This often leads to changes in menstrual bleeding and pelvic discomfort. Not everyone with adenomyosis has symptoms, but common signs include:
- Heavy or prolonged menstrual bleeding
- Painful periods or cramping that may worsen over time
- Pelvic pain or tenderness outside of periods
- Bloating or a feeling of fullness in the lower abdomen
- Pain during sex in some cases
Symptoms can vary in severity from mild to debilitating, and they often worsen with age.
Causes and Risk Factors
The exact cause of adenomyosis is not fully understood, but several factors can increase the likelihood of developing the condition. While having one or more of these factors does not mean you will definitely develop adenomyosis, they are linked to a higher risk.
| Age | Most common in women aged 40-50, though it can occur earlier. |
| Previous pregnancies | Giving birth may increase the risk. |
| Prior uteriune surgery | Procedures such as a C-section or fibroid removal may play a role. |
| Hormonal influences | Adenomyosis is sensitive to oestrogen, which may affect its development. |
| Endometriosis | Can occur alongside endometriosis; having endometriosis may increase the likelihood of adenomyosis. |
Diagnosing Adenomyosis
Adenomyosis can be difficult to diagnose because its symptoms are similar to other conditions, such as fibroids or endometriosis. Your healthcare provider may use a combination of approaches to make a diagnosis.
Your healthcare provider will usually begin by taking a detailed medical history and reviewing your symptoms, including your menstrual patterns, the severity and timing of any pain, and any changes you’ve noticed over time.
Imaging tests may then be used to confirm the diagnosis:
| Ultrasound | Uses sound waves to create images of the uterus, showing thickening of the uterine wall, changes in muscle texture, and areas where the lining has grown into the muscle. It is usually the first test because it is quick, non-invasive, and widely available. |
| MRI Scan | Provides detailed images of the uterus and surrounding tissues, clearly showing the extent of adenomyosis and how much of the lining has penetrated the muscle. MRI is used when ultrasound results are unclear or a more precise assessment is needed for treatment planning. |
Treatment Options
Treatment for adenomyosis depends on the severity of symptoms, your age, and whether you want to have children in the future. The goal is to reduce pain and manage heavy bleeding.
| Medications & Pain Relief | Mild symptoms may be managed with over-the-counter painkillers such as ibuprofen or paracetamol to reduce period pain and cramping. |
| Hormonal Treatments | Hormonal therapies can help control bleeding and reduce pain by regulating the menstrual cycle. Options include: -Hormonal contraceptives such as the combined pill, hormonal IUDs, or contraceptive implants. -Gonadotropin-releasing hormone (GnRH) analogues, which reduce oestrogen levels and temporarily shrink the uterus, creating a short-term “menopause-like” effect. They are usually prescribed for a few months to help control symptoms or before surgery. |
Surgical Options
| Uterine artery embolisation (UAE) | A minimally invasive procedure that reduces blood flow to the uterus, helping relieve pain and bleeding.Endometrial ablation - Removes or destroys the lining of the uterus to reduce heavy bleeding (not suitable if you want to become pregnant). |
| Adenomyomectomy | Removes the areas of adenomyosis while keeping the rest of the uterus intact. It can help reduce pain and heavy bleeding, although the surgery can be complex and symptoms may sometimes return. Adenomyomectomy is usually considered for women who want to preserve fertility or avoid a hysterectomy. |
| Hysterectomy | Procedure to remove the uterus, which provides a definitive cure for adenomyosis. It is usually considered only when other treatments have not relieved symptoms and when you no longer wish to have children. After a hysterectomy, periods stop completely, and the symptoms of adenomyosis will not return. |
Treatment is tailored to your needs, and your doctor will discuss the most appropriate options for your situation.
How can Lanthorn help?
Ultrasound Uterus & Ovaries - From £300
Uses sound waves to create detailed images, showing thickening of the uterine wall, changes in muscle texture, and areas where the lining has grown into the muscle. Quick, non-invasive, and widely available, it is often the first imaging test.
Pelvis MRI - £550
Provides high-resolution images of the uterus and surrounding tissues, clearly showing the extent of adenomyosis and uterine wall involvement. Useful when ultrasound results are unclear or for treatment planning.
Specialist referral and follow-up planning
We can help patients access gynecologists or fertility specialists and schedule ongoing imaging or monitoring if needed.
