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Heavy periods
Stomachache
Heavy bleeding during periods
Abdominal pain
Abdominal cramps
Prolonged heavy periods
Lower back pain
Sharp pelvic pain during menstruation
Chronic pelvic pain
Painful intercourse
Lower abdominal pressure
Not seeing your symptoms? No worries!
What is Adenomyosis?
Adenomyosis is a condition of the uterus (womb) that can occur in women. It occurs when cells of the uterine lining (endometrium) migrate or grow into the muscle layer (myometrium). This can cause the uterus to enlarge, and make menstruation more painful and heavier than normal. While it is not dangerous on its own, it can be very uncomfortable for patients and can affect their enjoyment of life. The heavy bleeding can also make patients anemic and affect their medical health. The exact cause is not known but uterine adenomyosis is more common in women who are in their 30's and 40's and have had children.
Typical Symptoms of Adenomyosis
- Stomach or abdominal pain in a specific area
- Periods that last more than 8 days
- Pain in the pelvis
- Pain in the lower abdomen
- Excessively heavy periods
- Vaginal bleeding or discolored discharge outside of your period
- Unusual changes in period
- Stomach or abdominal pain
Diagnostic Questions for Adenomyosis
Your doctor may ask these questions to check for this disease:
- Do you have stomach or abdominal pain in a specific area?
- Do your periods last more than 8 days?
- Are you experiencing pain in the pelvis?
- Do you have pain in your lower abdomen?
- Do you have excessively heavy periods?
Treatment of Adenomyosis
Adenomyosis only requires treatment if the symptoms are bothersome to the patient, or causing severe anemia. It typically improves and goes away on its own after menopause. If symptoms are bothersome, pain medication, hormonal pills or progesterone containing intrauterine devices can be helpful. For women that do not desire more children, a hysterectomy (surgery to remove the uterus) can also be considered and would be curative.
Reviewed By:
Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)
Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Nov 22, 2024
Following the Medical Content Editorial Policy
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Symptoms Related to Adenomyosis
Diseases Related to Adenomyosis
FAQs
Q.
Pelvic Pain? Why Your Uterus Is Hurting & Medically Approved Next Steps
A.
Pelvic or uterus pain is commonly from menstrual cramps, but can also stem from adenomyosis, fibroids, endometriosis, infection, IUD issues, polyps, or pregnancy complications, and many causes are treatable. There are several factors to consider; see below for the fuller picture and how each cause changes the next steps. Start by tracking your cycle and using NSAIDs if safe, heat, and gentle movement, then arrange a gynecology visit for persistent or disruptive pain, and seek urgent care for severe sudden pain, heavy bleeding, fever, fainting, or any intense pain during pregnancy; important nuances and when to choose each step are explained below.
References:
* Javed, N., & Panagides, J. C. (2022). Chronic Pelvic Pain in Women: A Review of Current and Future Approaches to Treatment. *Obstetrics and Gynecology Clinics of North America*, *49*(1), 173-189. https://pubmed.ncbi.nlm.nih.gov/35056976/
* Barcikowska, Z., Rajkowska-Labon, E., Chen, C., & Łukaszuk, K. (2022). Primary Dysmenorrhea: Advances in Pathogenesis and Management. *Journal of Clinical Medicine*, *11*(3), 631. https://pubmed.ncbi.nlm.nih.gov/35160408/
* Moran, L. J., & Roust, P. J. (2022). Endometriosis: Pathophysiology, Diagnosis, and Management. *Mayo Clinic Proceedings*, *97*(4), 784-798. https://pubmed.ncbi.nlm.nih.gov/35450849/
* Maia, J. R., & Szeliga, A. (2022). Adenomyosis: An Underdiagnosed and Understudied Disease. *Journal of Clinical Medicine*, *11*(3), 643. https://pubmed.ncbi.nlm.nih.gov/35160533/
* Mehedintu, C., & Plotogea, M. N. (2018). Chronic pelvic pain in women: A current approach to diagnosis and management. *Journal of Medicine and Life*, *11*(2), 93-97. https://pubmed.ncbi.nlm.nih.gov/29881667/
Q.
Is It Adenomyosis? Why Your Uterus Is Inflamed & Medical Next Steps
A.
Adenomyosis is a common reason a uterus appears enlarged or inflamed, caused by endometrial tissue growing into the uterine muscle and triggering bleeding within the wall that leads to heavy, painful periods, pelvic pressure, and sometimes anemia or fertility challenges. Diagnosis relies on history, exam, and imaging such as transvaginal ultrasound or MRI, and treatment ranges from NSAIDs and hormonal options including a hormonal IUD to procedures like uterine artery embolization, ablation, or hysterectomy based on symptoms and pregnancy goals. There are several factors to consider, including red flags and which option fits you best, so see the complete details below to guide your next medical steps.
References:
* Chapron C, et al. Adenomyosis: A Systematic Review of Diagnosis and Interventions. Front Surg. 2020 Jul 15;7:47. doi: 10.3389/fsurg.2020.00047. PMID: 32766329.
* Struble J, et al. Adenomyosis: An Update on Diagnosis and Treatment. J Clin Med. 2023 Apr 1;12(7):2680. doi: 10.3390/jcm12072680. PMID: 37049877.
* Zervoudis S, et al. Adenomyosis and chronic pelvic pain: a comprehensive review. J Clin Med. 2023 Jan 3;12(1):326. doi: 10.3390/jcm12010326. PMID: 36615174.
* Guo Y, et al. The Role of Inflammation in Adenomyosis Pathogenesis. Front Immunol. 2021 Sep 1;12:735773. doi: 10.3389/fimmu.2021.735773. PMID: 34539851.
* Maia H, et al. Management of adenomyosis: current medical and surgical options. Arch Gynecol Obstet. 2022 Jul;306(1):1-14. doi: 10.1007/s00404-022-06484-z. PMID: 35332309.
Q.
What conditions should be considered if heavy menstrual bleeding persists?
A.
Heavy menstrual bleeding, also known as menorrhagia, can be a significant concern for many women. If this condition persists, it is essential to consider various underlying causes to ensure appropriate diagnosis and management.
References:
Brenner PF. Differential diagnosis of abnormal uterine bleeding. Am J Obstet Gynecol. 1996 Sep;175(3 Pt 2):766-9. doi: 10.1016/s0002-9378(96)80082-2. PMID: 8828559.
Borzutzky C, Jaffray J. Diagnosis and Management of Heavy Menstrual Bleeding and Bleeding Disorders in Adolescents. JAMA Pediatr. 2020 Feb 1;174(2):186-194. doi: 10.1001/jamapediatrics.2019.5040. PMID: 31886837.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Lacheta J. Uterine adenomyosis: pathogenesis, diagnostics, symptomatology and treatment. Ceska Gynekol. 2019 Spring;84(3):240-246. English. PMID: 31324117.
https://www.prolekare.cz/en/specialist-agreementHarada T, Khine YM, Kaponis A, Nikellis T, Decavalas G, Taniguchi F. The Impact of Adenomyosis on Women's Fertility. Obstet Gynecol Surv. 2016 Sep;71(9):557-68. doi: 10.1097/OGX.0000000000000346. PMID: 27640610; PMCID: PMC5049976.
https://journals.lww.com/obgynsurvey/Fulltext/2016/09000/The_Impact_of_Adenomyosis_on_Women_s_Fertility.20.aspxVannuccini S, Petraglia F. Recent advances in understanding and managing adenomyosis. F1000Res. 2019 Mar 13;8:F1000 Faculty Rev-283. doi: 10.12688/f1000research.17242.1. PMID: 30918629; PMCID: PMC6419978.
https://f1000research.com/articles/8-283/v1Osada H. Uterine adenomyosis and adenomyoma: the surgical approach. Fertil Steril. 2018 Mar;109(3):406-417. doi: 10.1016/j.fertnstert.2018.01.032. PMID: 29566853.
https://www.fertstert.org/article/S0015-0282(18)30032-3/fulltextSzubert M, Koziróg E, Olszak O, Krygier-Kurz K, Kazmierczak J, Wilczynski J. Adenomyosis and Infertility-Review of Medical and Surgical Approaches. Int J Environ Res Public Health. 2021 Jan 30;18(3):1235. doi: 10.3390/ijerph18031235. PMID: 33573117; PMCID: PMC7908401.
https://www.mdpi.com/1660-4601/18/3/1235NIH NCBO Stat Pearls - Adenomyosis
https://www.ncbi.nlm.nih.gov/books/NBK539868/