Adenomyosis and age: what to know

Age alone cannot confirm or exclude adenomyosis. Heavy or painful periods, pelvic pressure, and pain deserve assessment based on their pattern and effect on daily life, whether they begin recently or have been present for years.

Adenomyosis is tissue similar to the womb lining growing within the muscular wall of the womb. Its symptoms can overlap with fibroids, endometriosis, and other causes of abnormal bleeding or pelvic pain, so the timing of symptoms is only one part of the assessment.

A clinician may ask about menstrual changes, pregnancies, fertility goals, medicines, and signs of anaemia. Pelvic examination and ultrasound may help clarify the cause; sometimes further imaging is useful when the diagnosis remains uncertain.

Keep a record of bleeding days, flooding, clots, pain, and any missed work or interrupted sleep. Bring the dates of your last periods and a list of medicines to an appointment.

Treatment is guided by symptom burden, contraception needs, fertility plans, other health conditions, and how close you may be to menopause. Options can include pain relief, medicines that reduce bleeding, hormonal treatment, and procedures. A discussion of benefits, limitations, and effects on future pregnancy should come before a procedure.

Arrange a medical review for periods that are becoming heavier or more painful, bleeding between periods, persistent pelvic discomfort, or tiredness and breathlessness that could reflect anaemia.

Seek urgent care for very heavy bleeding accompanied by fainting, marked dizziness, shortness of breath, chest discomfort, severe weakness, or sudden severe pelvic pain. Bleeding after menopause also needs prompt assessment because it should not be assumed to come from adenomyosis.

Ask what else could explain your symptoms, whether a blood count or imaging would help, and which options fit your fertility and contraception plans. If a procedure is proposed, ask how it changes the womb and whether symptoms could return or persist.