Adenomyosis and periods

In adenomyosis, tissue similar to the womb lining grows within the muscular wall of the womb. This tissue responds to menstrual hormones, while the surrounding muscle may become enlarged and tender. The condition commonly presents with heavy menstrual bleeding, strong cramps, pelvic pressure or pain that begins before bleeding and continues during the period. Some people also bleed between periods, while others have few or no symptoms.

Heavy bleeding can contribute to iron-deficiency anaemia. Possible clues include unusual tiredness, breathlessness, dizziness, headaches or a racing heartbeat. These symptoms deserve assessment rather than being treated as an unavoidable part of menstruation.

Keep a menstrual record showing bleeding days, flooding or clots, pain, medicines taken and effects on sleep, work or exercise. A clinician may discuss an examination, blood tests for anaemia and imaging if adenomyosis or another cause is suspected. Treatment is matched to symptom severity, contraceptive needs and future pregnancy plans.

Options can include pain relief, medicine that reduces menstrual bleeding, or hormonal treatment such as a hormonal coil. Procedures may be considered when symptoms remain disruptive, but their suitability depends on the womb, other conditions and whether you hope to become pregnant.

Arrange a medical appointment if periods are becoming heavier or more painful, bleeding occurs between periods or after sex, or symptoms regularly limit daily life. Seek urgent care for bleeding that rapidly soaks through menstrual protection, fainting, severe weakness, shortness of breath, sudden intense pelvic pain, or possible pregnancy with pain or bleeding.

Ask whether your bleeding pattern warrants a blood count or iron testing, what else could explain the symptoms, and which treatments fit your health history. If fertility matters to you, clarify how each option could affect attempts to conceive and what follow-up is needed if the first treatment does not help.