Adenomyosis explained simply

During the menstrual cycle, this tissue responds to hormonal changes within the muscle. The uterus may become tender or enlarged, and contractions can feel painful. Some people have mild symptoms or none, while others experience substantial disruption.

Adenomyosis may present with heavy or prolonged periods, strong menstrual cramps, pelvic aching, pressure, bloating, or pain during sex. These features overlap with fibroids, endometriosis, and other pelvic conditions, so symptoms alone do not confirm it.

Assessment begins with a detailed history and may include a pelvic examination and ultrasound or magnetic resonance imaging. Imaging can support the diagnosis and look for other causes, although findings and symptom intensity do not always match closely.

If symptoms are manageable, tracking them and reviewing pain relief may be enough. For heavier bleeding or troublesome pain, a clinician may discuss anti-inflammatory medicines, hormonal medicines, or a hormonal coil. Check medicine suitability if you have other medical conditions, take blood thinners, or could be pregnant.

Procedures such as uterine artery embolisation, endometrial ablation, or hysterectomy may be considered in selected circumstances. They differ in what they treat and how they affect the uterus, so pregnancy wishes and the source of bleeding must be discussed before choosing one.

Make an appointment if period pain or bleeding is worsening, pelvic pain continues outside menstruation, bleeding occurs between periods or after sex, or symptoms interfere with normal activities. Fatigue, breathlessness, palpitations, or dizziness can accompany anaemia caused by ongoing blood loss.

Seek urgent care for sudden severe pelvic pain, fainting, fever alongside pelvic pain, severe weakness, or bleeding that quickly soaks through menstrual products. Prompt assessment is also needed for pain or bleeding when pregnancy is possible.

Ask what supports the diagnosis, whether blood tests or imaging are needed, and which alternatives could explain the symptoms. For each treatment, discuss the expected effect on pain and bleeding, medicine risks, recovery, contraception, and future pregnancy.