Adenomyosis and ovarian cancer: understanding the difference

Adenomyosis does not itself mean ovarian cancer. Both conditions can be associated with pelvic discomfort or bloating, so symptoms alone cannot establish which condition is present.

In adenomyosis, tissue similar to the uterine lining grows within the muscular wall of the uterus. It may cause painful periods, heavy bleeding, pressure or an enlarged tender uterus. Ovarian cancer is a malignant growth arising from ovarian, fallopian-tube or nearby peritoneal cells.

Ovarian cancer can present with persistent abdominal swelling, pelvic or abdominal pain, feeling full sooner than expected, or changes in urination or bowel habits. These symptoms have many possible causes; their persistence and change from a person's usual pattern are reasons for assessment.

Arrange a clinical review for new, persistent or worsening pelvic symptoms. The clinician may ask about bleeding, pain, appetite, abdominal size, bladder and bowel changes, and family history, then examine the abdomen and pelvis.

A pelvic ultrasound can assess the uterus and ovaries, but imaging findings must be interpreted with the history and examination. Further scans, blood tests or referral may follow when an ovarian abnormality needs clarification. Genetic testing or tumour profiling applies only in selected cancer pathways, not as a routine test for adenomyosis.

Seek urgent help for severe sudden pelvic or abdominal pain, fainting, marked weakness, vomiting that prevents fluids, or very heavy vaginal bleeding with dizziness or breathlessness. Promptly report bleeding after menopause, a rapidly enlarging abdomen, or symptoms that continue and are becoming more intrusive.

Ask what features suggest adenomyosis, whether both ovaries were clearly seen on imaging, and whether any finding needs follow-up. If cancer is diagnosed, ask about its origin and stage, whether surgery or chemotherapy is proposed, how fertility or menopause may be affected, and whether genetic counselling is relevant.