Adenomyosis awareness in April

In adenomyosis, tissue similar to the lining of the uterus is found within the muscular wall of the uterus. It responds to hormonal changes and can make the uterus tender or enlarged. People with adenomyosis may have very painful periods, heavy or prolonged menstrual bleeding, pressure, pain during sex, or pelvic pain between periods; some have few or no symptoms. These features can overlap with fibroids, endometriosis and other conditions, so symptoms alone do not establish the diagnosis.

Record when bleeding and pain occur, whether you pass clots, how often you change period products, and how symptoms affect sleep, work, exercise or sex. A clinician may discuss a pelvic examination and imaging such as ultrasound or MRI. Treatment is tailored to symptom severity, pregnancy plans and personal preferences. Options may include pain relief, medicines that reduce bleeding, hormonal treatment such as a hormonal coil, or a procedure. Endometrial ablation, uterine artery embolisation and hysterectomy have different implications and are not suitable for everyone.

Arrange a medical assessment for periods that are becoming heavier or more painful, bleeding between periods, pain during sex, ongoing pelvic pressure, or fatigue and breathlessness that could accompany anaemia. Seek urgent care for very heavy bleeding with fainting, marked dizziness, weakness or shortness of breath, and for sudden severe pelvic pain, especially with fever, vomiting or possible pregnancy. Urgency comes from the severity and pattern of the symptom, not from whether adenomyosis is common.

Ask which diagnoses could explain your symptoms, whether you need a blood test for anaemia, and what imaging can and cannot show. Discuss whether you want to become pregnant because that can change the choice of medicine or procedure. It is also useful to ask how each option may affect bleeding, pain, fertility, recovery and the need for further treatment.