Effects of Adenomyosis

Adenomyosis occurs when tissue similar to the uterine lining grows into the muscular wall of the uterus. The muscle can become thicker, and the uterus may feel tender or enlarged. Some people have no symptoms; others experience heavy or prolonged bleeding, worsening cramps, pain during sex or pelvic aching between periods.

Heavy bleeding may contribute to iron-deficiency anaemia, which can add fatigue or breathlessness. Symptoms can interfere with work, sleep, exercise and intimacy. The pattern and severity vary, so treatment is guided by your symptoms, examination and imaging.

Keep a record of bleeding, pain, pain medicines and how symptoms affect daily activities. A clinician may discuss anti-inflammatory medicines, hormonal treatment or a [Hormonal Coil](/treatments/contraception-and-family-planning/hormonal-coil/), depending on your health and whether you hope to become pregnant.

If symptoms continue despite medicines, specialist options may include [Uterine Artery Embolisation](/treatments/gynaecological-surgery/uterine-artery-embolisation/), [Endometrial Ablation](/treatments/gynaecological-surgery/endometrial-ablation/) or [Hysterectomy](/treatments/gynaecological-surgery/hysterectomy/). These options have different effects on fertility and need individual discussion.

Arrange a clinical review if bleeding is becoming heavier, pain is new or persistent, or symptoms are limiting normal activities. Seek urgent help for soaking through protection rapidly, fainting, severe sudden pelvic pain, fever or a possible pregnancy with pain or bleeding.

Could adenomyosis explain my bleeding and pain? Should I be checked for anaemia? Which treatment fits my fertility plans? When would imaging or surgery be considered?