What should you know about extensive adenomyosis?

Adenomyosis occurs when tissue similar to the womb lining grows into the muscular wall of the womb. When the affected area is extensive, the womb may become enlarged or tender, and bleeding or period pain can be more disruptive. Symptoms vary: some people have heavy or painful periods, pelvic pain, pressure, fatigue from blood loss, or difficulty becoming pregnant, while others have few symptoms. An ultrasound or MRI may help describe the extent, but the scan needs to be interpreted alongside your symptoms and examination.

Arrange a gynaecology review to discuss symptom control, pregnancy plans, anaemia checks, and how the findings affect your options. Treatment may include medicines, a Hormonal Coil, or procedures such as Uterine Artery Embolisation, Endometrial Ablation, or Hysterectomy. These options have different effects on bleeding, pain, fertility, and future pregnancy, so the choice should match your priorities. Keeping a record of bleeding, pain, cycle timing, and missed activities can make the appointment more useful.

Seek urgent medical help for bleeding that is soaking through protection repeatedly, faintness, severe weakness, sudden severe pelvic pain, or pregnancy-related pain or bleeding. Contact a clinician promptly if pain is worsening, periods are becoming much heavier, or tiredness and breathlessness suggest anaemia. For background information, see Adenomyosis, Heavy Periods, Painful Periods, and Pelvic Pain.

Ask what the scan shows, whether your symptoms could have another cause, whether you need a blood count or iron assessment, and which option best fits your fertility plans. You can also ask how a Hormonal Coil, Uterine Artery Embolisation, Endometrial Ablation, or Hysterectomy might affect your body and future care.