What does pelvic pain feel like with adenomyosis?

Adenomyosis affects the muscle of the uterine wall. Pain may feel heavy, throbbing or tender rather than limited to a brief surface twinge. Some people notice cramps before or during bleeding, pain that spreads to the lower back or thighs, or discomfort with deep penetration. Heavy or prolonged periods and a feeling of pelvic fullness can occur alongside the pain.

Pain varies between people and can also occur outside a period. Pelvic pain has many possible causes, so its presence alone does not identify adenomyosis. A clinician may combine your symptom pattern, examination and imaging when considering the diagnosis.

Keep a record of when pain starts, where it is felt, how it relates to bleeding, and whether sex, bowel movements or urination change it. Rest, heat and a suitable pain reliever may help some people; check medicines with a clinician or pharmacist if you are pregnant, trying to conceive, or have other health conditions.

Arrange a gynaecology assessment if pain is recurring, worsening or affecting work, sleep, sex or daily movement. Bring your symptom record so the consultation can focus on the pattern rather than one isolated episode.

Seek urgent medical help for sudden severe pelvic pain, fainting, marked weakness, heavy bleeding, fever, vomiting or a rigid or very tender abdomen. If pregnancy is possible, urgent assessment is needed for pelvic pain with bleeding, dizziness or shoulder-tip pain.

Could adenomyosis explain my pain and bleeding pattern? What examination or imaging would help? Which treatments fit my plans for pregnancy, and what should I do if pain breaks through the agreed plan?