When to worry about painful periods with adenomyosis

Adenomyosis occurs when tissue similar to the womb lining grows into the muscular wall of the uterus. This can make the uterus tender and cause cramps that begin before bleeding, become stronger during a period or continue afterwards. Periods may also become heavier or last longer. Pain severity does not always match the extent of the condition, and pelvic pain can have more than one cause.

Record when pain starts, how long it lasts, bleeding changes, pain between periods and the effect on sleep, work or movement. Heat, gentle activity and rest may help some people. A clinician can discuss anti-inflammatory medicines, hormonal options or other treatments after considering pregnancy plans, medical history and other causes of bleeding. Avoid taking medicines that are unsafe for you or combining products without checking the label or asking a pharmacist.

Book an appointment if pain is worsening, newly severe, present outside periods, or no longer controlled by your usual plan. Seek prompt care for bleeding that soaks through protection repeatedly, dizziness, faintness, unusual fatigue or shortness of breath, which can occur with anaemia. Get urgent help for sudden severe pelvic pain, heavy bleeding with weakness, fever, vomiting or a possible pregnancy. These warning signs need assessment rather than being attributed to adenomyosis alone.

Ask whether imaging or blood tests are appropriate, how to check for anaemia, which treatment fits your pregnancy plans, and what change in symptoms should trigger urgent review.