SYMPTOM CHECKER Heavy periods and painful sex could be caused by adenomyosis – the common condition is mistaken for endometriosis



These are all symptoms more commonly associated with endometriosis – which is when tissue that lines the uterus grows on other pelvic organs.

But it might actually be the lesser-known “ugly sister” to the agonising condition – adenomyosis.

Both conditions share similar symptoms and women can have both at the same time, they’re caused by different issues.

Affects 1 in 10

Adenomyosis happens when the bits of tissue that line the uterus – known as the endometrium – grows into the muscle layer of the womb.

Like endometriosis and PCOS, it is thought to affect 1 in 10 women.

It can cause feelings of fullness or bloating which means women with the condition are often misdiagnosed as having irritable bowel syndrome (IBS).

As it can lead to excess bleeding, women are also at risk of becoming anaemic.

Consider diet

Gynaecologist Dr Anita Mitra says although there have been no studies looking into the link between diet and adeno, what you eat is still important in managing the symptoms.

If you’re bleeding loads, you need to make sure that you’re really stocking up on fibre and leafy green veg.

She told Stylist: “Why is that? So that you can do a good poo to help your body excrete the old oestrogen that it doesn’t need, as well as preventing constipation which could be worsening the pain of adenomyosis by putting extra pressure on your already inflamed uterus.

“My advice would be to keep a symptom diary if you think there’s a particular food that is affecting your symptoms, but seek advice from a nutrition professional before you seek to cut out entire food groups to make sure that you aren’t running into nutrient deficiencies. “

Keep a symptom diary if you think there’s a particular food that is affecting your symptoms

She also stresses that despite the fact that hysterectomies are often promoted as a cure for the condition, they definitely shouldn’t be your first thought.

Painkillers, oral contraceptive pills and the Mirena coil are all primary options.

Because the cause of the condition is still unknown, there’s not a lot out there other than hormonal treatments and very invasive surgeries.

Dr Mitra stresses that the initial options can be “quite life-changing for many women”.

They work by reducing the monthly thickening and shedding of the uterus – which is the main source of pain experienced by adenomyosis sufferers.

Unlike endometriosis, which can only be definitively diagnosed through a key-hole surgery, a diagnosis of adenomyosis can be done through both invasive and non-invasive methods.

The most common invasive method is a uterine biopsy (tissue sampling).

A biopsy of the uterus can also be performed to make the diagnosis by an abdominal key-hole surgical procedure (laparoscopy) but this remains limited to clinical trials.


Biopsies going through the vagina up to the uterus may have a role in the diagnosis of adenomyosis, but can potentially damage the uterus and therefore are avoided in women wishing to fall pregnant.

Ultrasound is also commonly available and can be done either using the probe on the abdomen or, preferably, placing the probe in the vagina.

However, ultrasound isn’t always the best choice as it only detects adenomyosis about 50-87 per cent of the time.

Magnetic resonance imaging (MRI) is a better choice as there are a number of typical features seen during MRI.

These vary throughout the cycle and in response to hormonal therapy but can reliably predict adenomyosis.

There is some evidence adenomyosis can reduce fertility, but this is still controversial.

Clinical studies are limited by difficulties and differences in diagnosis and their study designs have problems.

Some MRI studies show changes consistent with infertility, but because patients presenting with infertility in their 30s and 40s are more likely to be diagnosed with adenomyosis, it’s difficult to say if adenomyosis is the cause of their fertility issues.

When couples are undergoing assisted reproduction (such as IVF) there is limited evidence to support a negative impact on oocyte and embryo quality, implantation and pregnancy rates.

Overall, there appears to be limited negative impact of adenomyosis on allowing the embryos to implant or overall pregnancy rates.

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