Adenomyosis

What is adenomyosis

In adenomyosis, the tissue that normally lines your womb starts growing into the muscle wall of the womb. During your period, this tissue sheds and bleeds, causing pain and discomfort. It can also cause your womb to thicken and grow in size, making it hard to get pregnant.

In endometriosis, this tissue grows outside of the womb.

Signs and symptoms

Common symptoms include:

• painful periods and severe cramping (dysmenorrhoea)
• heavy or long periods (menorrhagia)
• constant pain or pressure in your legs, thighs and pelvic area (below your tummy)
• bloating, where your tummy sticks out more than usual
• pain during sex
• bleeding between periods or after sex
• frequent peeing, or pain when you poo.

Without treatment, symptoms can get worse and lead to low iron (anaemia), long term pelvic pain and trouble getting pregnant.

You can still have adenomyosis if:

• you don't have any symptoms
• you get normal periods
• you miss, or don’t get your period
• you’re younger or older than most women who have it.

When to get help

It’s important to get help early. See your GP if you have any common symptoms, heavy or unhealthy periods or bloating for more than 3 weeks.

Before your appointment

Your GP will ask about your symptoms, how long you’ve had them, and how they affect you. It’s important to give them as much information as possible.

Before your appointment, write down:

• how often you get your period
• when you have pain, what it feels like and where in your body it is
• how intense the pain is each time – give it a score out of 10
• how much you bleed, including how often you have to change your tampon, pad, cup or disc.

Record any other symptoms, for example – constipation, diarrhoea, nausea, bloating, mood changes, or if you feel very tired.

Your notes will help your GP understand:

• what are your best and worst days
• triggers, such as certain foods or stress
• how often you miss work, exercise or social events
• any patterns or trends you notice
• how it's affecting your life.

Describing pain

Words you can use to describe your pain include:

• stabbing
• burning
• dull
• aching
• sharp
• constant
• throbbing
• shooting
• cramping.

How to track your symptoms

Symptom diaries and period tracking apps can help you keep track of your symptoms. Many apps offer features to protect your identity and health data.

Some women prefer to make notes in their phone or computer calendar and use colours and emojis to represent symptoms. You can also use voice notes or draw where the pain is on a body map.

Diagnosis

To help find out what's happening, your GP might do:

• a pelvic exam, where they check inside your vulva, vagina and cervix
• blood and tissue tests
• medical imaging tests like ultrasound and MRI, to check your ovaries and womb (uterus).

You might need to see a specialist and have more tests to confirm your diagnosis.

Talk to your GP if you don’t agree with your diagnosis. If you need more help, see another GP for a second opinion.

Treatment

Your treatment will depend on your age, symptoms and whether you want to get pregnant.

It might include:

• medicine to reduce pain, swelling and bleeding
• hormone therapy
• pelvic physiotherapy
• surgery to remove the lining of the uterus
• removing the womb (hysterectomy).

Read more about how adenomyosis can be treated on the healthdirect website.

Care at home

Taking a warm bath or putting a heat pack on your tummy can help to relieve symptoms. You can also take paracetamol and ibuprofen or use a TENS machine for any pain.

It may also help to:

• stay active and get enough sleep
• reduce stress and inflammation
• eat a healthy diet with plenty of fresh fruit and vegetables
• take dietary supplements, such as vitamin D and fish oil
• try alternative therapies, such as acupuncture.

Stress can increase inflammation, and this can make conditions like adenomyosis more painful or harder to manage.

Read more about:

• your menstrual cycle and sleep on the Sleep Foundation website
• eating a healthy diet on the Boost your health website
• using a tens machine or acupuncture, and how to reduce stress on the healthdirect website.

Having a baby

Adenomyosis can make it harder to get pregnant and there's a higher chance of losing your pregnancy or giving birth too early.

If you think you want to have children either now or in the future, you should talk to your GP. They can talk to you about treatments, such as:

• hormone therapy
• fertility medicines
• surgery (laparoscopy)
• IVF (in vitro fertilisation)
• IUI (intrauterine insemination).

Pregnancy doesn’t cure adenomyosis, but your symptoms might improve while you're pregnant or breastfeeding because you're not having a period.

Menopause

In the years leading to menopause, your hormone levels change. You might get heavier periods more often.

Your symptoms should improve after menopause when you stop having a period. Painful, heavy bleeding often stops.

Learn more about managing menopause.