Adenomyosis

Key points

  • Adenomyosis is a non-cancerous condition.
  • Adenomyosis can cause pelvic pain, heavy, painful or irregular periods.
  • Adenomyosis can be difficult and take time to diagnose
  • Treatment options include non-hormonal and hormonal medicines and surgical procedures.

What is adenomysosis?

Adenomyosis is a condition where the endometrium (lining of the womb) is found deep in the myometrium (muscle of the uterus).

We do not know exactly why adenomyosis happens but it is likely that people with adenomyosis have a predisposition due to their genes, immune system and hormones.

Adenomyosis is not an infection and it is not contagious. It is benign (not cancerous).

How common is adenomyosis?

Adenomyosis is present in as many as one in ten people of reproductive age. It is more common in people aged 40-50 years and who have had children.

What are the symptoms?

The most common symptoms are:

  • Heavy, painful or irregular periods
  • Pre-menstrual pelvic pain and feelings of heaviness discomfort in the pelvis

Less common symptoms are:

  • Pain during sexual intercourse
  • Pain related to bowel movements

About one third of people experience few or no symptoms; other people suffer with many effects. It can also affect other aspects of a person's life including their general physical health and emotional wellbeing. Symptoms will stop after the menopause.

Adenomyosis does not appear to decrease the chance of pregnancy however it is linked to an increased risk of miscarriage and premature birth.

How is adenomyosis diagnosed?

Adenomyosis can take a long time, even years, to diagnose because the symptoms and severity can vary between people.

Your doctor may organise and perform a transvaginal ultrasound scan and/or an MRI to investigate your symptoms.

How is adenomyosis treated?

The right treatment depends on symptoms but also other factors including age, desire for children and preserving fertility, views on surgery and what treatments have been tried already.

Options include:

  • Doing nothing if symptoms are mild, you are trying for a pregnancy or nearing menopause
  • Non hormonal treatments such as tranexamic acid or mefanamic acid to reduce pain and bleeding with your period
  • Hormones such as the oral conceptive pill, Depo-Provera ™ injection, Nexplanon™ implant and Mirena™ coil or types that cause a temporary and false menopause state (Zoladex™)
  • Hysterectomy (removal of the womb), for women not wishing to preserve fertility
  • Uterine artery embolisation, a procedure whereby tiny particles are injected into blood vessels via a catheter in the groin aiming to block of the blood supply to the adenomyosis and cause it to shrink

Internet forums provide information and support, but the unregulated information needs to be interpreted with caution. The following organisations may be helpful:

If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.

How to contact us:

Brunel building
Southmead Hospital
Westbury-on-trym
Bristol
BS10 5NB

0117 414 6769

© North Bristol NHS Trust. This edition published May 2021. Review due May 2023. NBT003386

Adenomyosis