Adenomyosis causes, symptoms, diagnosis and Treatment

Endometrial tissue lines the uterus. When this tissue grows into the muscular walls of the uterus, it is known as adenomyosis.  During each menstrual cycle, the displaced tissue goes on behaving as usual – thickens, sheds and bleeds. The uterus becomes bulky and painful and leads to heavy periods.

What are the symptoms of Adenomyosis?

  • Painful and heavy menstrual bleeding
  • Prolong menstruation
  • Dyspareunia – Painful intercourse
  • Chronic pelvic pain
  • Dysmenorrhea – excessive pain during menstruation
  • Severe abdominal cramping and sharp pelvic pain
  • Pressure and tenderness in the lower abdomen
  • The uterus becomes large or bigger in size

In some cases, adenomyosis can cause only mild to moderate discomfort with no signs and symptoms.

Adenomyosis Causes

The exact cause of adenomyosis is unknown. However, there are many theories regarding the causes – such as the following:

Retrograde menstruation is the backflow of the menstrual blood due to outside to inside invasion.

According to some experts, there might be an involvement of the endometrial cells that line the uterus in attacking the muscle of the uterine wall (invasive tissue growth). Endometrial cells may directly invade the wall of the uterus due to uterine incisions made during C-section (Caesarean section).

No matter how adenomyosis develops, the growth of the condition largely depends on the Estrogen circulating in the body.

Bone marrow stem cells origin (Denovo metaplasia): According to one theory, the stem cells of the bone marrow might attack the uterine muscles and cause adenomyosis.

What are the risk factors for adenomyosis?

The following are the risk factors for adenomyosis:

Age – middle-age women are at risk (women in their 40s and 50s)

Prior surgery – uterine fibroids surgery, C-section and dilatation and curettage.

How is Adenomyosis Diagnosed?

Conditions such as uterine fibroids, endometriosis, and endometrial polyps can cause symptoms similar to the signs and symptoms of adenomyosis – making it difficult to diagnose. Therefore, your gynaecologist has to rule out the possibilities of other conditions prior to diagnosing adenomyosis. To ensure this, she thoroughly evaluates your condition based on the signs and symptoms, pelvic examination (it is done to check for a tender and enlarged uterus) and certain diagnostic tests – such as Ultrasound and MRI of the uterus.


Adenomyosis mostly resolves after menopause in a majority of women. Therefore, doctors formulate an effective treatment plan based on the age of the woman and how close is she to menopause. Women with severe pain and abdominal discomfort from adenomyosis get relief from severe pain by starting anti-inflammatory medicines; hormonal medicines may lessen heavy bleeding and pain. If any of these treatments fail to offer any relief, then your doctor may suggest an intrauterine device or lastly hysterectomy depending on the age factor.

Bottom Line

Many women consider adenomyosis less harmful. However, heavy and prolonged bleeding can lead to chronic anaemia, weakness and fatigue and other health issues. In addition, adenomyosis causes excessive bleeding and pain and can disrupt day-to-day life and activities.

When to See a doctor?

Don’t delay in seeking medical help. Meet a gynaecologist if you have severe abdominal cramps with tenderness and pressure in the lower abdomen. If severe cramping during your periods and heavy bleeding are interfering with your daily activities, then make an appointment with Dr Rajeshwari Reddy.