Adenomyosis: Symptoms, Diagnosis and Treatment Options

Modern imaging techniques and advances in treatment have improved the ability to diagnose adenomyosis and offer personalized treatment options, ranging from medical management to minimally invasive procedures in selected patients.

Adenomyosis may cause heavy menstrual bleeding, pelvic pain, and discomfort that can affect quality of life.

In brief

Adenomyosis is a common gynecologic condition in which tissue similar to the uterine lining grows within the muscular wall of the uterus. This can lead to heavy menstrual bleeding, severe menstrual cramps, chronic pelvic pain, and fatigue that may significantly affect daily life. Although adenomyosis is common, many women remain undiagnosed for years or assume their symptoms are a normal part of menstruation.

What Is Adenomyosis?

Under normal circumstances, the endometrium (the lining of the uterus) remains inside the uterine cavity. In adenomyosis, endometrial-like tissue grows into the muscular wall of the uterus. As this tissue responds to hormonal changes during the menstrual cycle, it can cause inflammation, enlargement of the uterus, pain, and abnormal bleeding.

The condition is most commonly diagnosed in women between the ages of 35 and 50, although it may occur in younger women as well.

Symptoms of Adenomyosis

Symptoms vary from one woman to another.

Common symptoms include:

  • Heavy menstrual bleeding
  • Prolonged menstrual periods
  • Severe menstrual cramps
  • Chronic pelvic pain
  • Pelvic pressure or fullness
  • Fatigue related to anemia
  • Reduced quality of life

Some women experience no symptoms and are diagnosed incidentally during imaging studies.

What Causes Adenomyosis?

The exact cause of adenomyosis is not fully understood.

Several theories have been proposed, including:

  • Migration of endometrial tissue into the uterine muscle
  • Hormonal influences
  • Chronic inflammatory processes
  • Genetic factors
  • Adenomyosis may also occur alongside other gynecologic conditions.

Adenomyosis vs. Endometriosis: What Is the Difference?

Many women confuse adenomyosis with Endometriosis.

  • Adenomyosis
    Endometrial-like tissue grows within the muscular wall of the uterus.
  • Endometriosis
    Endometrial-like tissue grows outside the uterus, such as in the ovaries, pelvis, or bowel.

Although they are distinct conditions, they can occur together.

How Is Adenomyosis Diagnosed?

Diagnosis is typically based on:

  • Medical history and symptom review
  • Gynecologic examination
  • Pelvic ultrasound
  • Pelvic MRI when appropriate

These imaging studies help identify characteristic changes in the uterus and assess the extent of disease.

Is Adenomyosis Dangerous?

Adenomyosis is a benign condition and is not considered a form of cancer.

However, its symptoms can have a substantial impact on:

  • Daily activities
  • Work performance
  • Physical activity
  • Emotional well-being
  • Overall quality of life

Treatment Options for Adenomyosis

Treatment depends on symptom severity, age, reproductive goals, and individual patient factors.

  • Medical Therapy
  • Anti-inflammatory medications
  • Pain-relieving medications
  • Hormonal Therapy
  • Oral contraceptive pills
  • Hormonal intrauterine devices (IUDs)
  • Other hormone-based treatments
  • Minimally Invasive Treatments

In selected patients, uterine artery embolization may be considered as an alternative to surgery.

Surgical Treatment
In certain cases, surgical intervention or hysterectomy may be recommended.

When Should You Seek Medical Evaluation?

You should consider medical evaluation if you experience:

  • Heavy or prolonged menstrual bleeding
  • Severe menstrual pain
  • Persistent pelvic discomfort
  • Recurrent anemia
  • Symptoms that interfere with daily life

Early diagnosis may help guide treatment and improve long-term quality of life.

Schedule a Consultation

If you are experiencing heavy bleeding, severe menstrual cramps, or chronic pelvic pain, a comprehensive evaluation may help identify whether adenomyosis is contributing to your symptoms.

Schedule a consultation with Dr. Adam Farkas to learn more about available treatment options, including minimally invasive therapies that may help improve your quality of life.

Dr. Adam Farkas
Dr. Adam FarkasDirector, Vascular Interventional Radiology Unit and Vascular Anomalies Clinic, Shaare Zedek Medical Center, Jerusalem, Israel. Chair, Israel Society of Interventional Radiology. Updated May 31, 2026.Medically reviewed by Dr. Adam Farkas, MD, May 31, 2026.

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At the consultation Dr. Farkas goes over your imaging and records with you, explains which options exist and checks whether a catheter-based treatment suits your condition.

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