Patient education: Uterine adenomyosis (The Basics)

What is uterine adenomyosis? — This is a condition that causes heavy, painful periods. In people who have uterine adenomyosis, the uterus gets larger than normal (figure 1). This happens because the kind of cells that normally line the inside of the uterus start to grow in the walls of the uterus. Uterine adenomyosis will be called just "adenomyosis" here.

Adenomyosis often happens along with other conditions that affect the uterus, especially endometriosis. Endometriosis is a condition in which the kind of cells normally found only in the uterus starts to grow outside of the uterus. Adenomyosis can also happen in people with fibroids, which are abnormal growths that form in the muscle of the uterus.

What are the symptoms of adenomyosis? — The symptoms can include:

●Heavy periods

●Painful periods

●Pain in the lower belly

Should I see a doctor or nurse? — Yes. If you have very heavy or painful periods, see your doctor or nurse. Often, there are treatments that can help.

Will I need tests? — Maybe. There is no test that can show for sure whether you have adenomyosis. But there are some tests that can help your doctor or nurse figure out what might be causing your symptoms.

For example, your doctor or nurse might send you for an ultrasound. Some people might also get an MRI, but this is less common. Both of these tests create pictures of the inside of your body. They can show if your uterus is enlarged or has other signs of adenomyosis.

How is adenomyosis treated? — There are several treatments that might reduce the heavy bleeding and pain caused by adenomyosis. They include:

●Pain medicines – Ibuprofen (sample brand names: Advil, Motrin) can help with pain and reduce menstrual bleeding.

●Intrauterine device ("IUD") – An IUD is a small device that fits inside the uterus and is normally used to prevent pregnancy. One type of IUD, which releases the hormone progestin, might help with the symptoms of adenomyosis. (IUDs must be placed in the uterus by a doctor or nurse.)

●Birth control pills

●Other medicines – These includes medicines that are commonly used for treating endometriosis or fibroids.

●Uterine artery embolization – This procedure decreases the blood supply to the uterus. It is usually not done in people who might want to get pregnant.

●Surgery – Surgery to remove the uterus, called "hysterectomy," will permanently remove adenomyosis. But other treatments are usually tried first. After a hysterectomy, it is not possible to get pregnant.

If you might want to get pregnant, other types of surgery might be an option. These include removing or burning the extra tissue that grows in adenomyosis.

Your doctor can talk to you about your options and help you choose the treatment that is best for you.

More on this topic

Patient education: Heavy periods (The Basics)
Patient education: Painful periods (The Basics)
Patient education: Endometriosis (The Basics)
Patient education: Uterine fibroids (The Basics)
Patient education: Deciding to have a hysterectomy (The Basics)

Patient education: Heavy periods (Beyond the Basics)
Patient education: Painful menstrual periods (dysmenorrhea) (Beyond the Basics)
Patient education: Endometriosis (Beyond the Basics)
Patient education: Uterine fibroids (Beyond the Basics)
Patient education: Abdominal hysterectomy (Beyond the Basics)