Can adenomyosis cause constipation without bowel endometriosis?

Yes—adenomyosis can contribute to constipation even when endometriosis isn’t actually growing on or in the bowel. A uterus affected by adenomyosis can become enlarged and very tender, and the inflammation and cramping around your period can create a heavy “pressure” feeling in the pelvis that makes bowel movements more difficult.

Pain and pressure can also trigger pelvic floor guarding (your muscles subconsciously tightening to protect against pain). When those muscles stay tight, it can be harder to relax and empty fully, leading to straining or the sensation of incomplete evacuation. Many patients have adenomyosis and endometriosis together, so our team often evaluates for overlapping causes and can help you understand what’s driving your constipation and which treatment options may fit your goals—reach out to schedule a consultation if you’d like a personalized plan.