How do I tell fibroids from endometriosis or adenomyosis?

Fibroids most often show up as heavy or prolonged bleeding (sometimes with clots) and “bulk” symptoms like pelvic pressure, frequent urination, constipation, or a feeling of fullness. Endometriosis more typically causes inflammatory, cycle-linked pelvic pain, deep pain with sex, and pain with bowel movements or urination—sometimes even when bleeding isn’t especially heavy. Adenomyosis can overlap with both, but commonly combines very heavy bleeding with intense cramping and a tender, sometimes enlarged uterus.

Symptoms alone can’t reliably separate these conditions, and it’s also possible to have more than one at the same time. Ultrasound may identify fibroids as well-defined masses in the uterus, while MRI can be especially helpful for spotting patterns consistent with adenomyosis and mapping endometriosis-related findings. Our team can help interpret your symptoms alongside imaging to clarify what’s driving them and discuss the next best steps for relief.