How is adenomyosis diagnosed—MRI, ultrasound, or surgery?

Adenomyosis is most often diagnosed with a combination of your symptoms, a pelvic exam, and high-quality imaging—usually an expert transvaginal ultrasound and sometimes an MRI. On imaging, we look for patterns that suggest adenomyosis within the uterine muscle, such as changes in the junctional zone, small myometrial cysts, or a more enlarged, “globular” uterine shape.

Most patients do not need surgery just to confirm adenomyosis. Instead, imaging findings plus your clinical story typically provide enough clarity to guide next steps, including whether medical management, fertility planning, or surgical options make sense. If you’re unsure which test is best for your situation or you’ve had conflicting results, our team can review prior imaging and help you decide what evaluation will be most informative.