When is adenomyosis more likely than endometriosis?

Adenomyosis often rises to the top of the list when your main pattern is heavy, painful periods (sometimes with clots) and deep, crampy uterine pain that can linger between cycles. On exam, the uterus may feel uniformly enlarged and tender rather than having a normal size with more localized tenderness.

Imaging can help distinguish the two: a high-quality pelvic ultrasound or MRI may show features such as a thickened junctional zone or small cysts within the uterine muscle (myometrium), which supports adenomyosis. Because it’s common to have adenomyosis and endometriosis together, our team typically evaluates both possibilities so your treatment plan matches the full picture—reach out if you’d like a focused review of your symptoms and imaging.