Adenomyosis

Understand diagnosis, symptom management, and care for this uterine condition, with practical guidance on MRI/ultrasound imaging, fertility planning, surgical choices, and how diffuse and focal forms differ.

Diffuse Adenomyosis Fertility Considerations Focal Adenomyosis Imaging & Diagnosis (MRI, Ultrasound)Surgical Options Symptoms & Management

Overview

Adenomyosis occurs when endometrial glands and stroma grow into the uterine muscle (myometrium), causing an enlarged, tender uterus with heavy periods, cramping, and pelvic pressure. It is distinct from endometriosis, which grows outside the uterus, but the two conditions often coexist and can compound pain and fertility challenges. Learn how clinicians recognize adenomyosis, when imaging helps, and how the pattern of disease—diffuse versus focal—shapes care choices and expectations over time.

Care is individualized around goals such as symptom relief, cycle control, and preserving or completing fertility. Explore how medications, devices, and non-hormonal strategies ease pain and bleeding; when advanced imaging clarifies diagnosis and guides therapy; and what to consider when weighing uterus‑sparing procedures versus definitive surgery. For scan specifics and report language, see Imaging & Diagnosis (MRI, Ultrasound). For daily relief strategies, visit Symptoms & Management. For disease patterns, compare Diffuse Adenomyosis and Focal Adenomyosis. Fertility planning and pregnancy outcomes are covered in Fertility Considerations, and operative decision‑making in Surgical Options.

How is adenomyosis different from endometriosis?

Adenomyosis is endometrial tissue growing within the uterine muscle, often causing heavy bleeding, severe cramps, and a bulky, tender uterus. Endometriosis grows outside the uterus and may affect the bowel, bladder, or nerves, with different diagnostic and surgical considerations. The two can coexist, so care may also involve guidance in Endometriosis.

How is adenomyosis diagnosed—do I need MRI or surgery?

Diagnosis is usually made with expert transvaginal ultrasound or MRI based on features like a thickened junctional zone, myometrial cysts, and a globular uterus. Surgical confirmation is not required for most people; imaging plus symptoms and exam typically suffice. For details on what scans show and how results guide care, see Imaging & Diagnosis (MRI, Ultrasound).

Can adenomyosis affect fertility or pregnancy?

Yes. Adenomyosis is linked with lower implantation rates and higher risks of miscarriage and preterm birth, especially in diffuse disease. Preconception planning—sometimes including medical pretreatment, IVF strategy adjustments, or targeted surgery for focal disease—is outlined in Fertility Considerations.

What treatments help if I want to avoid hysterectomy?

Many improve with NSAIDs and hormonal therapies such as a levonorgestrel IUD, progestins, or combined pills; short‑term GnRH analogs/antagonists may be used selectively. Uterus‑sparing surgery can help focal adenomyosis when symptoms persist despite medicines. Day‑to‑day pain and bleeding strategies are covered in Symptoms & Management, and candidacy for procedures in Surgical Options.

Do symptoms improve after menopause or return after treatment?

Symptoms often lessen after natural menopause as estrogen declines, though persistence can occur, especially when endometriosis or pelvic floor dysfunction coexist. After hysterectomy, adenomyosis itself does not recur because the uterus is removed, but pain can have other causes. Ongoing follow‑up helps align symptom control with changing hormonal status.