In short
Both involve tissue like the lining of the uterus growing where it shouldn’t. In endometriosis it grows outside the uterus; in adenomyosis it grows into the muscle wall of the uterus. Adenomyosis typically causes heavy, painful periods and an enlarged uterus. The two often occur together.
On this page
The key difference
| Endometriosis | Adenomyosis | |
|---|---|---|
| Where | Outside the uterus: ovaries, pelvic lining, bowel, bladder | Inside the muscle wall of the uterus |
| Main symptoms | Painful periods, pelvic pain, pain with sex, bowel and bladder pain | Heavy, painful periods; pelvic pressure; a bulky, tender uterus |
| Often found in | Teens to 40s | Often diagnosed in the 30s and 40s, though it can occur earlier |
| Diagnosis | Symptoms, specialised ultrasound or MRI; laparoscopy for some | Specialised ultrasound or MRI |
| Fertility | Can affect fertility | Can affect fertility and pregnancy |
Can you have both?
Yes, and it’s common. Many people with endometriosis also have adenomyosis. This is one reason some people still have pain after endometriosis surgery: adenomyosis inside the uterine wall isn’t removed by laparoscopy.
Pain that stops you living your life isn’t normal.
Talk it through with an Australian doctor online. No referral needed.
Adenomyosis symptoms
- Heavy periods, sometimes with clots or flooding
- Painful periods, often getting worse over time
- Pelvic pain or pressure
- Pain during sex
- Tiredness from blood loss
Some people have no symptoms.
How adenomyosis is diagnosed
A transvaginal ultrasound by someone experienced in looking for adenomyosis, or an MRI, can show typical changes in the uterine wall. Research published in Human Reproduction Update recommends combining symptoms with imaging findings. Blood tests may check for anaemia from heavy bleeding.
Treatment for adenomyosis
- Pain relief and treatment to reduce heavy bleeding
- Hormonal treatments, including a hormonal intrauterine device, which can reduce both bleeding and pain
- Iron for anaemia if needed
- Other procedures for some people
- Hysterectomy, which is the only cure, for people who have finished having children and whose symptoms aren’t controlled
When to see a GP
See a GP if periods are heavy or painful enough to affect daily life, if you’re soaking through pads or tampons, or if you feel tired and short of breath, which can be a sign of anaemia.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Chapron C, Vannuccini S, Santulli P, et al. Diagnosing adenomyosis: an integrated clinical and imaging approach. Hum Reprod Update. 2020;26(3):392-411.
- Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-1256.
- Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Hum Reprod Open. 2022;2022(2):hoac009.
- healthdirect. Adenomyosis.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.