Adenomyosis (ad-uh-no-my-O-sis) occurs when the tissue that normally lines the uterus (endometrial tissue) grows into the muscular wall of the uterus. The displaced tissue continues to act normally â thickening, breaking down and bleeding â during each menstrual cycle. An enlarged uterus and painful, heavy periods can result.
The cause of adenomyosis remains unknown, but the disease usually resolves after menopause. For women who have severe discomfort from adenomyosis, hormonal treatments can help. Removal of the uterus (hysterectomy) cures adenomyosis.
Sometimes, adenomyosis causes no signs or symptoms or only mild discomfort. However, adenomyosis can cause:
Your uterus might get bigger. Although you might not know if your uterus is enlarged, you may notice that your lower abdomen feels tender or causes pelvic pressure.
If you have prolonged, heavy bleeding or severe cramping during your periods that interferes with your regular activities, make an appointment to see your doctor.
The cause of adenomyosis isn't known. There have been many theories, including:
Regardless of how adenomyosis develops, its growth depends on the circulating estrogen in women's bodies.
Your doctor may suspect adenomyosis based on:
In some instances, your doctor might collect a sample of uterine tissue for testing (endometrial biopsy) to verify that your abnormal uterine bleeding isn't associated with another serious condition. But an endometrial biopsy won't help your doctor confirm a diagnosis of adenomyosis.
The only way to confirm adenomyosis is to examine the uterus after hysterectomy. However, pelvic imaging such as ultrasound and MRI can detect signs of it.
Other uterine diseases can cause signs and symptoms similar to adenomyosis, making adenomyosis difficult to diagnose. Conditions include fibroid tumors (leiomyomas), uterine cells growing outside the uterus (endometriosis) and growths in the uterine lining (endometrial polyps).
Your doctor might conclude that you have adenomyosis only after ruling out other possible causes for your signs and symptoms.
If you often have prolonged, heavy bleeding during your periods, you can develop chronic anemia, which causes fatigue and other health problems.
Although not harmful, the pain and excessive bleeding associated with adenomyosis can disrupt your lifestyle. You might avoid activities you've enjoyed in the past because you're in pain or you worry you might start bleeding.
To ease pelvic pain and cramping related to adenomyosis, try these tips:
Risk factors for adenomyosis include:
Most cases of adenomyosis â which depends on estrogen â are found in women in their 40s and 50s. Adenomyosis in these women could relate to longer exposure to estrogen compared with that of younger women. However, current research suggests that the condition might be common in younger women.