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Disease: Adenomyosis Adenomyosis
Category: Gynecological diseases
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Disease Definition:

Tissue that normally lines the uterus (endometrium) also starts growing within the muscular walls of the uterus in this condition.

Although women with adenomyosis usually also have endometriosis, but adenomyosis isn't the same as endometriosis. Endometriosis is a condition in which the uterine lining becomes implanted outside the uterus. Though adenomyosis disappears after menopause, but its cause is still not known. There are treatments that can help women who experience severe discomfort from adenomyosis, but the only cure for this condition is hysterectomy.

This condition is generally harmless, though it can be quite painful. It usually develops in women who are in their late childbearing years after they've had children.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


In some cases the condition is only mildly uncomfortable or even "silent", causing no signs or symptoms. In other cases the patient may experience some of these signs and symptoms:

  • Bleeding between periods
  • Sever cramping or sharp, knife-like pelvic pain during menstruation (dysmenorrhea)
  • Passing blood clots during period
  • Heavy or prolonged menstrual bleeding
  • Experiencing pain during intercourse
  • Menstrual cramps that last throughout the period and worsen as the person gets older

The uterus may increase to double or even triple its normal size. In this case, the lower abdomen may feel tender or seem to be bigger, despite the fact that the patient may not know that their uterus is enlarged.


Some experts speculate that adenomyosis originates within the myometrium (uterine walls) from endometrial tissue deposited there when the uterus was first forming in the female tissue. However, other experts believe that adenomyosis is the result of the direct invasion of endometrial cells into the uterine walls.

C-section (Caesarean section) can sometimes make this invasion of cells easier. Yet another suggestion links between adenomyosis and childbirth. During the postpartum period, an inflammation of the endometritis (uterine lining) may cause a break in the normal boundary of the cells of the uterus. The growth of adenomyosis depends on the circulating estrogen in a woman's body, regardless of how it develops, and it resolves when estrogen disappears at menopause.

Despite all these theories, the exact cause of adenomyosis is still not known.



Because of the pain and excessive bleeding, adenomyosis can have a negative effect on a woman's lifestyle, even though it's not harmful. Because a woman with this condition won't know when or where she might start bleeding, she may start avoiding the things that she normally enjoyed. Adenomyosis may also cause a person to miss work or school due to painful periods and it could even strain relationships.

When adenomyosis is suspected, contacting the doctor is quite important because the recurring pain may lead to irritability, anger, depression, feelings of helplessness and anxiety.

Chronic anemia may result in case a woman experiences prolonged and heavy bleeding. Unlike endometriosis, adenomyosis usually doesn't affect fertility.


After menopause, adenomyosis usually resolves. This means that treatment will depend on how close a woman is to menopause. Treatment options may include:

Hormone therapy:
The heavy bleeding and pain related to adenomyosis may be controlled by hormone-containing patches, vaginal rings or controlling the menstrual cycle through combined estrogen-progestin oral contraceptives. Progestin-only contraception, such as an intrauterine device containing progestin or a continuous-use birth control pill usually provide relief by leading to amenorrhea, which is the absence of menstrual periods.

Anti-inflammatory drugs:
Anti-inflammatory medications may be recommended, such as ibuprofen to control the pain, in case a woman is nearing menopause. She should take them two or three days before her period starts and continue taking them during it, so that the flow of menstrual blood is reduced in addition to relieving pain.

If a woman's menopause is years away and her pain is severe, she may be recommended surgery to remove the uterus (hysterectomy). Removing the ovaries isn't necessary to control adenomyosis.


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