Adenomyosis Symptoms: Understanding Heavy Bleeding, Pain & Infertility

Adenomyosis: endometrial tissue grows into the uterine muscle (myometrium). Common in 30s–40s, often coexists with endometriosis/fibroids.

Symptoms

• Heavy/prolonged menstrual bleeding (most common)
• Pelvic pain: Lower abdomen/back, worsens with menses
• Dyspareunia: Painful intercourse
• Infertility/subfertility: Altered uterine environment impairs implantation
• Other: Bloating, urinary frequency, fatigue

Diagnosis

• Clinical history + pelvic exam (enlarged, boggy uterus)
• Transvaginal ultrasound (junctional zone thickening)
• MRI (gold standard for extent)

Treatment

• NSAIDs, tranexamic acid for bleeding
• Hormonal: OCPs, progestins, LNG-IUD, GnRH agonists
• Uterine artery embolization
• MRI-guided focused ultrasound
• Hysterectomy (definitive, if childbearing complete)

See a gynecologist for evaluation if you suspect adenomyosis.