Adenomyosis Awareness Month: More Than “Just Bad Periods”

Adenomyosis occurs when tissue similar to the lining of the uterus grows into the muscle of the uterus. This can cause the uterus to become swollen and lead to symptoms that can significantly impact a person’s day-to-day life.

This simple description captures something many women experience- but often struggle to have recognised or taken seriously.

During Adenomyosis Awareness Month, it’s worth highlighting what this condition actually looks like in real life - and importantly, what can be done about it.

What does adenomyosis feel like?

Adenomyosis doesn’t just affect your period - it can affect your entire month.

Common symptoms include:

• Heavy or prolonged periods

• Severe cramping

• Chronic pelvic pain

• Bloating or pelvic pressure

• Constipation or bowel symptoms

• Pain with sex

• Ongoing fatigue

That fatigue is often overlooked- but can be significant, particularly if heavy bleeding leads to iron deficiency or anaemia.

For many women, these symptoms are gradual and progressive - worsening over time and increasingly impacting work, exercise, relationships, and mental wellbeing.

Why does it happen?

When endometrial-like tissue sits within the muscle of the uterus, it behaves in a hormone-responsive way - thickening and shedding with each cycle.

This leads to:

• Inflammation within the uterine muscle

• A bulky, enlarged uterus

• Increased uterine contractility and pain

It’s also common for adenomyosis to coexist with endometriosis or fibroids, which can make symptoms more complex.

How is it diagnosed?

The good news is we no longer need surgery to diagnose adenomyosis in most cases.

Ultrasound

A specialist transvaginal ultrasound is usually the first step and can detect typical features such as:

• A heterogeneous (patchy) uterine muscle

• Myometrial cysts

• Asymmetrical thickening

MRI

MRI can be helpful if:

• The diagnosis is unclear

• There are co-existing conditions (e.g. fibroids, endometriosis)

• Surgical or interventional planning is needed

What are the treatment options?

Treatment is very individual and depends on your symptoms and whether you are planning a pregnancy.

First-line: medical management

• Hormonal treatments

  • Levonorgestrel IUD (Mirena)

  • Progesterone therapies

  • Combined oral contraceptive pill

• Tranexamic acid for heavy bleeding

• Anti-inflammatories for pain

Interventional options

• Uterine artery embolisation (UAE)
  A minimally invasive procedure that can reduce bleeding and pain in selected women

Surgical options

• Hysterectomy
  The only definitive cure for adenomyosis
  Considered when symptoms are severe and other treatments haven’t worked

Why awareness matters

Adenomyosis is common - but frequently under-recognised.

Many women are told:

• “Your scans are normal”

• “It’s just part of having periods”

• “It will settle after pregnancy”

…but for many, symptoms persist and worsen.

The reality is:
👉 Heavy, painful periods are common- but not normal
👉 There are effective treatments available
👉 You deserve to be heard and taken seriously

When should you seek help?

If you recognise these symptoms - especially if they are impacting your day-to-day life - it’s worth seeking review.

Early diagnosis can:

• Improve symptom control

• Prevent progression

• Open up more treatment options

A final word

Adenomyosis can be life-altering - but it is also treatable.

This Adenomyosis Awareness Month is about shifting the conversation - from normalising suffering to recognising, diagnosing, and managing this condition properly.