Adenomyosis: Pain and Causes

Adenomyosis: Pain and Causes

What is Adenomyosis?

According to the Mayo Clinic, Adenomyosis 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 — thickening, breaking down and bleeding — during each menstrual cycle. An enlarged uterus and painful, heavy periods can result.


Symptoms don’t always occur with Adenomyosis but when they are present, you may experience one or more of the following:
  • Heavy or extended menstrual bleeding
  • Severe sharp pains and cramping. It is sometimes described as a knifelike pain during your period.
  • Pelvic pain, chronic
Adenomyosis can cause your uterus to swell or become bigger. You may not feel your uterus as being bigger but you may experience tenderness in your lower abdomen or pelvic pressure.


Doctors are still unsure of the cause of Adenomyosis. This condition usually goes away after menopause because you no longer have a menstrual cycle. Some suggested theories per Mayo Clinic:

Invasive tissue growth

Some experts believe that adenomyosis results from the direct invasion of endometrial cells from the lining of the uterus into the muscle that forms the uterine walls. Uterine incisions made during an operation such as a cesarean section (C-section) might promote the direct invasion of the endometrial cells into the wall of the uterus.

Developmental origins.

Other experts suspect that adenomyosis originates within the uterine muscle from endometrial tissue deposited there when the uterus first formed in the fetus.

Uterine inflammation related to childbirth.

Another theory suggests a link between adenomyosis and childbirth. Inflammation of the uterine lining during the postpartum period might cause a break in the normal boundary of cells that line the uterus. Surgical procedures on the uterus can have a similar effect.

Stem cell origins.

 A recent theory proposes that bone marrow stem cells might invade the uterine muscle, causing adenomyosis.


Diagnosis can include an exam or perform one of the following:
  • Review your symptoms and signs
  • Perform a pelvic exam. This exam can present an enlarged or a tender uterus
  • An ultrasound of the uterus imaging
  • MRI of the uterus
Performing an endometrial biopsy may be needed to obtain uterine tissue for testing. This won’t diagnosis Adenomyosis but it can be examined for abnormal tissue. Having uterine fibroids, endometriosis or endometrial polyps can make diagnosis even more difficult because of their similarities in symptoms. Read about endometrioma symptoms.


According to Mayo Clinic, Adenomyosis often goes away after menopause, so treatment might depend on how close you are to that stage of life. Treatment options for adenomyosis include:

Anti-inflammatory drugs.

Your doctor might recommend anti-inflammatory medications, such as ibuprofen (Advil, Motrin IB, others), to control the pain. By starting an anti-inflammatory medicine one to two days before your period begins and taking it during your period, you can reduce menstrual blood flow and help relieve pain.

Hormone medications.

Combined estrogen-progestin birth control pills or hormone-containing patches or vaginal rings might lessen heavy bleeding and pain associated with adenomyosis. Progestin-only contraception, such as an intrauterine device, or continuous-use birth control pills often lead to amenorrhea — the absence of your menstrual periods — which might provide some relief.


If your pain is severe and no other treatments have worked, your doctor might suggest surgery to remove your uterus. Removing your ovaries isn’t necessary to control adenomyosis.

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