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Uterine Adenomyosis


Charlie Kilpatrick

, MD, MEd, Baylor College of Medicine

Reviewed/Revised Feb 2023

In adenomyosis, tissue from glands in the lining of the uterus (endometrium) grows into the muscular wall of the uterus. The uterus becomes enlarged, sometimes doubling or tripling in size.

  • Adenomyosis can cause heavy, painful menstrual periods and pelvic pain.

  • Doctors suspect adenomyosis when they do a pelvic examination, and they often do ultrasonography or magnetic resonance imaging to support the diagnosis.

  • An intrauterine device that releases a synthetic female hormone called levonorgestrel may help relieve symptoms, but hysterectomy is most effective.

How many women have adenomyosis is unclear, partly because it is hard to diagnose.

The cause of adenomyosis is unknown. Adenomyosis may be more common among women who have had more than one pregnancy.

Symptoms of Uterine Adenomyosis

Symptoms of adenomyosis include heavy and painful periods (dysmenorrhea), vague pain in the pelvic area, and a feeling of pressure on the bladder and rectum. The heavy bleeding may lead to anemia Anemia Due to Excessive Bleeding Anemia due to excessive bleeding results when loss of red blood cells exceeds production of new red blood cells. When blood loss is rapid, blood pressure falls, and people may be dizzy. When... read more . Sometimes sexual activity is painful.

Symptoms usually disappear or lessen after menopause.

Diagnosis of Uterine Adenomyosis

  • A pelvic examination

  • Ultrasonography or magnetic resonance imaging

Doctors may suspect adenomyosis when they do a pelvic examination and discover that the uterus is enlarged, round, and softer than normal.

Doctors often diagnose adenomyosis based on the results of pelvic ultrasonography Ultrasonography Sometimes doctors recommend screening tests, which are tests that are done to look for disorders in people who have no symptoms. If women have symptoms related to the reproductive system (gynecologic... read more Ultrasonography or magnetic resonance imaging (MRI). Ultrasonography is often done with a handheld ultrasound device inserted into the vagina (called transvaginal ultrasonography).

However, for a definitive diagnosis of adenomyosis, doctors must examine tissues taken from the uterus. The only way to obtain these tissues is to remove the uterus (hysterectomy).

Treatment of Uterine Adenomyosis

  • A levonorgestrel intrauterine device

  • Birth control pills

  • For severe symptoms, hysterectomy

Using an intrauterine device Intrauterine Devices (IUDs) Intrauterine devices (IUDs) are small, flexible, T-shaped plastic devices that are inserted into the uterus. In the United States, 12% of women who use contraception use IUDs. IUDs are popular... read more Intrauterine Devices (IUDs) (IUD) that releases a synthetic female hormone called levonorgestrel can help control the bleeding and painful menstrual periods. Doctors may recommend taking birth control pills (oral contraceptives), but the pills may not be effective.

Analgesics may be taken for pain.

If symptoms are severe, a hysterectomy is done. A hysterectomy completely relieves symptoms.

Drugs Mentioned In This Article

Generic Name Select Brand Names
AfterPill, EContra EZ, EContra One-Step, Fallback Solo, Kyleena , LILETTA, Mirena, My Choice, My Way, Next Choice, Next Choice One Dose, Norplant, Opcicon One-Step, Plan B, Plan B One-Step , Preventeza, React, Skyla, Take Action
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