From the Guidelines
Adenomyosis symptoms typically include painful, heavy, or prolonged menstrual periods, chronic pelvic pain, pain during intercourse, and a feeling of pressure or bloating in the lower abdomen, as well as bulk symptoms such as pressure, pain, fullness, bladder, or bowel symptoms. Many women also experience menstrual bleeding that lasts longer than normal, blood clots during menstruation, and spotting between periods 1. The condition occurs when the endometrial tissue that normally lines the uterus grows into the muscular wall of the uterus, causing the uterus to enlarge and become tender. Some women may have no symptoms at all, while others experience severe discomfort that interferes with daily activities. Symptoms often worsen with age and typically improve after menopause when estrogen levels decline. The severity of symptoms generally correlates with how deeply the endometrial tissue has penetrated the uterine muscle and how widespread the condition is within the uterus.
Common Symptoms
- Painful, heavy, or prolonged menstrual periods
- Chronic pelvic pain
- Pain during intercourse
- Feeling of pressure or bloating in the lower abdomen
- Bulk symptoms such as pressure, pain, fullness, bladder, or bowel symptoms
- Menstrual bleeding that lasts longer than normal
- Blood clots during menstruation
- Spotting between periods
According to recent studies, medical management or uterine artery embolization (UAE) is usually appropriate for the initial therapy for a reproductive age patient with uterine fibroids and concurrent adenomyosis, symptomatic with heavy uterine bleeding or bulk symptoms 1. Progestin IUDs and combined oral contraceptives have both been shown to reduce painful and heavy menstrual bleeding in randomized controlled trials 1. It is essential to consult with a healthcare provider for proper diagnosis and treatment options, which may include pain medications, hormonal treatments, or in severe cases, surgical interventions.
From the Research
Symptoms of Adenomyosis
The symptoms of adenomyosis can vary, but common manifestations include:
- Pelvic pain
- Dysmenorrhea (painful periods) 2, 3, 4, 5
- Heavy menstrual bleeding 2, 3, 4, 5, 6
- Subfertility 2
- Dyspareunia (painful intercourse) 4
- Abnormal uterine bleeding 3, 5, 6
Asymptomatic Cases
It's worth noting that adenomyosis can also be asymptomatic in some cases, with approximately a third of cases showing no symptoms 4.
Coexisting Conditions
Adenomyosis often coexists with other gynecological conditions, such as endometriosis or fibroids, which can cloud the clinical presentation and make diagnosis more challenging 2, 3, 5, 6.