Adenomyosis and endometriosis are similar women’s health issues that are often misunderstood. Both affect the uterus, have no known cause and can produce similar symptoms, such as painful periods. While they have a few common traits, they’re not the same thing.
“Many women consider adenomyosis and endometriosis the same condition,” says Dr. Curtis J. Elam, board-certified physician with Beaufort Memorial Obstetrics & Gynecology Specialists. “As similar as these two issues may be, they’re unique health issues that require very different approaches to care.”
Learn about the risks and symptoms for each and what treatment options may help.
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Adenomyosis and Endometriosis Defined
The uterine lining, composed of endometrial tissue, is essential for a healthy pregnancy. When pregnancy does not occur, this tissue signals the body to begin menstruation. However, when issues arise with endometrial tissue, conditions like adenomyosis and endometriosis emerge, leading to impactful symptoms that can disrupt daily life.
- Adenomyosis occurs when endometrial tissue begins to grow into the outer walls of the uterus, resulting in a thickened uterine muscle wall.
- Endometriosis, on the other hand, involves the growth of tissue resembling endometrial tissue in various parts of the body. These lesions can appear on the bladder, fallopian tubes, under the ovaries and in rare instances, even in the lungs or other areas.
Your Risk for Adenomyosis and Endometriosis
Though it’s unclear what causes endometriosis or adenomyosis, certain women are at higher risk for each condition.
According to the National Institutes of Health, risk factors for an endometriosis diagnosis include:
- Family history (mother, sister or daughter has the condition)
- Early menstruation that starts before turning 11
- Heavy periods that last more than a week
- Menstrual cycles that last fewer than 27 days
Potential risk factors for adenomyosis may include:
- Being between 35 and 50 years old
- Experiencing abnormally short menstrual cycles
- Having fibroids or endometriosis
- Starting menstruation at age 10 or earlier
- Undergoing uterine surgery, such as dilation and curettage (D&C)
“Pregnancy seems to reduce the likelihood of endometriosis, serving as a sort of protective mechanism against this troubling condition,” Dr. Elam says. “On the other hand, a history of pregnancy actually increases your odds of adenomyosis.”
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Similar and Separate Symptoms
Adenomyosis, diagnosed or undetected, often causes no symptoms. When symptoms do arise, they may mimic those of endometriosis. Symptoms of adenomyosis shared with endometriosis include:
- Heavy menstrual bleeding (with adenomyosis, this bleeding may last a long time)
- Painful menstrual periods that grow worse
- Pelvic pain during your period or sexual intercourse
Endometriosis may cause additional symptoms, including female infertility. In fact, the American Society for Reproductive Medicine states that between 20 and 50% of women who experience infertility have endometriosis. Other symptoms you may experience with endometriosis include:
- Abdominal pain
- Bleeding or spotting between periods
- Fatigue
- Gastrointestinal discomfort
- Painful bowel movements, urination or intercourse
Detecting Abnormal Endometrial Tissue
If you suspect something has gone wrong with your body’s production of endometrial tissue, contact your OBGYN or primary care provider.
“Symptoms typically start us down the diagnostic path,” Dr. Elam says, “but a definitive diagnosis requires more information.”
With adenomyosis and endometriosis, uncovering your underlying condition takes a few steps. Your provider may perform the following:
- Imaging studies — Ultrasound and MRI scans give a good view of your uterus and help rule out other conditions, such as uterine fibroids.
- Pelvic exam — By physically examining your pelvic region, your provider can feel abnormal masses, tender areas or an enlarged uterus.
- Surgical biopsy — Your provider removes a small bit of tissue from your uterus or other area. This tissue then undergoes laboratory examination to aid in diagnosis.
Choosing Treatment for Your Symptoms
Treatment of adenomyosis and endometriosis focuses on bringing symptomatic relief. Depending on your symptoms and preferences, your care team may recommend conservative approaches or surgical intervention.
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Conservative Care for Endometriosis and Adenomyosis
There are several conservative ways to address adenomyosis and endometriosis. Based on your needs, your health provider may suggest one of the following:
- Clotting medication — Tranexamic acid is an oral medication that promotes blood clotting. It can help treat heavy bleeding common with adenomyosis.
- Hormone therapy — If you experience heavy bleeding, progesterone can help ease symptoms. Birth control pills and intrauterine devices (IUDs) are two types of hormone therapy that help manage abnormal menstruation.
- Pain relievers — Over-the-counter or prescription medication can take the edge off any pain you experience. A common choice is nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
- Watchful waiting — If your symptoms are mild or you have no symptoms, you may prefer no treatment at all. This is especially common if your symptoms came along during menopause.
“Menopause can bring on adenomyosis symptoms,” Dr. Elam says, “and the symptoms often resolve when menopause ends.” If you choose no treatment, contact your care team if symptoms arise later on that affect your quality of life.
You may also find relief with acupuncture or supplements, such as omega-3 fatty acids or magnesium. Talk with your care provider to find out if you should consider one of these alternative therapies.
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Treatment Options When Symptoms Persist
Severe symptoms that continue after conservative treatment may benefit from a more aggressive approach. Options include:
- Endometrial ablation — A surgeon uses heat to remove tissue inside the uterus without an incision to treat some instances of heavy menstrual bleeding.
- Hysterectomy — Surgery to remove the uterus may bring relief from some adenomyosis or endometriosis symptoms.
- In vitro fertilization — Endometriosis can cause infertility. If this happens to you, in vitro fertilization can help you become pregnant while living with endometriosis.
- Nerve removal — When endometriosis causes severe pain, a surgeon may remove specific nerves. This stops those nerves from sending pain signals to your brain, helping you feel less pain.
- Patch removal — A surgeon identifies and removes patches of endometriosis tissue throughout the body. Unless you plan to become pregnant afterward, your care provider may encourage you to take hormone therapy.
“Thanks to medical advances, we have an array of surgical and nonsurgical options that help reduce adenomyosis and endometriosis symptoms and get women back to life,” Dr. Elam says. “So, if you’re feeling odd symptoms and wonder if it’s adenomyosis, endometriosis or another condition, speak up. That’s the only way your care provider can help you feel your best.”
At Beaufort Memorial, our women’s providers are here for you through every age and stage of life. Request an appointment with a women’s health provider today.
