What is adenomyosis? 6 symptoms and how to cope

Physical Wellbeing

Oct 14

Written By Calm Editorial Team

Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA

Struggling with painful periods and bloating? Adenomyosis might be to blame. Learn what adenomyosis is, why people struggle to get diagnosed, and 16 treatment options.

Many women and people with uteruses experience pain and discomfort as part of the menstrual cycle. But if you’ve ever dealt with severe bloating, pelvic pressure, and even some spotting between periods, you might be dealing with a condition called adenomyosis.

This condition can be easily misdiagnosed, as so many of the symptoms are common for someone who gets a period. But if you’re experiencing disruptive menstrual symptoms that can’t be explained, you should be able to get the care you need.

Adenomyosis—a buildup of extra uterine lining inside the uterus—often shows up as a stealthy, persistent, and frequently minimized experience. And unlike other conditions that come with a clear diagnosis and treatment path, adenomyosis can take years to uncover. In the meantime, those dealing with it are left managing unpredictable pain, fatigue, and emotional whiplash without validation or support.

Let’s explore what’s happening with this condition, the most common signs and symptoms, and a few manageable ways to care for yourself before or after a diagnosis.

What is adenomyosis?

Adenomyosis is a medical condition where tissue similar to the endometrium (the lining of the uterus) starts growing into the muscular wall of the uterus itself. Over time, this tissue thickens the uterine walls and can lead to an enlarged uterus, which may cause pain or lead to heavier periods and relentless cramping.

Many people describe adenomyosis as the sister of endometriosis. But the two conditions are distinctly different. Endometriosis happens when the tissue grows outside the uterus, whereas with adenomyosis, the tissue stays within the uterus, just in the wrong place.

Unfortunately, no one knows exactly why adenomyosis happens. Some researchers think it’s linked to repeated uterine trauma, like childbirth or surgical procedures. While others believe hormonal or inflammatory factors may play a role.

Most commonly, this condition is diagnosed in people over 30 who’ve had children, but it can affect anyone with a uterus, regardless of age or reproductive history.

6 common symptoms of adenomyosis

This condition can be tricky to recognize because it doesn’t always look the same from person to person. For some, it means daily pelvic pain. For others, it’s heavier periods or unexplained bloating. Here are some common symptoms to look out for:

Heavy or prolonged bleeding: Bleeding through pads or tampons quickly, periods lasting longer than a week, and large clots can point to adenomyosis. This can also lead to anemia and fatigue.
Chronic pelvic pain: Pain that often feels deep, dull, and achy. Additionally, it might continue beyond your period and flare up throughout your cycle.
Pelvic pressure or bloating: An enlarged uterus can cause a heavy, full feeling or make clothes fit differently, especially around your lower belly.
Pain during sex: For some, deep penetration triggers sharp pain due to inflammation and thickened uterine walls.
Spotting between periods: Seeing light bleeding before your period starts or randomly throughout your cycle.
Fertility issues: While many people conceive without issue, this condition can sometimes make it harder to get pregnant or carry to term.

Importantly, these symptoms often overlap with other conditions, like fibroids or endometriosis. So, if something doesn’t feel right to you, trust yourself and push for answers.

Why is it so hard to get an adenomyosis diagnosis?

The reason this condition is so hard to diagnose has to do with the way the symptoms present and the current diagnostic tools available to physicians.

The symptoms—heavy bleeding, sharp pelvic pain, persistent bloating—are real and disruptive, but they rarely scream “adenomyosis” to a doctor.

Instead, they blend into a fog of overlapping conditions like fibroids, endometriosis, or hormonal irregularities. And because these symptoms are often brushed off as just “bad periods,” many people spend years bouncing between providers before anyone even mentions adenomyosis by name.

In addition to this, there’s no simple, noninvasive test that can confirm adenomyosis with certainty. Ultrasounds and MRIs can offer clues, but those clues are subtle, easy to miss, and inconsistently interpreted depending on the provider.

The only way to truly confirm adenomyosis for sure is by examining uterine tissue after a hysterectomy — something most people understandably want to avoid.

So instead, the diagnosis often lives in a frustrating gray zone: suspected, suggested, but not confirmed. This leaves many people navigating intense symptoms without a clear label, a plan, or the validation that comes from being properly seen and understood.

How to cope with adenomyosis: 10 ways to care for yourself

Living with adenomyosis can be painful, exhausting, and deeply frustrating. But there are options out there that can help you function, rest, and live your life with a little more ease. Here are 10 tips that can help you find some relief.

1. Heat therapy

Heating pads, hot water bottles, or warm baths can soothe pelvic pain, especially during your period. Try a wearable heat wrap if you need to be mobile, or use heat before bed to ease sleep disruptions.

2. Movement (when possible)

Low-impact activities like walking, stretching, swimming, or gentle yoga can improve circulation and reduce muscle tension around your pelvis. But remember that it’s okay if this isn’t doable every day.

3. Meal planning around flare-ups

Some people find that cutting back on inflammatory foods, like ultra-processed snacks and foods with added sugars, can help reduce their bloating and discomfort. Also, warm, easy-to-digest meals like soups and broths can feel gentler on your gut during a flare-up.

💙 Bring more balance into your body by listening to Dr. Michelle May’s series Mindful Eating.

4. Period tracking

Consider using a symptom tracker to log bleeding, pain, mood shifts, and energy levels. Over time, this can help you notice patterns. Plus, it can help you plan appointments and vacations.

5. Comfort-first wardrobe

On bloated or heavy-bleed days, tight pants can make everything feel worse. So, lean into soft waistbands, loose dresses, and layers that you can quickly peel off when you get hot flashes or chills.

6. Plan for rest

If your symptoms wipe you out for several days a month, plan accordingly and build in recovery time. Consider clearing your calendar when you can, prepping easy meals ahead of time, or even delegating non-urgent tasks during flare-up windows.

7. Mental health support

Talk to a therapist, especially one familiar with chronic illness. They can help you process frustration, grief, and burnout. If therapy isn’t accessible or affordable at the moment, journaling can help create space for you to vent and reflect.

8. Support groups and forums

Online communities like Reddit’s r/adenomyosis, Facebook groups, or health-specific forums can be validating places to swap tips, share doctor recommendations, and remember you’re not alone in this. That said, be mindful of your capacity, as some spaces can be overwhelming.

9. Educating your inner circle

Tell your close friends and family what adenomyosis is and how it affects you so that they know what you’re going through. Even just telling one trusted person who understands can make your hard days feel a little more bearable.

10. Grieving what’s changed

It’s normal to feel sadness or anger about what’s been lost or interrupted, as living with a chronic illness can impact every area of your life. So, as you care for yourself, also allow yourself to grieve.

💙 Support yourself through loss and pain by listening to Lama Rod Owens’ series Caring For Your Grief.

Adenomyosis FAQs

How do I get an adenomyosis diagnosis?

Diagnosis typically starts with a pelvic exam, where a doctor may notice an enlarged or tender uterus. From there, they may order imaging. This is typically a transvaginal ultrasound or, if more detail is needed, an MRI. These tools can help suggest if you have adenomyosis.

But these scans can’t confirm the diagnosis definitively. That only happens when a uterus is examined under a microscope, usually after a hysterectomy. Because of this, many people are left with a “probable” diagnosis based on symptoms and imaging alone. This isn’t ideal, but it’s often enough to begin treatment.

What are the causes of adenomyosis?

The exact cause of adenomyosis isn’t fully understood, but several theories exist. Some researchers believe it’s linked to uterine trauma, like previous childbirth, C-sections, or other uterine surgeries. Others suggest that hormonal fluctuations, chronic inflammation, or developmental anomalies may play a role.

And while these theories differ, what’s clear is that adenomyosis isn’t caused by anything you did wrong. It’s not preventable, and it’s not something you could have controlled. While this might feel frustrating, help and treatment are available.

What impact does adenomyosis have on mental health?

Chronic pain and the uncertainty that comes with a difficult-to-diagnose condition can take a serious toll on your emotional wellbeing. In fact, many people with adenomyosis report symptoms of anxiety, depression, or medical trauma, especially after being dismissed by providers.

Heavy bleeding and unpredictable flares can also disrupt your daily life. This can lead to missed work, social withdrawal, and sleep issues.

How does adenomyosis affect fertility?

Adenomyosis can potentially interfere with embryo implantation, increase the risk of miscarriage, and contribute to complications like preterm labor. With that said, plenty of people with adenomyosis go on to conceive and carry healthy pregnancies.

If fertility is a goal of yours, it’s worth working with a reproductive endocrinologist or fertility specialist familiar with the condition. They can help turn you onto treatment plans like hormonal management, fertility medications, or assisted reproductive technologies like IVF.

How is adenomyosis different from endometriosis?

Both conditions involve tissue similar to the uterine lining growing where it shouldn’t, but they appear in different locations. In adenomyosis, the tissue grows into the muscular wall of the uterus, while in endometriosis, it grows outside the uterus on organs like the ovaries, bladder, bowel, or pelvic walls. Endometriosis often involves sharper pain and bowel or bladder issues.

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adenomyosis

Calm Editorial Team