It used to be that discussing anything period-related was pretty taboo. But thankfully, this trend has started to shift in recent years. While you've probably heard of endometriosis, the condition in which uterine tissue wanders outside the uterus, you might not be as familiar with adenomyosis. Both conditions can lead to some severe symptoms like heavy periods and super intense cramping, and if you live with either condition, you know how challenging they can be. But there are some critical differences between adenomyosis and endometriosis that women should know about.
With endometriosis, tissue that normally lines the inside of the uterus starts growing outside of it. And while the displaced tissue continues to thicken throughout the menstrual cycle, it doesn’t shed as it normally would during your period since it’s no longer part of the uterine lining. As this tissue continues to spread outside of the uterus, it gets trapped, and can lead to pelvic pain and fertility problems for some women. While both conditions involve the displacement of uterine tissue, adenomyosis is its own thing. And while adenomyosis often gets confused with endometriosis, the two conditions are actually totally different.
According to the Mayo Clinic, adenomyosis happens when uterine tissue (or endometrial tissue) pushes into the muscular walls of the uterus. So while endometrial tissue breaks out of the uterus with endometriosis, with adenomyosis, it grows into the uterine wall. As this tissue builds up throughout the menstrual cycle, it continues to thicken, break down, and bleed, and can cause super severe cramping and extra heavy periods.
Up until recently, adenomyosis wasn’t a well-known condition, as it only affects up to two to three percent of women, according to Well + Good. But while relatively uncommon, some doctors do note that the condition might also be underdiagnosed. Given that the displaced uterine cells keep doing their thing throughout the menstrual cycle (building up, breaking down, and bleeding), the result is often an enlarged uterus that can grow up to two to three times its normal size. An enlarged and painful uterus can mean “Painful periods, painful sex, and heavy periods,” as Dr. Adeeti Gupta, MD, founder of NYC-based Walk In GYN Care, told Well + Good.
Medical News Today says that about one-third of women with adenomyosis won't have any symptoms, while others report period pain and ongoing symptoms so intense that they interfere with daily life. And while the causes of adenomyosis aren’t really well understood at this point, doctors think inflammation and physical injury — like from trauma, childbirth, or C-sections — might play a part in its development. Per Well + Good, the condition can negatively affect a woman’s fertility during the childbearing years. But if fertility concerns don’t reveal the condition earlier in life, it’s usually not diagnosed until a woman is well into her forties or fifties.
As adenomyosis is an estrogen-dependent condition, according to Well + Good, it typically resolves after menopause. In the meantime, doctors do recommend treatments if symptoms are present. Pelvic exams, ultrasounds, MRIs, and biopsies are all methods used to detect adenomyosis. And if you are diagnosed with the condition, your doctor might prescribe anti-inflammatory medications or hormone therapies, among other treatment options, according to Healthline.
Healthline further notes that since women often have endometriosis and adenomyosis at the same time, researchers are still working to figure out the role that adenomyosis might play in infertility. Some studies suggest that it could cause problems, and does up the risk of infertility and miscarriage for some women. While more research is needed to fully understand the impact of adenomyosis on women’s health and fertility, it’s important to see your doctor if you have any concerns, or if your symptoms are severe — you have options.