Emergency? If you are soaking through a pad or tampon every hour, feel faint or short of breath, or might be pregnant and are bleeding with pain, call 911 or go to the nearest emergency room. Know the warning signs
Book now

Adenomyosis

In adenomyosis, tissue similar to the uterine lining grows into the muscular wall of the uterus. The uterus can become enlarged and tender, and periods often become heavy and painful.

By the AUB editorial teamUpdated September 2026PALM-COEIN: AUB-A

Symptoms

  • Heavy or prolonged periods
  • Painful periods that may worsen over time
  • Pelvic pressure or pain between periods, or pain with sex

Some people have no symptoms. Adenomyosis often occurs alongside fibroids or endometriosis.

Diagnosis

A transvaginal ultrasound by an experienced sonographer can show characteristic changes. MRI gives a more detailed picture when the diagnosis is unclear or surgery is being planned.

Treatment without surgery

  • The levonorgestrel IUD, which reduces both bleeding and pain for many people
  • Combined hormonal birth control or progestin-only medication, often taken continuously
  • NSAIDs such as ibuprofen or naproxen for pain and to reduce bleeding
  • Tranexamic acid for heavy bleeding
  • Medications that lower estrogen, used for a limited time

Surgery

Hysterectomy is the only definitive cure. It is reserved for people who have finished childbearing and have not gotten enough relief from other options.

Sources

  1. Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393–408.
  2. American College of Obstetricians and Gynecologists. Practice Bulletin No. 128: Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012;120(1):197–206 (reaffirmed).

Related