Adenomyosis is a condition in which endometrial tissue, which normally lines only the uterine cavity, grows into the uterine muscle (myometrium). This causes the uterus to become thicker and enlarged, and may lead to various symptoms such as:

• Severe menstrual cramps (dysmenorrhea)

• Heavy menstrual bleeding or prolonged periods

• Pain during sexual intercourse (dyspareunia)

• A dragging sensation or chronic lower abdominal/pelvic pain

• An enlarged, firm uterus palpable as a mass in the lower abdomen

• Possible infertility issues (though not always)

Possible Causes and Risk Factors The exact cause of adenomyosis remains unclear, but potential factors include:

• Age (more commonly seen in women aged 30–50 years or those who have previously given birth)

• Uterine surgery or vaginal delivery in the past

• Hormonal imbalances

Diagnosis

• Transvaginal ultrasound (TVUS): May show features of a thickened/enlarged uterus suggestive of adenomyosis.

• MRI: Used when greater diagnostic clarity is needed.

Treatment (depends on symptom severity and desire for future fertility)

• Medications

  • Pain relievers (NSAIDs)

  • Hormonal therapy: combined oral contraceptives, progestin-only methods, or hormonal patches

  • GnRH agonists (to lower estrogen levels)

• Procedures or Surgery

  • Ablation or targeted destruction of abnormal tissue (in selected cases)

  • Hysterectomy (for severe symptoms in women who do not desire future pregnancy)

If you suspect adenomyosis, you should consult a gynecologist for a thorough evaluation and a personalized treatment plan that best suits your needs.