Understanding Adenomyosis: Symptoms, Causes & Your Path to Relief

Table Of Content

Riddhi's Story and the Reality of Adenomyosis

Remember Riddhi from our pages on period pain? For years, she experienced periods that were not just painful, but also incredibly heavy and prolonged, mostly lasting more than seven days. She would go through multiple sanitary pads and felt a constant, heavy pressure in her lower abdomen, as if her uterus was swollen. She would feel exhausted all the time, a kind of fatigue that even a good night’s sleep couldn’t fix. Unlike many of her friends, her pain was debilitating. Yet, instead of seeing it as a sign of something wrong, she saw her ability to endure period pain as a mark of strength, a “badge of honour” that made her feel tougher than others. She never discussed her symptoms with her mother or a gynaecologist, convincing herself that this pain was simply her normal.

But as the pain and exhaustion took their toll, her mental health began to suffer. She became increasingly anxious about her periods, constantly worried about when the next cycle would hit and whether she would be able to go to college or meet her friends. The emotional burden of the pain and the constant fatigue led to a breakdown one day, a moment of raw vulnerability that forced her to confront the fact that she couldn’t “brave” this period pain alone anymore. It was only after this mental toll became unbearable that she decided to seek medical help.

Riddhi’s story is also a common one – Adenomyosis. It is a condition often mistaken for just a little more severe period pain, but nevertheless a part of a girl’s life. It’s a condition where the symptoms—from heavy bleeding to chronic fatigue—can be debilitating, yet are often dismissed, leading to a significant delay in diagnosis and treatment.

Adenomyosis affects an estimated 23.5 million women in India. The Indian Journal of Obstetrics and Gynecology Research estimates a prevalence rate of 6- 39% for adenomyosis with the typical age range of 35 years to 50 years.

This page is dedicated to understanding adenomyosis: what it is, its symptoms, potential causes, and the available treatments that can offer significant relief, just like Riddhi eventually found.

The infographic titled “Adenomyosis x India” highlights the hidden burden of adenomyosis in Indian women, a common but often misdiagnosed women’s reproductive health issue. It features a circular illustration of diverse women with a pink overlay and states that an estimated 2.35 crore Indian women suffer from this painful uterus condition, which is often dismissed as “just bad periods.” Below, a dark blue speech bubble with the heading “A Long and Lonely Road” explains how the normalisation of period pain leads to a frustrating and often lonely struggle for adenomyosis diagnosis and proper menstrual health care. The infographic has a pink background, includes the campaign message “Stop the Period Pain” with a speech bubble icon Which is a knowledge initiative campaign by Blue Cross Laboratories the makers of meftal spas., and lists the website www.painfulperiods.in at the bottom, aiming to raise awareness about chronic pelvic pain in women and promote timely diagnosis and treatment

What is Adenomyosis?

Adenomyosis is a condition where the tissue that normally lines the uterus (the endometrium) grows into the muscular wall of the uterus (the myometrium). This misplaced tissue continues to function as it should –  thickening, breaking down, and bleeding with each menstrual cycle. Because this blood is trapped within the muscle wall, it causes the uterus to become enlarged, swollen, and tender, leading to intense pain, heavy bleeding and other symptoms.

This educational infographic titled "Understanding Adenomyosis" compares a healthy uterus vs adenomyosis using cartoon-style illustrations. On the left, a normal uterus is depicted as a smiling pink organ with a smooth surface and clearly visible ovaries. The caption explains that in a healthy uterus, the uterine lining grows inside the uterus, sheds with every menstrual cycle, and exits through the vaginal canal. On the right, the uterus with adenomyosis symptoms is shown with a frowning face, sweat droplets, and red patches inside the uterine muscle wall, symbolizing inflammation and menstrual pain. The caption explains that in adenomyosis, the endometrial tissue grows into the muscle wall of the uterus and becomes trapped, shedding with each cycle but causing chronic pelvic pain, severe cramps, and heavy periods—a condition referred to as secondary dysmenorrhea. The graphic ends with the campaign message "STOP The Period Pain." Which is a knowledge initiative campaign by Blue Cross Laboratories the makers of meftal spas., with the website www.painfulperiods.in

Adenomyosis Symptoms: Recognising the Red Flags

While the primary symptom of endometriosis is often severe menstrual pain (dysmenorrhea), it’s crucial to recognise that the pain associated with endometriosis is often more intense and can differ from typical period cramps. Many women with endometriosis describe pain that significantly impacts their daily life. If you are wondering how you know if your painful periods are due to endometriosis, or if you are curious about what are the first signs of endometriosis, paying close attention to these symptoms is key.

Common Adenomyosis Symptoms

Severe Period Pain

Severe cramping or sharp, knifelike pelvic pain during menstruation (dysmenorrhea)

Heavy Bleeding (Menorrhagia)

Needing to change a pad or tampon every one to two hours or more frequently for several consecutive hours.

Prolonged Periods (Menorrhagia)

Menstrual bleeding that lasts for more than seven days.

Blood Clots

Passing blood clots that are larger than a coin (or about 2 cm in diameter).

Chronic Pelvic Pain

Many women with adenomyosis experience a feeling of tenderness, pressure, or chronic pain in their lower abdomen that isn’t limited to their menstrual cycle.

Pain During Intercourse

This is a common symptom due to the enlarged and tender uterus.

Enlarged Uterus

A doctor may be able to feel that the uterus is enlarged during a physical exam.

Bloating

Bloating or fullness in your body.

Anemia

Due to heavy blood loss, women with adenomyosis can develop anemia, leading to fatigue, dizziness, and weakness.

Infertility

Adenomyosis can sometimes make it difficult to conceive.

Adenomyosis Causes: What We Know

The exact cause of adenomyosis is not fully understood, but some theories exist. Unlike endometriosis, which is often linked to retrograde menstruation, adenomyosis is thought to be caused by a breakdown of the barrier between the uterine lining and the muscular wall, allowing the endometrial cells to invade. Researchers also believe that factors such as prior uterine surgery (like a C-section), multiple childbirths, genetics, and hormonal factors may play a role.

Diagnosing Adenomyosis: Seeking Answers

If you suspect you might have adenomyosis based on your symptoms, the first step is to consult a gynaecologist. They will listen to your detailed medical history and use common diagnostic methods to understand if you have adenomyosis:

Pelvic Exam

A physical examination to check for any abnormalities.

Ultrasound or MRI

Imaging techniques that can help identify the thickening of the uterine wall and other signs of the disease.

Definitive Diagnosis

The only definitive way to confirm adenomyosis is by examining the uterus after a hysterectomy. However, advanced imaging and clinical symptoms are often enough for a diagnosis.

Do you suspect your period pain could be Adenomyosis?

Stop guessing, start knowing. Our Period Pain Calculator helps you determine the severity and understand the red flags you need to know for a confident conversation.
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Adenomyosis Treatment: Finding Your Path to Relief

While a hysterectomy is the only definitive cure for adenomyosis, effective treatments are available to manage symptoms and significantly improve quality of life, especially for women who want to preserve their fertility. The best treatment approach will depend on the severity of your symptoms and your individual circumstances.

Your gynaecologist will discuss various treatment options, which may include:

  • Pain Medication: Prescription based non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain. Since such pain medications are non-steroidal, they are absolutely safe to consume.
  • Hormonal Therapy: Medications like birth control pills or hormonal IUDs can help manage the growth of the tissue and control symptoms.
  • Uterine Artery Embolisation: This is a newer, less invasive procedure that blocks blood flow to the affected area, causing the adenomyosis to shrink.
  • Surgery: In more severe cases, a hysterectomy (removal of the uterus) may be recommended, which cures the condition entirely.

Adenomyosis Without Intervention: The Cost of Waiting

Like many progressive diseases, adenomyosis can worsen over time without intervention. The normalisation of pain and the delay in diagnosis often mean that women in India don’t receive treatment until the disease has progressed significantly. This inaction comes at a personal and societal cost that goes far beyond simple physical discomfort.

Here’s a look at what can happen with no intervention:

Progressively Worsening Pain: The Impact on Daily Life

The symptoms that were once manageable with medication can become debilitating, leading to more missed school days for young women and decreased productivity at work for adults. This significantly reduces a woman’s quality of life and can affect her social life, career, and education.

Chronic Anemia: The Added Burden

The heavy menstrual bleeding that is a hallmark of adenomyosis can lead to chronic anemia. This is a particularly critical point in India, where an estimated 49% of women of reproductive age already suffer from anemia. The added blood loss from untreated adenomyosis can severely worsen this pre-existing condition, causing persistent fatigue, weakness, and an increased risk of other health complications.

Fertility Challenges: A Growing Concern

As the uterus becomes more enlarged and its function is impaired by adenomyosis, the risk of infertility and miscarriage can increase. In a society where family planning and childbearing are often central to a woman’s life, the impact of untreated adenomyosis on fertility can be a significant source of emotional distress and a barrier to a woman’s sense of fulfillment and well-being.

The image is an awareness infographic titled "The Hidden Cost of Adenomyosis", with a blue-purple overlay showing a woman appearing to be in pain, holding her lower abdomen—a common visual associated with adenomyosis symptoms and pelvic pain. It highlights four serious consequences of adenomyosis in women, each labeled with a pink speech bubble icon. The first cost is that adenomyosis is a progressive disease, meaning it worsens over time without intervention and involves more than just pain—underscoring the need for early adenomyosis diagnosis and effective treatment for adenomyosis. The second cost is progressively worsening pain, where symptoms like severe menstrual cramps, chronic pelvic pain, and heavy periods can become debilitating and interfere with daily activities, pointing to the impact on quality of life with adenomyosis. The third cost is chronic anemia, caused by heavy menstrual bleeding, leading to fatigue, dizziness, and other long-term health issues, which are key signs of menstrual disorders. The fourth cost is fertility challenges, where an enlarged uterus increases the risk of infertility due to adenomyosis and makes natural conception difficult, making this a crucial issue for those struggling with reproductive health. The graphic ends with the campaign message "STOP The Period Pain." Which is a knowledge initiative campaign by Blue Cross Laboratories the makers of meftal spas and provides a website link: www.painfulperiods.in,

If you are diagnosed with adenomyosis, your gynaecologist may also check for other related conditions such as Endometriosis and PCOS, as these conditions can sometimes coexist or share similar symptoms. We also have a dedicated guide on Uterine Fibroids.

Illustration highlighting endometriosis symptoms and painful periods. The central image is a cartoon-style female reproductive system showing the uterus, ovaries, and fallopian tubes, with a sad facial expression, teary eyes, and red marks indicating pelvic pain. Dark red patches representing endometrial tissue growth outside the uterus are visible on the uterus, fallopian tubes, and ovaries—depicting a classic case of endometriosis disease. Pain indicators like squiggly lines and "Zzz" marks surround the uterus to emphasize chronic period pain. At the top, the text reads: “Endometriosis” in bold pink letters, followed by a description in black italics: “Tissue similar to the uterine lining abnormally grows outside the uterus.” At the bottom right, there's a pink speech bubble with the words “Stop the Period Pain,” supporting awareness for severe menstrual cramps and period pain treatment. Bottom left includes the website link: www.painfulperiods.in. The background is a soft pink watercolor texture, maintaining a gentle and supportive tone. The graphic portrays the campaign message "STOP The Period Pain." Which is a knowledge initiative campaign by Blue Cross Laboratories the makers of meftal spas.
A pink, cartoon-style illustration of a uterus with PCOS showing a sad facial expression and teardrops under its eyes, symbolizing discomfort. Both ovaries are depicted with multiple small ovarian cysts, representing Polycystic Ovary Syndrome. The right ovary (on the left side of the image) has 5 visible cysts, and the left ovary (on the right side) has 6 cysts. Wavy lines and lightning bolt symbols near the lower part of the uterus suggest pelvic pain or cramping, common symptoms of PCOS in women. The background features a soft pink watercolor texture. At the top, bold text reads: “PCOS (Polycystic Ovary Syndrome)”. Below, in smaller text: “Cysts on ovaries prevent them from regularly releasing eggs,” indicating irregular periods and potential fertility issues due to PCOS. At the bottom right corner, a logo says “Stop the Period Pain” with a pink speech bubble icon. The website “**www.painfulperiods.in**” is written in pink in the bottom left corner. The graphic portrays the campaign message "STOP The Period Pain." Which is a knowledge initiative campaign by Blue Cross Laboratories the makers of meftal spas.
An illustrated educational graphic about uterine fibroids, a common cause of painful periods. The background is pink with a soft watercolor texture. At the top, bold pink text reads "Uterine Fibroids", followed by black italic text saying, "Non-cancerous growths in the uterus that develop within or on the uterine walls." Below the text is a cartoon-style illustration of a uterus with a sad face, eyes shut tight, and tears coming from both eyes, indicating severe menstrual cramps and pelvic pain. The uterus is depicted in pink with fallopian tubes and ovaries on each side. Multiple yellowish, bumpy fibroid tumors in uterus are shown growing on various parts of the uterus, including inside and on its outer wall. Zigzag lines around the uterus represent period pain and discomfort. In the bottom right corner, pink text says, "Stop the Period Pain" next to a speech bubble icon. In the bottom left corner, the website "www.painfulperiods.in" is displayed, suggesting a resource for information on uterine fibroids treatment and relief from painful menstruation. The graphic portrays the campaign message "STOP The Period Pain." Which is a knowledge initiative campaign by Blue Cross Laboratories the makers of meftal spas.
Illustration depicting adenomyosis, a condition where the uterine lining abnormally grows into the muscle wall of the uterus, leading to severe menstrual pain and other adenomyosis symptoms. The background features a soft pink watercolor texture. At the top, the word "Adenomyosis" appears in bold pink text, followed by a description in black italicized font that reads, "Uterine lining abnormally grows into the muscle wall of the uterus." The central cartoon-style image shows a pink uterus with a sad facial expression, tears near the fallopian tubes, and red spots on the upper right side representing abnormal tissue growth. Wavy red and black lines around the uterus symbolize cramps and pelvic pain, common in painful periods caused by adenomyosis. The uterus has arms that are holding the ovaries, which also appear distressed. At the bottom left is the website "www.painfulperiods.in," and in the bottom right corner, a pink speech bubble appears next to the phrase "Stop the Period Pain" in bold pink text, highlighting a call to action for those suffering from chronic period pain and seeking help for their uterine health. The graphic portrays the campaign message "STOP The Period Pain." Which is a knowledge initiative campaign by Blue Cross Laboratories the makers of meftal spas.

Hope and Support: Tackling Adenomyosis In India

Just like Riddhi, who found relief and a renewed sense of well-being after her diagnosis and intervention, there is hope for managing adenomyosis and living a full and active life. The pain of adenomyosis is often dismissed in India as “just a part of being a woman,” leading to years of suffering and misdiagnosis. But this narrative can and must change. By empowering our girls with knowledge and creating supportive systems, we can ensure early intervention for those who need it most.

A crucial part of this is breaking the silence and fostering open conversations about menstrual health. In many parts of India, discussing periods openly is still a taboo subject, which often prevents women and young girls from seeking help. Riddhi’s journey, from silently enduring the pain to finally seeking a diagnosis, highlights the immense courage it takes to break this cycle. Her story serves as a powerful reminder that while enduring pain may seem like a strength, true strength lies in seeking help and prioritising one’s health.

To increase adenomyosis, we recommend the following action plan:

Expand Period Education Beyond Hygiene

School curricula should move beyond basic menstrual hygiene to include comprehensive Period Pain Workshops. These workshops should educate girls on the signs of common disorders like period pain & adenomyosis, empowering them to recognise and seek help for abnormal symptoms.

Establish Accessible Period Health Points

Schools and colleges should have designated “Period Health” counselors or nurses. This creates a safe, non-judgmental space where girls can discuss their symptoms and get professional advice without fear of stigma.

Role of Govt. Policy

Initiatives under “Beti Bachao, Beti Padhao” can increase awareness, promote early diagnosis, and ensure access to comprehensive care for women suffering from adenomyosis.

Remember, the journey toward healing begins with one voice. It begins with the courage to speak up, to challenge the idea that period pain is something to be silently endured. By sharing your story, seeking support from healthcare professionals, and connecting with others who understand, you not only find a path to relief for yourself but also become a part of a larger movement to change the narrative for every woman.

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References:

  1. International Journal of Reproduction, Contraception, Obstetrics and Gynecology
  2. Journal of Ayurveda and Integrated Medical Sciences
  3. Indian Journal of Obstetrics and Gynecology Research
  4. Max Healthcare, Adenomyosis Treatment
  5. Apollo Hospitals, Adenomyosis: Symptoms, Causes, and Treatments
  6. Fortis Healthcare, All You Need to Know About Adenomyosis
  7. Healthcare Radius, Noninvasive treatment for Adenomyosis introduced
  8. Pristyn Care, Adenomyosis