Information alert

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This is information for women who have been given a diagnosis of adenomyosis (pronounced: add-en– oh-my-oh-sis). It is designed to provide information about the condition and answer some of the questions you may have.

The wall of the womb is made up of two layers. The outer muscle layer is called the myometrium and the inner lining is called the endometrium. Adenomyosis is a condition in which the cells that form the inner lining of the womb (endometrium) are found in the muscle layer (myometrium), where they are not normally present.

Endometrium - Myometrium image .jpg

No one knows exactly what causes adenomyosis. Genetics and some hormones may play a role. It is not thought that contraceptive pills or coils cause adenomyosis.

Approximately 20% of women attending a gynaecology clinic will have adenomyosis. It is most common in women in their 40s and 50s, women who have been pregnant in the past, and in women with endometriosis.

(Endometriosis is a condition in which the cells which line the womb are found in areas outside of the womb, for example on the ovaries or fallopian tubes).

Both transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) can be used to diagnose adenomyosis. Neither of these use any radiation.

Ultrasound is more widely available than MRI, and so is the first-line investigation for adenomyosis.

Studies at UCLH have shown that the more ultrasound features of adenomyosis you have, the more severe your symptoms are likely to be.

About 35 out of every 100 women who have adenomyosis do not experience any symptoms, and do not need any treatment.

4 to 5 out of every 10 women with adenomyosis experience heavy periods, and between 1 and 3 out of every 10 women with adenomyosis experience painful periods. More rarely, women experience irregular vaginal bleeding. These symptoms should stop after menopause.

Adenomyosis is a benign condition. This means it is not known to be pre- cancerous. Although it may cause troublesome symptoms, it does not carry a risk of serious illness or death.

There is no evidence to suggest adenomyosis affects becoming pregnant naturally.

However, there is some recent evidence to suggest adenomyosis may reduce the chances of successful fertility treatment in women who have struggled to conceive naturally.

Various factors may influence which treatment you choose:

  • Your age and whether you are close to the menopause
  • Whether you want to become pregnant
  • If you have already tried any treatments and whether they have worked for you
  • How you feel about having surgery

Depending on the above factors and the nature of your symptoms the following treatments may be offered:

  • Painkillers
  • Tablets which reduce menstrual flow (usually Tranexamic acid)
  • Hormonal treatments that include the contraceptive pill or Mirena coil
  • An interventional radiological procedure called ‘uterine artery embolisation’. This is a procedure carried out through a small incision in the groin, where the major blood vessel supplying the womb is blocked off.
  • Surgery
    • The only way to cure adenomyosis is to remove the womb (an operation called a hysterectomy)
    • This can be performed as a keyhole or open procedure, depending on the size of your womb
    • Because a hysterectomy is major surgery with significant risks, it tends to be offered as a last resort
    • Removing the womb means you cannot become pregnant again, so is only suitable once you are certain you have completed your family
    • There are some surgical options that do not involve removing the womb but there is not yet enough evidence to justify their routine use.

No. If you have been told you may have adenomyosis based on a scan but do not experience any symptoms, there is no need to seek treatment.

More information can be found at:

UCLH cannot accept responsibility for information provided by other organisations.

Mehasseb M, Habiba MA 2009, ‘Adenomyosis uteri: an update’

The Obstetrician & Gynaecologist, Vol. 11, pp. 41-47.

Naftalin J, Hoo W, Pateman K, Mavrelos D, Foo X, Jurkovic D. 2014.

‘Is adenomyosis associated with menorrhagia?’ Human Reproduction, Vol. 29, No.3,pp. 473–479.

Naftalin J, Hoo W, Pateman K, Mavrelos D, Holland T, Jurkovic D. 2012. ‘How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic’ Human Reproduction, Vol. 27, No.12, pp. 3432–3439.

Naftalin J, Hoo W, Nunes N, Holland T, Mavrelos D, Jurkovic D. 2016. ‘Association between ultrasound features of adenomyosis and severity of menstrual pain’. Ultrasound in Obstetrics & Gynaecology, Vol. 47, pp. 779–783.

Mavrelos D, Holland TK, O'Donovan O, Khalil M, Ploumpidis G, Jurkovic D, Khalaf Y. 2017. ‘The impact of adenomyosis on the outcome of IVF-embryo transfer’. Reproductive Biomedicine Online, Vol 35(5), pp. 549-554.

Original image courtesy of Canadian Cancer Society.













Page last updated: 22 May 2024

Review due: 01 February 2025