Adenomyosis or adeno, is a disease where the lining of the uterus (the endometrium) grows into the muscle wall of the uterus (myometrium). During the menstrual phase of the menstrual cycle, the endometrial tissue causes numerous microscopic bleeds in the muscle wall.

The exact cause of adenomyosis is unknown, however there are two theories posed currently. One theory is thought to be due to metaplasia (where one type of cell, changes into another type of cell). The other is a tissue injury and repair process. Where the repeated injury through the muscle wall over-stretching due to excessive contractions for an unknown reason, injures the cycles in part of the uterus (junctional zone). This process, along with hormones and inflammation further increases the contractions and the process repeats, causing breakdown in the integrity of the muscle and the endometrial lining into the muscle layer.

The only known cure for adenomyosis currently is via a hysterectomy.

The symptoms of adenomyosis can differ for each person affected, making it difficult at times for clinicians to suspect adenomyosis. People with adenomyosis may also have no symptoms at all of the disease.

Symptoms include:

- heavy bleeding during or between periods

- pain with periods (dysmenorrhea)

- pain during or after intercourse (dyspareunia)

- pain with urination (dysuria)

- pain with bowel movements (dyschezia)

- chronic pelvic pain

- back pain

- leg pain

- pressure or feeling ‘heavy’ in abdomen or pelvis

- fatigue

- nausea

- bloating

- infertility

- mental health impacts: depression or anxiety

Adenomyosis can be diagnosed where there is evidence of symptoms, in conjunction with medical imaging and keyhole surgery (laparoscopy). MRI or ultrasound can be used to identify thickening of the muscle layer (myometrium), irregular shape, discontinuous junctional zone, as well as other signals. Where two or more are present, along with symptoms, a diagnosis of adenomyosis can be formed. During laparoscopy, the appearance of an enlarged uterus and an uneven, boggy texture.

- pelvic physiotherapy

- acupuncture and Traditional Chinese Medicine

- naturopathy

- hormonal contraceptives and devices (e.g. contraceptive pill, intra-uterine device)

- non-steroidal anti-inflammatory drugs (NSAIDS)

- pain relief medications (analgesia)

- anti-inflammatory diet and lifestyle

- osteopathy

- IVF or fertility treatments where fertility is impacted

- hysterectomy

- uterine artery embolisation