Adenomyosis

Adenomyosis: A Closer Look

Many women are told their painful, heavy periods are just something to “put up with.” But if your cycle is affecting your energy, mood or day-to-day life, there may be more to it. One possible explanation that often gets missed? Adenomyosis.

This condition can mimic the symptoms of fibroids and endometriosis, yet it often goes undiagnosed. If you’ve been told “everything looks normal” but still don’t feel like yourself, you’re not alone. As a private gynaecologist in London, I often meet women who feel heard for the first time after years of being dismissed.

What is Adenomyosis?

Adenomyosis occurs when tissue similar to the endometrial lining grows into the muscular wall of the uterus. Unlike regular menstruation, this trapped tissue can’t shed properly. As a result it can cause chronic inflammation, pelvic pain and an enlarged, tender uterus. Some women also experience pressure on the bladder leading to increased urinary frequency.

It shares characteristics with endometriosis but is a separate condition that presents its own unique challenges.

Who gets Adenomyosis?

Adenomyosis is estimated to affect up to 1 in 10 women, particularly those in their 30s and 40s or women who have had children. Because it can look like other causes of heavy bleeding, like fibroids, it’s often mislabelled or completely overlooked.

An accurate diagnosis may require a combination of consultations, imaging and specialist expertise.

Recognising the symptoms

Symptoms can range from mild to severe and often overlap with other gynaecological conditions. Common signs include:

• Intense menstrual cramps

• Heavy or prolonged periods

• Pelvic pain or a dragging sensation

• Pain during sex

• Abdominal bloating or feeling of heaviness

• Fatigue around your period

If these sound familiar, talking to a private gynaecologist can help you get the clarity and care you deserve.

What causes it?

While the exact cause of adenomyosis is still unknown, several factors are thought to contribute:

• Inflammation after childbirth or surgical procedures (e.g. caesarean section)

• Hormonal imbalances, particularly oestrogen

• Developmental changes during foetal uterine developmentWhatever the cause, it’s not your fault — and your experience is valid.

Risk Factors

Some women are more likely to develop adenomyosis. These include:

• Being over 40

• Previous uterine surgery (e.g. caesarean section)

• Multiple pregnancies

• Family history of adenomyosis

• Painful periods or heavy bleeding

Because symptoms overlap with other conditions, imaging is essential to confirm diagnosis and rule out fibroids or endometriosis.

Diagnosis

Diagnosing adenomyosis can be tricky without the right tools. A full diagnostic process usually involves:

• A thorough symptom history

• Physical exam to detect uterine tenderness or enlargement

• Transvaginal ultrasound scan

• MRI for clearer imaging

Some cases are only confirmed after surgery but this is rare with modern imaging. At Happiher we work with highly trained radiologists to get timely and accurate diagnoses using specialist ultrasound and MRI where necessary.

Fertility and Adenomyosis

Adenomyosis doesn’t always affect fertility but for some women it can make conception more difficult or contribute to miscarriage. If you’re trying to conceive and suspect an underlying uterine issue a full assessment is crucial.

The good news is many women with adenomyosis go on to have successful pregnancies — especially with early diagnosis and expert care. Our team at Happiher can work alongside fertility specialists if needed.

Treatment

There’s no one size fits all solution for adenomyosis — treatment depends on your symptoms, fertility goals and personal preferences. Options include medical therapies and targeted procedures.

Common treatments are:

• Hormonal therapy (combined pill or Mirena coil) to reduce bleeding and pain

• Medications to regulate hormones to suppress the activity of misplaced tissue

• Mefenamic acid and other NSAIDs for pain relief

At Happiher we develop a bespoke care plan tailored to you — always with a focus on short-term relief and long-term health.

Pain Management

Pain relief is often the first step. We recommend:

• Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce cramping

• Antispasmodics to relieve muscle tension* Lifestyle changes such as gentle movement, stress management and anti-inflammatory diets

For many women this holistic approach can make a big difference to comfort and quality of life.

Minimally Invasive Options

When symptoms are severe or medical therapy isn’t enough surgery may be considered. Dr Kaur specialises in advanced minimally invasive techniques such as:

• Laparoscopic (keyhole) surgery

• Robotic-assisted procedures which offer higher precision and faster recovery

• Fertility-sparing options wherever possible

In rare cases when symptoms are extreme and fertility isn’t a concern hysterectomy may be discussed — but this is always a last resort never a first option.

Living with Adenomyosis

Adenomyosis isn’t just about your periods — it can affect your relationships, career, sleep and sense of wellbeing. But with the right medical team and treatment plan you can get your life back and feel like yourself again.

Our approach at Happiher is simple: expert care with empathy and clarity so no woman is left in the dark.

Ongoing Care and Support

After diagnosis regular follow up is important. Managing adenomyosis isn’t a one off appointment — it’s a journey. Your care plan may involve:

• Regular check ins with a private gynaecologist

• Reviewing medications and adjusting dosages

• Monitoring symptoms like pelvic pain, heavy bleeding or fatigue

• Discussing options like surgery or further imaging if symptoms persist

Women deserve high quality care that adapts to their changing needs. With the right support you can make informed decisions and take control of your condition.

Why Choose Happiher?

When you choose Happiher you’re choosing:

• A gynaecologist who listens and validates your symptoms

• Specialist imaging with expert radiologists

• Access to minimally invasive and robotic-assisted treatment

• Personalised support that addresses your physical and emotional needs

• Appointments available at Chelsea & Westminster, The Lister and The Wellington

We offer rapid access to care — often with appointments available the very next day.

Conclusion

If you’ve been living with painful periods, fatigue or unexplained pelvic pressure now is the time to explore what’s really going on. You don’t need to wait years for a diagnosis — and you don’t need to suffer in silence.Get in touch