Adenomyosis

Adenomyosis: A Guide to Understanding This Often Overlooked Condition

For many women, living with heavy, painful periods has become so normalised that seeking help doesn’t even feel like an option. But when your monthly cycle starts interfering with your everyday life — physically, emotionally, and even professionally — something more could be going on. One often-missed culprit? Adenomyosis.

Adenomyosis can cause symptoms similar to fibroids or endometriosis but often goes undiagnosed. If you’ve been told “everything looks normal” but your symptoms persist, this guide is for you. As a private gynaecologist in London, I frequently support women who finally feel validated after years of silent suffering.

What is Adenomyosis? A Guide from an Adenomyosis Specialist

Adenomyosis occurs when tissue similar to the lining of the womb (the endometrium) grows into the muscular wall of the uterus. Each month, this tissue responds to hormonal changes, thickens, breaks down, and bleeds — but unlike a normal period, this blood has nowhere to go. The result is inflammation, pain, and often a swollen or tender uterus. Adenomyosis can also lead to physical pressure on the bladder, resulting in symptoms such as urinary frequency.

Though it shares similarities with endometriosis, which involves tissue growing outside the uterus, adenomyosis is a distinct condition with its own challenges.

How Common Is It?

It’s estimated that 1 in 10 women may be affected by adenomyosis, particularly those in their 30s and 40s or women who’ve had children. However, because it can only be definitively diagnosed through imaging or post-surgical tissue analysis, many cases go unrecognised — or are misdiagnosed as fibroids or heavy menstrual bleeding (menorrhagia).

Proper diagnosis often requires multiple consultations and appointments with a specialist.

What Are the Symptoms of Adenomyosis?

Symptoms can vary widely in severity. Some women may experience mild discomfort, while others face debilitating pain and fatigue.

The most common symptoms include:

• Heavy, prolonged periods

• Severe menstrual cramps

• Pelvic pressure or tenderness

• Pain during intercourse

• Bloating or a “bulky” feeling in the lower abdomen

• Chronic fatigue, especially around the menstrual cycle

If you have any concerns about these symptoms, it is important to seek professional advice from a specialist.

Because these symptoms overlap with other gynaecological conditions, it’s important to be assessed by a specialist familiar with complex pelvic conditions.

What Causes Adenomyosis?

The exact cause of adenomyosis isn’t fully understood, but several theories exist:

• Inflammation related to childbirth or surgery (e.g., C-section)

• Hormonal imbalances (especially oestrogen)

• Developmental differences during uterine formation in the womb

Adenomyosis affects the reproductive system, leading to various symptoms and complications.

Regardless of cause, adenomyosis is not something you’ve caused, and it is absolutely valid to seek support if symptoms are affecting your quality of life.

Risk Factors

Several risk factors can increase the likelihood of developing adenomyosis. These include age, with adenomyosis more common in women over 40, and previous uterine surgery, such as a cesarean section. Women who have had multiple pregnancies or have a family history of adenomyosis are also at higher risk. Additionally, women who experience heavy bleeding or painful periods may be more likely to develop adenomyosis. Private gynaecologists can help identify these risk factors and provide exceptional care to women with adenomyosis. An ultrasound scan or MRI scan can help confirm the diagnosis and rule out other conditions, such as fibroids or endometriosis. (Keep keywords: mri scan, painful periods, private gynaecologists, ultrasound scan, exceptional care, heavy bleeding, endometriosis, women, diagnosis, fibroids, surgery, ultrasound, adenomyosis, age, bleeding, identify, scan, confirm, rule)

How Is Adenomyosis Diagnosed?

Diagnosis can be challenging, but advancements in imaging have made it much easier to detect.

A typical diagnostic process includes:

• Detailed symptom history

• Pelvic examination to check for a tender or enlarged uterus

• Transvaginal ultrasound, often the first imaging tool used

• MRI, which provides more detailed visualisation of the uterine wall

A consultant will guide you through the necessary testing to ensure an accurate diagnosis.

In some cases, adenomyosis may only be confirmed after a hysterectomy, but this is not required for diagnosis or treatment — especially with the right imaging and clinical expertise.

At Happiher, we use specialist ultrasound techniques and collaborate with expert radiologists to ensure accurate, timely diagnosis.

Adenomyosis and Fertility

Unlike endometriosis, adenomyosis doesn’t always interfere with fertility — but in some cases, it can affect implantation or contribute to recurrent miscarriage. If you’re struggling to conceive, a thorough evaluation of your uterus is essential.

The good news? Many women with adenomyosis go on to have healthy pregnancies with the right support and treatment plan.

Treatment Options for Adenomyosis

The best treatment for adenomyosis depends on how severe your symptoms are, whether you’re trying to conceive, and your personal preferences.

There is a range of treatments available, including both medication and procedures such as uterine artery embolisation (UAE).

At Happiher, we develop personalised treatment plans for each woman. Options include:

• Hormonal management is often the first line of treatment for adenomyosis.

• The pill, progestogen-only methods, or the Mirena coil (IUS) to reduce bleeding and pain

• Hormone-regulating medications to slow or suppress the activity of misplaced endometrial tissue

Pain Management in Adenomyosis

Addressing patients' concerns about pain is a crucial part of managing adenomyosis.

Non-steroidal anti-inflammatory drugs (NSAIDs) are often the first line of treatment for managing pain associated with adenomyosis. These medications help reduce inflammation and alleviate pain, making daily activities more manageable.

Antispasmodics and lifestyle strategies to ease cramps and improve comfort can also be beneficial. Techniques such as regular exercise, heat therapy, and dietary adjustments can play a significant role in reducing discomfort and enhancing the quality of life for patients.

Minimally Invasive Surgery

For severe cases, or when adenomyosis is causing structural changes or complications, surgery may be an option. Surgeons play a key role in performing minimally invasive procedures for adenomyosis. Dr Kaur specialises in:

• Laparoscopic (keyhole) surgery

• Robotic-assisted procedures, offering high precision with minimal recovery time

• Fertility-preserving approaches wherever possible

In rare, extreme cases where symptoms are unmanageable and fertility is not a concern, hysterectomy may be considered — but this is a last resort and not the default recommendation.

Living with Adenomyosis

Adenomyosis can affect far more than just your periods. It can disrupt your sleep, your energy, your work, and your sense of self. But you don’t have to live in the dark with it. With the right care, you can feel better — and more empowered. A supportive team and comprehensive services are essential for managing adenomyosis effectively.

At Happiher, we combine advanced diagnostics with empathetic care, giving you a clear plan and the support to feel confident about your body again.

Follow Up and Support

After adenomyosis has been diagnosed, follow-up appointments with a private gynaecologist are crucial to monitor the condition and adjust treatment options as needed. Women with adenomyosis may experience symptoms such as pelvic pain, heavy bleeding, and painful periods, and may require ongoing support and care. Mefenamic acid or other painkillers can help alleviate symptoms, and hormone medication may be prescribed to help control bleeding. In some cases, surgery, such as a hysterectomy, may be necessary to treat adenomyosis. Private gynaecologists can provide high-quality care and support to women with adenomyosis, helping them to manage their symptoms and improve their quality of life. Regular appointments and follow-up care can help women with adenomyosis to take control of their condition and make informed decisions about their treatment options. Contacting a specialist or private gynaecologist in London can provide women with access to exceptional care and treatment for adenomyosis. (Keep keywords: painful periods, private gynaecologists, exceptional care, heavy bleeding, high quality care, treatment options, pelvic pain, follow up, mefenamic acid, treatment, appointments, women, symptoms, pain, surgery, hysterectomy, medication, adenomyosis, bleeding, life, london, diagnosed, treat, access, specialist, quality, control, painkillers)

Why Choose Happiher?

If you’re looking for an adenomyosis specialist in London, here’s what you can expect at Happiher:

• A gynaecologist who listens and believes your symptoms

• Specialist imaging and diagnostics

• Minimally invasive and robotic-assisted treatment options

• A holistic approach to your physical and emotional wellbeing

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

Next day appointments are often available. Contact Happiher for more information.

Final Thoughts

If you’ve been living with pain, heavy bleeding, or exhaustion every month, don’t wait any longer to find answers. Adenomyosis is real, and so is the relief that comes with expert, compassionate care.

Whether you’re exploring your symptoms for the first time or looking for a second opinion, Happiher is here to help — without judgment, without delay.