--- title: "Adenomyosis" description: "How adenomyosis affects the womb, what scans can show, and the treatment choices for pain and heavy bleeding. Includes when to get help, with UK and US notes." url: "https://myruva.co/learn/adenomyosis" language: "en-GB" topic: "Symptoms" published: "2026-10-18" updated: "2026-10-19" author: "Ruva team" reading_minutes: 4 --- # Adenomyosis How adenomyosis affects the womb, what scans can show, and the treatment choices for pain and heavy bleeding. Includes when to get help, with UK and US notes. *Written and reviewed by the Ruva team · Updated 2026-10-19 · Symptoms* ## Key points - In adenomyosis, the lining of the womb grows into its muscle wall. - It can cause heavy, painful periods, but some people have no symptoms. - Ultrasound scans, and sometimes MRI scans, help clinicians check for adenomyosis. - Treatment choices depend on your symptoms and whether you want a pregnancy in future. Heavy periods and pain can be part of adenomyosis. This is a condition where the lining of the womb grows into the womb’s muscle wall. Some people have no symptoms. Others have pain bad enough to stop them doing everyday things. Treatment depends on how it affects you. ## Where adenomyosis happens The womb (uterus) has an inner lining and an outer layer of muscle. Adenomyosis affects that muscle layer. Endometriosis is a different condition. In endometriosis, tissue like the womb lining grows outside the womb, for example around the ovaries. The names sound alike, but they describe problems in different places. No one knows what causes adenomyosis. It is benign, which means it isn’t thought to lead to cancer. Symptoms can include heavy or painful periods, pain in the pelvis between periods, a feeling of fullness or bloating, and pain during sex. A clinician can look into these symptoms and check for other causes. ## What an appointment and scan involve A GP may ask about your periods, feel your tummy and talk to you about an internal examination. You can ask for a friend, family member or another member of staff to be in the room. Say what you’re comfortable with before the examination starts, and ask the clinician to explain what they’re checking. An ultrasound scan is usually the first test for adenomyosis. A scan through the vagina and an MRI scan can both help find it. MRI may help if an ultrasound hasn’t given enough information. The scan is one part of the check. Ask the clinician how the results fit with your symptoms. You may read that adenomyosis can only be confirmed after a hysterectomy (removal of the womb). MedlinePlus explains the difference between confirming it by looking at tissue from a removed womb and assessing it from symptoms and scans. UCLH describes ultrasound and MRI as ways to diagnose it. This guidance doesn’t say you normally need surgery to collect tissue before you can get care. ## Options for bleeding and pain If a scan suggests adenomyosis but you have no symptoms, you may not need treatment. If symptoms are bothering you, options include anti-inflammatory painkillers and tranexamic acid for heavy bleeding. Your pharmacist, GP or doctor can tell you whether these suit you. Follow the leaflet and any prescription instructions. Hormone treatment is another option. A hormonal coil, called an IUS in UK guidance, can make periods lighter and less painful. If a coil doesn’t suit you or you don’t want one, you can ask about other hormonal contraception. A heat pad, or a hot water bottle wrapped in a tea towel, may help with pain alongside your treatment. ## When specialist treatment is considered If the first treatments don’t help, ask about specialist options. A hysterectomy removes the womb and can cure adenomyosis. But it is major surgery, and it means you can’t carry a pregnancy in future. UCLH describes it as a last resort. Say if keeping your womb matters to you, including if you’re unsure about pregnancy. Symptoms often settle after menopause. That can be part of the treatment discussion, along with what you prefer and how well past treatments have worked. Ask what a treatment aims to improve and what its risks are. You can also ask about other options if you decide against it. Book a GP appointment (UK), or see your doctor (US or elsewhere), for any vaginal bleeding after menopause, even a small amount or bleeding that happens once. Don’t assume adenomyosis is the cause. ## Getting help for pain or changing bleeding Call 999 now (UK) or 911 (US), or your local emergency number, if pain in your pelvis comes with feeling faint, difficulty breathing or heavy vaginal bleeding, or is severe or getting worse. Also call for heavy vaginal bleeding with feeling faint, collapse or difficulty breathing, even without pelvic pain. Get help today from NHS 111 or an urgent GP service (UK), or your doctor or urgent care service (US or elsewhere), if period pain is worse than usual and painkillers haven’t helped. Do the same if you have pain in your pelvis and are or could be pregnant, or if the pain comes with a very high temperature or feeling hot, cold or shivery. Use emergency care for the symptoms above. Book a GP appointment (UK), or see your doctor (US or elsewhere), for heavier or more painful periods, pain during sex, or bleeding between periods or after sex. ## When to get help - **Emergency:** Call 999 now (UK) or 911 (US), or your local emergency number, if pain in your pelvis comes with feeling faint, difficulty breathing or heavy vaginal bleeding, or is severe or getting worse. Also call for heavy vaginal bleeding with feeling faint, collapse or difficulty breathing, even without pelvic pain. - **Same day:** Get help today from NHS 111 or an urgent GP service (UK), or your doctor or urgent care service (US or elsewhere), if period pain is worse than usual and painkillers haven’t helped. Do the same if you have pain in your pelvis and are or could be pregnant, or if the pain comes with a very high temperature or feeling hot, cold or shivery. Use emergency care for the symptoms above. - **Book an appointment:** Book a GP appointment (UK), or see your doctor (US or elsewhere), for heavier or more painful periods, pain during sex, or bleeding between periods or after sex. Also book an appointment for any vaginal bleeding after menopause, even a small amount or bleeding that happens once. ## Where you live Services and advice differ between countries. - **UK:** NHS guidance lists a hormonal coil (IUS), other hormonal contraception and medicines for bleeding or pain. - **US:** MedlinePlus describes hormonal birth control, pain medicines and hysterectomy for severe symptoms. - **Elsewhere:** Outside the UK and US, ask your local clinician which checks and treatments are available to you. ## Sources 1. [Adenomyosis](https://www.nhs.uk/conditions/adenomyosis/), NHS 2. [Adenomyosis](https://www.uclh.nhs.uk/patients-and-visitors/patient-information-pages/what-adenomyosis), University College London Hospitals NHS Foundation Trust 3. [Adenomyosis](https://medlineplus.gov/ency/article/001513.htm), MedlinePlus 4. [Pelvic pain](https://www.nhs.uk/symptoms/pelvic-pain/), NHS 5. [Recognizing medical emergencies](https://medlineplus.gov/ency/article/001927.htm), MedlinePlus 6. [Postmenopausal bleeding](https://www.nhs.uk/symptoms/post-menopausal-bleeding/), NHS --- This guide is general information to help you keep and use your own records. It isn’t medical advice. If you’re worried about a symptom, or something changes suddenly, talk to a doctor, nurse or pharmacist.