How to tell the difference between endometriosis and adenomyosis, according to a gynaecologist

If you’ve heard of endometriosis, it’s likely you may have heard of adenomyosis too. Both are endometrial conditions affecting the womb tissue. However, endometriosis and adenomyosis are not the same and understanding which condition you may be suffering from is key for getting the appropriate treatment you need.

Endometriosis is a condition that affects 1 in 10 women and in the UK it’s the second most common gynaecological condition. According to the NHS, adenomyosis similarly affects as many as 1 in 10 women of reproductive age but is usually more common in women aged 40-50 years who have had children.

In light of Endometriosis Awareness Month this March, intimate health expert Dr Shirin Lakhani breaks down exactly how to tell the difference between endometriosis and adenomyosis, including the varying symptoms and treatment options. 

What is endometriosis?

“Endometriosis is an often painful disorder where tissue similar to the lining of the uterus (your womb) grows in other places, such as in your ovaries, fallopian tubes and the tissue lining of your pelvis.

“The tissue acts like the tissue would do in the womb so it still breaks down and bleeds with the menstrual cycle but it cannot exit the body so it becomes trapped. It can lead to cysts, scar tissue and adhesions. It can cause extreme pain.

“Endometriosis is often not recognised by the health system and new statistics have revealed that 62 per cent of women would put off going to the doctor with symptoms of endometriosis and 47 per cent of the female population would be concerned to tell their employer they need to take time off due to their symptoms.”

There are currently 1.5 million UK women living with the condition and yet it takes on average eight years to be diagnosed. “This just isn’t acceptable,” says Dr. Lakhani.

“Endometriosis can be mistaken for other conditions, which also cause pelvic pain, such as ovarian cysts or pelvic inflammatory disease.”

What is Adenomyosis?

“Adenomyosis is a condition that causes the lining of the womb to bury into the muscular wall of the womb,” says Dr. Lakhani. The condition can affect the whole womb or a part of it.

“The displaced tissue continues to act normally — thickening, breaking down and bleeding — during each menstrual cycle and it can result in an enlarged uterus and heavy periods. It can cause your uterus to double or triple in size.”

What are the biggest similarities between endometriosis and adenomyosis?

“Both conditions can cause heavy menstrual bleeding and can lead to anemia from the heavy bleeding so iron supplements may help,” says Dr. Lakhani.

“It’s possible to have both conditions and doctors don’t know what causes either condition. Endometriosis can sometimes be diagnosed with an ultrasound or an MRI. The only way to know you definitely have it is with surgery so your doctor can look for endometrial tissue.

“With Adenomyosis, your uterus may feel bigger than usual and tender if you push on your stomach. It can be diagnosed with an ultrasound or MRI.