Adenomyosis is a condition that happens when endometrial tissues (uterus lining) grow into the muscular wall of the uterus. As the tissue has grown into the muscular layers of the uterus when you menstruate this tissue acts the same as it would if it were inside the uterus. This tissue will bleed and because there is nowhere for the blood to go it is trapped in little pockets within the muscular layers of the uterus. This disease affects women’s fertility, menstrual symptoms and is often associated with a high risk of miscarriage.

In one study, ultrasound data showed that 20.9% of women of the general population showed sonographic signs of adenomyosis. One third of women who may have adenomyosis have no symptoms, yet research is showing that women who are using assistance to get pregnant, 20-25% of them will have adenomyosis.
Adenomyosis differs from endometriosis in the fact that endometriosis is uterine tissue that is growing external to the uterus typically on other pelvic organs.

Signs and Symptoms

  • Painful periods/abnormal bleeding
  • Heavy periods
  • Iron deficiency leading to fatigue and dizziness.
  • Painful sex
  • Chronic pelvic pain

The cause of Adenomyosis is unknown, no one single theory can explain the disease. However, for this condition to occur oestrogen is required. Therefore, women in their reproductive years are most affected.

Diagnosis of Adenomyosis

  • Transvaginal ultrasound performed by a trained gynaecologist
  • MRI to exclude other conditions such as fibroids.

There is no one test that has been agreed upon to diagnose adenomyosis. The only way to 100% confirm would be to do a pathological test on a uterus removed via hysterectomy.


  • Exercise
  • Acupuncture
  • Anti-inflammatory medications
  • Mirena IUD
  • Contraceptive pill
  • Endometrial ablation
  • Laparoscopic removal of adenomyosis

Surgery is a difficult option and it may not reduce pain or bleeding. Removal of the uterus (hysterectomy) is the gold standard treatment if you do not wish to have children. If you were wishing to have a future pregnancy, surgery isn’t the best option for yourself.

As a women’s health physiotherapist there is space for us in the management of the symptoms of endometriosis. Yes, the pathology behind the two are different but when it comes to managing pelvic pain and painful sex there are some tools in our toolbox that may give you some benefits. We are trained in helping your pelvic floor muscles work with your body not against it and ensuring that with training, you may experience some symptoms relief in terms of ongoing pelvic pain.

Our experienced physiotherapists at Bump are always here to help you on your journey and improve your quality of life. Get in touch today!


  • Adenomyosis is a growing of endometrial tissue into the muscular layers of the uterus
  • Symptoms include: abnormal/heavy bleeding, painful periods, chronic pelvic pain, painful sex
  • Good evidence for adequate diagnosis via transvaginal ultrasound or MRI
  • Main treatment is removal of uterus for after reproductive years however management via Mirena, hormonal birth control and pain relief can manage symptoms.
  • Physiotherapy can assist with managing symptoms of pelvic pain and complete a pelvic floor retraining program if assessed as necessary