Whilst many people have heard of or been diagnosed with endometriosis, it’s lesser known ‘twin’ adenomyosis (pronounced ah-duh-no-mai-oh-sus) remains a mystery to most. So what is adenomyosis, and how does it differ from its sister condition?
Endometriosis
Endometriosis is a condition that causes endometrial tissue similar to the lining of the uterus (the one that you shed during your period) to grow outside of the uterus. These growths can occur on on the ovaries, pelvic tissue, abdomen and other places in the body including the lungs and chest in rarer cases.
The symptoms of endometriosis are wide and varying, though generally manifest as the following:
- Painful periods
- Excessive bleeding
- Pain during sex
- Gastrointestinal issues like constipation, diarrhea and bloating
- Fertility problems
- Mental and emotional issues like depression, brain fog or difficulty concentrating
Endometriosis affects an estimated 5-10% of women of reproductive age and up to 50% of women who are infertile.
Adenomyosis
Much lesser spoken about or researched, adenomyosis is a condition that causes the lining of the uterus to grow into the muscular wall of the uterus, rather than the uterus itself. This tissue then continues to act as it normally would during your menstrual cycle, thickening before your period before shedding and bleeding during it.
This can cause the following symptoms, many of which overlap with endometriosis:
- Enlarged uterus
- Heavy bleeding during periods
- Long periods (5 days or more)
- Severe, sharp pelvic pain
- Bloating and abdominal pressure
- Pain during sex
- Fertility problems
Around 1 in 3 people with adenomyosis do not experience any symptoms at all, meaning that it is often very difficult to diagnose.
The Difference
Whilst in many ways similar, with often overlapping symptoms, the two conditions are distinct in a number of different ways.
Where the Tissue Grows
The main thing to think about when establishing the difference between endometriosis and adenomyosis is where exactly the rogue endometrial tissue is growing. Where with endometriosis, it grows outside of the uterus, adenomyosis grows inside the uterus, though within its muscular wall. With the latter, the cells never go outside of the uterus, however with endometriosis they can grow in many other places in your body.
Symptoms
Whilst the way that people experience both illnesses can be extremely similar, those with adenomyosis are more likely to experience symptoms that are related to their period or more localised to the area of the uterus. This can often (but not always) mean that they do not have symptoms outside of their menstrual cycle. Adenomyosis sufferers are also more likely to experience heavy and extended periods, and less likely to receive a diagnosis as their symptoms are seen as ‘normal’ periods.
Endometriosis symptoms can be somewhat more wide-reaching depending on where the tissue is growing within the body. This can mean that the symptoms and pain are present throughout the whole menstrual cycle and are not necessarily related to it. People with endometriosis are more likely to experience somewhat ‘random’, non-gynaecological symptoms like nausea, diarrhea, constipation and pain in other parts of the body.
Diagnosis
Due to the fact that adenomyosis grows inside the uterus, it can often be diagnosed either via ultrasound or a Magnetic Resonance Imaging (MRI) scan to examine the uterus and uterine wall from the outside.
Endometriosis can only be diagnosed with a laparoscopy, a surgical procedure involving examining the abdomen to see where the endometrial tissue is growing. Surgeons need to see where the endometrial tissue is growing to be able to confirm that it is in fact endometriosis, though many gynaecologists can make a semi-firm diagnosis based on the symptoms and areas of pain outside of surgery.
