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What is the Difference Between Endometriosis and Adenomyosis?

Allison Boelcke
By Allison Boelcke
Updated May 17, 2024
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Endometriosis and adenomyosis are two gynecological conditions that both affect the endometrium, the lining of the uterus. Endometriosis is a condition in which the endometrium abnormally develops outside of the uterus, while adenomyosis is a condition in which the endometrium grows into the muscular walls of the uterus instead of lining the outside of the uterus.

Although neither of the conditions’ causes are known for certain, one of the main differences between endometriosis and adenomyosis are the possible causes. Retrograde menstruation, a condition in which menstrual blood moves back up into the fallopian tubes instead of exiting the body, is thought to be one of the primary factors in causing endometriosis. There is not as much agreement on the causes of adenomyosis, but typically the causes are thought to be related to uterine damage from childbirth or surgery.

Endometriosis and adenomyosis may share some symptoms, but they also usually have different symptoms that make them distinctive from one another. The symptoms of endometriosis often include severe pelvic cramps, especially during menstruation, pain during and after intercourse, heavy menstrual periods or bleeding between periods, and infertility. Adenomyosis may not cause any symptoms in some women with the condition, but if it does, one of the symptoms that differentiates it from endometriosis is a swollen or tender lower abdomen. Endometriosis may also lead to infertility and tends to occur in women who have never given birth, while adenomyosis more commonly develops after childbirth.

Treatment options for endometriosis and adenomyosis tend to be similar; however, women with endometriosis will generally be more likely to require more serious treatment options than those with adenomyosis. The symptoms of both of these conditions may be relieved with the use of over-the-counter pain relievers or hormonal birth control methods. Women with endometriosis who experience severe debilitating pain or interfertility may opt for surgery to remove the excess endometrial tissue outside of the uterus to improve their chances of conceiving a child.

Since adenomyosis usually occurs after childbirth and subsides with menopause, women may not feel as much of a need to have the condition surgically treated, especially since it doesn’t tend to affect fertility like endometriosis does. Adenomyosis can be definitively treated with a hysterectomy, a procedure in which the uterus is surgically removed, because the excessive tissue growth only occurs inside of the uterus itself. Endometriosis may persist after a hysterectomy, since the endometrium tissue grows outside of the uterus.

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Discussion Comments

By fify — On Jun 13, 2013

@feruze-- Different pain and inflammation reducing drugs for pelvic pain treatment and hormone therapy for menstrual irregularities are usually given for both endometriosis and adenomyosis.

My aunt had endometriosis and she was suffering a lot. Since she didn't plan to have any more kids, she had a total hysterectomy. Unless, you want more kids, removal of the uterus and or ovaries is the most effective treatment for endometriosis.

By SarahGen — On Jun 13, 2013

@feruze-- It is possible to have them together, but what makes you think that you have either or both of these conditions? Have you had a pelvic exam and ultrasound?

In addition to these, a laparoscopy is usually needed to diagnose endomemtriosis and an MRI is needed to diagnose adenomyosis. You can't know if you have either of these conditions simply from symptoms.

If you have pelvic pain during intercourse, menstruation and urination, it might be endometriosis. Rarely, adenomyosis can cause these symptoms as well but like the article said, it causes no symptoms or only mild symptoms in most women. You need to see a doctor about your symptoms.

By bear78 — On Jun 12, 2013

Is it possible to have both endometriosis and adenomyosis? What is done in that situation?

I have had abdominal pain and pelvic pain for some time and I have very heavy periods.

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