Adenomyosis: The Hidden Cause of Heavy, Painful Periods

Adenomyosis is a condition in which the endometrial tissue that normally lines the inside of the uterus grows into the muscular wall of the uterus itself (the myometrium). As a result, the uterus becomes enlarged and thickened, responding abnormally to the monthly hormonal cycle — causing heavy bleeding, severe cramping, and a swollen, tender uterus around menstruation.

Many women confuse adenomyosis with endometriosis because the symptoms overlap considerably. The key difference is location: endometriosis involves tissue growing outside the uterus, while adenomyosis involves tissue growing within the uterine muscle wall. Some women have both conditions simultaneously.

Common symptoms of adenomyosis include periods that are heavier or longer than normal, severe menstrual cramps (dysmenorrhea), chronic pelvic pain, a bulky or tender uterus, and a sense of heaviness or bloating in the lower abdomen. In some cases it can also affect fertility. Symptoms typically worsen with age and improve after menopause.

Diagnosis of adenomyosis can now be made with high-resolution ultrasound or MRI — no surgery required. At THE FIT CLINIC Bangkok, our urogynecology specialists are experienced in identifying adenomyosis and designing personalised treatment plans that may include hormonal therapies, the Mirena IUS, endometrial ablation, or surgical referral when appropriate.

If you have been living with heavy, painful periods for years and dismissing it as "just how you are," it is worth getting a specialist assessment. Treatable pain is not something you have to accept.