Adenomyosis: The Little-Known Condition That Can Cause Heavy, Painful Periods

Heavy, painful periods are a fairly common problem. One in five women experience heavy periods, and as many as half of all women have some kind of menstrual pain, a condition known as dysmenorrhea.

Painful and heavy periods can have many causes, including endometriosis, fibroids, and ovarian cysts. These conditions are fairly well-known. But there’s another cause that many women have never heard of: adenomyosis.

At Women’s Healthcare of Princeton in Princeton, New Jersey, our team of care providers, led by Dr. Maria Sophocles, has extensive experience diagnosing and treating a full range of conditions, including adenomyosis, that can cause menstruation-related symptoms. We’ve prepared this information about adenomyosis to share with you.

Thickened uterine walls

Adenomyosis occurs when the walls of your uterus thicken. This thickening happens when endometrial tissue that lines your uterus extends beyond where it should be and grows into the muscle that makes up the outer uterine walls.

As your uterine walls become thicker, the uterus may actually increase in size. 

In addition to heavy, painful periods, adenomyosis can cause pain during sex and chronic pain throughout the pelvic area. Women with adenomyosis sometimes find that their menstrual pain – which some describe as knife-like – gets worse over time.

Who gets adenomyosis?

Although any woman can develop adenomyosis, it is more likely to occur if you are over 40, have given birth, or have had uterine surgery, including a C-section, fibroid surgery, or a D&C (dilatation and curettage).

Treating adenomyosis

Diagnosing adenomyosis or other causes of heavy, painful periods starts with a pelvic exam. During the exam, we look for an enlarged uterus or other signs of uterine problems.

If we suspect adenomyosis, we may order diagnostic tests such as an ultrasound or MRI. Other conditions such as endometriosis and uterine fibroids have symptoms that are similar to those of adenomyosis, and diagnostic testing can give us the information we need to make a precise diagnosis.

Treatment options

Adenomyosis usually resolves on its own after menopause. Until then, treatment options include:


Over-the-counter anti-inflammatory medications, such as ibuprofen, may help relieve adenomyosis pain.

Hormone treatment

The hormones in hormone-containing birth control, such as the pill, a vaginal ring, or a patch, may help control bleeding and pain.


If your pain and bleeding are severe, and you’ve completed your family, we may recommend a hysterectomy. At Women’s Healthcare of Princeton, we offer minimally invasive laparoscopic and robot-assisted surgery that offers many benefits, including smaller incisions and faster recuperation than open surgery.

Relief for your menstrual symptoms

If you have painful, heavy periods – or any other menstrual issues that are interfering with your life – it’s important to have them evaluated. To make an appointment for an exam with one of our trusted providers at Women’s Healthcare of Princeton, call our office at 609-246-5541 or use our online booking tool.

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