What's the difference between adenomyosis and endometriosis?

·5-min read
Photo credit: Yuri Arcurs peopleimages.com - Getty Images
Photo credit: Yuri Arcurs peopleimages.com - Getty Images

Thanks to celebrities like Molly-Mae Hague and Halsey, who have spoken honestly about their experience with endometriosis (a condition where tissue similar to the lining of the womb starts to grow in other places, such as the ovaries and fallopian tubes), more people than ever are aware of it. Other symptoms can include fatigue, debilitating period pain, pain during sex and bladder issues.

But, as society learns more about endometriosis , there still seems to be some confusion around adenomyosis, a condition with some similar symptoms that affects roughly one in 10 people of reproductive age, according to the NHS.

Adenomyosis vs endometriosis

To find out more about the symptoms of adenomyosis and endometriosis – and to uncover the key differences between the two conditions – we spoke to Dr Nitu Bajekal, consultant gynaecologist and co-author of Living PCOS Free.

What is adenomyosis?

"Adenomyosis is an oestrogen-dependent chronic inflammatory condition that can affect women and those assigned female at birth (AFAB) at any age," Dr Bajekal tells Cosmopolitan UK. But, she adds, "It is more [common] in the second half of their reproductive phase (late 30s, 40s and 50s)."

Explaining what exactly adenomyosis is, Dr Bajekal continues: "In adenomyosis, some of the lining (endometrium) of the womb (uterus) that sheds every month burrows itself deep into muscle wall (myometrium) of the womb and continues to grow and bleed each month, enlarging the womb."

As for what causes adenomysis, the expert says: "The reasons for developing adenomyosis are not entirely clear, but some of the risk factors include caesarean sections and previous treatment to the lining of the womb such as treatment of fibroids and childbirth."

Adenomyosis symptoms

  • Painful and/or heavy periods

  • Chronic pelvic pain

  • Painful intercourse

  • Anaemia

  • Tiredness and fatigue

  • Low iron stores

  • A bulky enlarged uterus which is quite tender on internal examination

Adenomysosis treatment

Adenomysosis, Dr Bajekal points out, is not life threatening or cancerous, "but it can impair quality of life significantly." As such, there are a number of treatments available to help those suffering with the condition.

"Many women and those AFAB benefit from an intrauterine device containing progesterone – this stops or lightens periods and prevents the lining from growing as much," the expert explains. "The contraceptive pill, both the combined and progesterone pill, may help in some situations too," she adds, noting that some people may choose to have their womb removed (hysterectomy) later in life. "This is a major operation and not without risks," Dr Bajekal says, noting that those considering this route will need to discuss options with their doctor before proceeding.

Photo credit: Zoran Mircetic - Getty Images
Photo credit: Zoran Mircetic - Getty Images

In addition to medical treatment, the expert tells us there are a number of "lifestyle modifications" that can help soothe andemyosis symptoms. These include "eating an abundance of whole plant foods (fruits, green leafy vegetables, intact whole grains, legumes, herbs and spices, nuts and seeds), weight loss where indicated, addressing sleep, managing stress, avoiding smoking and alcohol and doing regular exercise to reduce excess oestrogen levels, normalise hormone levels and reduce inflammation."

What is endometriosis?

Endometriosis on the other hand, explains Dr Bajekal, is when: "Tissue similar to the endometrial lining, that grows and bleeds with each menstrual cycle, is found outside the uterus."

This abnormal tissue, she adds, "causes endometriotic deposits on the back of the womb, bowel and ovaries, often creating scarring, pelvic adhesions and ovarian cysts." Rarely, the expert points out, "endometriosis can be found in distant places such as the lung, nose or on caesarean section scars."

The condition is not uncommon, affecting at least one in 10 people of reproductive age, as well as up to 70% of people who are undergoing investigation for chronic pelvic pain. "Increasing prevalence of endometriosis may be attributed to a combination of delayed childbirth, better diagnosis, environmental factors, pesticides, and changes in diets, especially an increase in saturated fats found almost exclusively in animal-derived foods, especially red meat," the expert adds.

Endometriosis symptoms

  • Painful and/or heavy periods

  • Pelvic pain

  • Painful sex

  • Bowel issues

  • Urinary symptoms

  • Infertility

Endometriosis treatment

Treatment for endometriosis can include having a laparoscopy (a type of keyhole surgery) to investigate what's going on inside the abdomen, particularly the womb, fallopian tubes, ovaries, bladder and bowel. After the procedure, doctors will decide the best course of action moving forward which may include removing scar tissue or having a hysterectomy.

"Some women will benefit from going on to hormonal contraception if fertility is not desired immediately to manage the symptoms of endometriosis," Dr Bajekal adds.

Are adenomyosis and endometriosis the same?

Explaining the key differences between the often misunderstood conditions, Dr Bajekal tells us that adenomyosis tends to affect older women (although, not always), whilst endometriosis more so impacts younger women. As well as that, "endometriosis is defined as the deposition of tissue outside the womb (even in places like a wound or in the lungs) and has a more detrimental effect on fertility," she adds.

Photo credit: Maskot - Getty Images
Photo credit: Maskot - Getty Images

As for why people sometimes get adenomyosis and endometriosis mixed up, the expert notes: "They are quite similar and often co-exist. There is a difference [between them] although symptoms can be very similar, and both are oestrogen-dependent conditions."

What to do if you think you have adenomyosis or endometriosis

"My advice to women and those AFAB is to track their menstrual cycles, make a note of symptoms and see a doctor," the expert advises, noting that it can be difficult to get a diagnosis for such conditions – shockingly, on average it can be as long as seven years for endometriosis – as "painful periods are often not taken seriously." Because of this, it's important to be aware of your body and the symptoms you're experiencing, and to be persistent when it comes to seeking support from your doctor.

This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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