What is the Difference Between Endometriosis and Adenomyosis?

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.