What’s the Difference between Adenomyosis and Endometriosis?

At first glance, both adenomyosis and endometriosis are gynaecological conditions that affect the tissue lining of the uterus, called the endometrium. They are both painful and debilitating, severely affecting the lives of women who suffer from them, and, in many cases, causing a barrier to fertility. In the past, both conditions were thought to be parts of the same disease, but the truth is that adenomyosis and endometriosis affect the body in very different ways. They cause distinctive internal symptoms, often impact different age groups, and require diverse treatment plans. We take a closer look at both conditions and the key differences between them below.

What is adenomyosis?

Adenomyosis is a painful condition, where the lining of the uterine wall (the endometrium) breaks through the muscle wall of the uterus (the myometrium). This can affect just one part of the uterus or the whole structure. It causes swelling of the uterus, heavy, painful periods and severe cramping. It can also cause discomfort or pain during sex.

Who is at risk from adenomyosis?

Adenomyosis can affect women at any age in their reproductive period but is most common in women in their 40s and 50s. It often occurs after women have already had children. Women who have had previous uterine surgery, like a caesarean, are more at risk from adenomyosis.

What is endometriosis?

Endometriosis is a condition where the cells that line the womb, the endometrium, start to grow outside the womb. These can often be found on the ovaries and the fallopian tubes. Although this uterine tissue is outside the womb it still behaves like normal endometrium cells, in that it breaks down and bleeds. This blood has nowhere to go and can cause inflammation and scarring. Women suffering from endometriosis may experience extremely painful cramping and abnormally heavy bleeding during their period. They may also have pain during sex or going to the toilet and experience difficulty trying to conceive.

Who is at risk from endometriosis?

Endometriosis can impact women at any age in their reproductive years although it is most common in women who are yet to give birth aged between 20 and 40. There is thought to be a genetic component to endometriosis with women more likely to be affected if their mothers or other members of their family have the disease.

What are the key differences between Adenomyosis and Endometriosis?

Although both these gynaecological conditions affect the uterus, they are defined by some distinct differences. These include:

Location

Adenomyosis occurs in the uterus exclusively. Endometriosis can affect the fallopian tubes, ovaries, intestines and other organs. This means endometriosis can, if untreated, cause irreparable damage outside of the uterus.

Related Medical Issues

Women suffering from adenomyosis are less likely to have associated health issues. While endometriosis sufferers have a higher likelihood of developing fibromyalgia, chronic fatigue, and other diseases.

Diagnosis

Adenomyosis is usually diagnosed after an ultrasound or hysteroscopy. Endometriosis is often much more difficult to diagnose and may require further tests including a laparoscopy (a small surgery where a camera is inserted through the uterine wall).

Onset of Symptoms

Adenomyosis symptoms usually present much more rapidly than the symptoms of endometriosis. Endometriosis often develops slowly over many years with symptoms not becoming acute until the later stages of the disease. This is one of the reasons that diagnosis of endometriosis is so complex.

Age

Both adenomyosis and endometriosis can occur in women at any age during their reproductive life. However, adenomyosis is more likely to affect older women who have already had children whereas endometriosis is more common in women in their 20s and 30s who are yet to give birth.

Treatment

Hormonal and anti-inflammatory drugs are often used to treat adenomyosis. In endometriosis, conservative treatment is usually only effective in its early stages (often before diagnosis). Therefore, surgical intervention is more likely to be required.

What should I do if I think I may be suffering from adenomyosis and endometriosis?

If you are suffering from any of the symptoms described above, then you should make an appointment to speak to a doctor or gynaecologist about your concerns as soon as possible. They can perform a range of tests to diagnose these conditions, and, if necessary, discuss appropriate treatment options.