A condition many people haven’t heard of
Most people have heard of endometriosis, but ask the same group about adenomyosis and you’ll often get a blank look. The two conditions have some symptoms in common, they sometimes coexist, but they’re distinct and they often need different approaches to management.
Adenomyosis is gradually getting more recognition, and that’s a positive thing. Greater awareness means more people speak with their doctor about heavy or painful periods rather than putting up with them. As an independently owned ultrasound clinic with locations in Jindalee and Springfield Central, we regularly perform scans for patients being investigated for adenomyosis. Here’s what we’d like you to know.
What is adenomyosis?
Adenomyosis is a condition where tissue similar to the lining of the uterus (the endometrium) is found within the muscular wall of the uterus (the myometrium). With each menstrual cycle, this tissue can respond to hormones, contributing to inflammation, an enlarged uterus, and symptoms such as heavy bleeding and pain.
Adenomyosis can be focal, where the affected tissue is in one localised area, or diffuse, where it’s spread more broadly through the uterine wall. Both presentations can show characteristic features on ultrasound when they’re assessed carefully.
Symptoms to be aware of
Symptoms of adenomyosis vary, and some people have no symptoms at all. Common features that lead patients to see a doctor include:
Heavy menstrual bleeding, sometimes with clots
Painful periods, particularly cramping that worsens over time
Chronic pelvic pain or pressure, sometimes between periods
A bloated lower abdomen or a feeling that the uterus is enlarged
Pain with intercourse
Difficulty falling pregnant or recurrent pregnancy concerns
These symptoms aren’t unique to adenomyosis. They overlap with conditions including fibroids, endometriosis and polyps. That’s exactly why imaging plays a role in helping clinicians work through the possibilities.
How pelvic ultrasound supports the work up
Transvaginal pelvic ultrasound is one of the main imaging tools used in adenomyosis assessment. When performed thoroughly by an experienced sonographer, it can identify features such as an asymmetrically thickened uterine wall, small cysts within the myometrium, irregularities at the junctional zone, and a globular shape to the uterus. These features support the clinical picture rather than providing a stand-alone diagnosis.
In some cases, MRI may be requested in addition to ultrasound, particularly if the uterus is very enlarged or if surgical planning is needed. Your referring doctor will advise on whether further imaging is helpful in your situation.
What to expect at your scan
Pelvic ultrasound for suspected adenomyosis is generally performed both externally and transvaginally. The internal portion of the scan provides the level of detail needed to assess the uterine wall properly, so it’s usually an important part of the assessment.
Before we begin, your sonographer will ask about your symptom history, your menstrual cycle and any previous investigations. Bringing previous reports or images is helpful, particularly if you’ve had earlier scans showing fibroids or other findings.
The scan itself usually takes around 30 minutes. We’ll explain what you’ll feel, give you privacy to change, and only proceed once you’re comfortable. You can pause or stop at any point.
What ultrasound can’t tell us
As with endometriosis, a normal looking pelvic ultrasound doesn’t entirely rule out adenomyosis. Some forms can be subtle, and in some cases, imaging features and symptoms don’t line up neatly. Your doctor will pull together the picture from your symptoms, examination, our report, and any other tests they’ve ordered.
Our role isn’t to label what you have. It’s to gather as much accurate, useful imaging information as possible, so the doctor caring for you has clearer ground to stand on when they discuss next steps with you.
Treatment options exist
Adenomyosis is generally manageable, and there are options. These can include hormonal treatments, pain management strategies, lifestyle approaches, hormonal IUDs, and in some cases, surgical procedures. The right pathway depends on your symptoms, your age, whether you’re trying to fall pregnant, and your personal preferences.
Discuss treatment options with your GP, gynaecologist or specialist. They’ll go through what each option involves, what the likely benefits and risks are, and what fits your circumstances best. Imaging is a piece of that conversation, not the whole conversation.
When to see a doctor
If your periods are interfering with daily life, if pain or bleeding has changed, or if you’ve been quietly putting up with symptoms because someone once told you they were normal, please consider booking an appointment with your GP. Period pain that stops you from going to school, work or your usual activities deserves medical attention.
Frequently asked questions
Is adenomyosis the same as endometriosis?
No, but they share similarities and they can occur together. Endometriosis involves tissue outside the uterus, while adenomyosis involves tissue within the uterine muscle wall.
Can ultrasound definitively diagnose adenomyosis?
Ultrasound can show features consistent with adenomyosis, but a single test rarely provides the whole answer. Your doctor will combine our findings with your symptoms, examination and other tests as needed.
Will the scan hurt if I already have a lot of pelvic pain?
It might be uncomfortable, particularly the transvaginal portion. Tell your sonographer how you’re feeling so they can adjust their approach.
Do I need a referral?
Yes, a current referral from a GP, specialist or eligible allied health practitioner is required.
Can I book at the new Jindalee clinic?
Yes, we’d love to look after you at our Jindalee location. Call (07) 3170 1352 or book online with your referral.
Awareness opens the door to better conversations
Adenomyosis Awareness Month, marked each April, is a reminder that period pain isn’t something to dismiss. If something doesn’t feel right, ask. If your first appointment doesn’t feel like enough, ask again. Diagnostic imaging is one of many tools that can help, and our team is here whenever a pelvic ultrasound forms part of your pathway.
