While endometriosis has gained widespread attention in recent years, another equally painful and prevalent condition—adenomyosis—remains largely unknown. Despite affecting millions of women, adenomyosis often goes undiagnosed, leaving many to suffer in silence. Experts say it’s time to change that.
Dr. Ananya Rao, a gynecologist specializing in chronic pelvic pain, says awareness is key. “Adenomyosis is not rare. It’s just rarely talked about,” she explains. “We need to empower women to know when something is wrong with their periods and to seek proper care. Heavy periods might be common, but they are not always normal.”
What Is Adenomyosis?
Adenomyosis occurs when the tissue that lines the uterus grows into the muscle wall of the uterus. This causes the uterus to become swollen and inflamed, leading to heavy or long-lasting periods, severe cramps, bloating, pelvic pressure, and fatigue.
Many women describe the pain as constant and intense. It often disrupts their ability to work, socialize, or perform everyday tasks. Unlike typical period pain, discomfort from adenomyosis can last throughout the entire menstrual cycle.
Though similar to endometriosis—which involves tissue growing outside the uterus—adenomyosis affects the uterine muscle itself. The two conditions can exist together, making diagnosis even more difficult. But while awareness of endometriosis has grown, adenomyosis remains under-researched and under-discussed.
How Common Is It?
Globally, up to 10% of women may have adenomyosis, a rate similar to endometriosis. In India, the condition is particularly common among women undergoing hysterectomies for abnormal bleeding.
A study in Pondicherry found that more than half of such women had adenomyosis. Other studies from Kerala and South India showed prevalence rates ranging from 16% to 24%. Most affected women are between 41 and 50 years old—those in the perimenopausal stage.
The most common symptoms include heavy bleeding, pelvic pain, and severe cramping. However, some women—around 7%—experience no symptoms at all.
Symptoms Often Ignored
Many women are told that heavy bleeding or severe cramps are “just part of being a woman.” Some are advised to take painkillers or to relax and not worry. This downplaying of symptoms leads many to accept their pain as normal.
This pattern is part of what doctors call the “female pain bias.” It refers to the tendency to dismiss women’s pain or treat it as less serious. It contributes to delays in diagnosis and limited treatment options for many gynecological conditions.
Why the Silence?
There are several reasons why adenomyosis remains hidden. First, medical research has historically focused more on male bodies, leaving female-specific conditions behind. Second, diagnosing adenomyosis without surgery is difficult, as there are no widely used non-invasive tests.
Cultural taboos also play a role. In many places, including India, menstruation is still considered a private or shameful topic. This makes it harder for women to talk about period-related pain or demand proper care.
In short, adenomyosis is ignored because women’s health and pain are still not taken seriously enough.
Treatment Options
There is no single cure for adenomyosis, but several treatments can help manage it:
- Hormonal therapy: Birth control pills, hormone-releasing IUDs, and medications like GnRH agonists can ease symptoms, but don’t cure the disease.
- Pain relief: NSAIDs such as ibuprofen may help, though often not enough.
- Surgery: In serious cases, options like endometrial ablation, uterine artery embolization, or hysterectomy may be considered.
Because a clear diagnosis often happens only after a hysterectomy, many women spend years trying different treatments before finding lasting relief.
Why We Need More Awareness
Better awareness of adenomyosis can change lives. When women know what’s happening in their bodies, they can ask the right questions, get earlier diagnoses, and receive better care.
Most importantly, they can stop feeling alone.
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