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  • Endometriosis and adenomyosis are both gynecological diseases that affect the tissue lining of your uterus, called the endometrium
  • Don’t be fooled by these similarities, though, as there are key differences that set endometriosis and adenomyosis from each other

Comparing Endometriosis to Adenomyosis


At first glance, it may seem like endometriosis and adenomyosis are similar conditions. They’re both gynecological diseases1,2 that affect the tissue lining of your uterus, called the endometrium.

Plus, the endometrial tissue in endometriosis and adenomyosis acts in a similar manner — it thickens, breaks down and bleeds during a woman’s monthly period.3,4

Not much is also known about what exactly causes endometriosis or adenomyosis, although several theories have been highlighted, such as retrograde menstruation, genetics, hormones, uterine inflammation (usually after childbirth) and adenomyoma or the invasive growth of abnormal tissues.5,6

Don’t be fooled by these similarities, though, as there are key differences that set endometriosis and adenomyosis from each other. Keep on reading to learn how to distinguish these two diseases apart.

Symptoms That You Should Watch Out For

If you have endometriosis, the tissue grows outside your uterus, in places such as your ovaries, bowel or among tissue lining your pelvis.7 Patients with adenomyosis have tissue that exists within and grows inside or into the muscular wall in your uterus.8

Most of symptoms of both endometriosis and adenomyosis are quite alike, which is why it can be difficult at first to diagnose which of these two conditions is affecting you or someone you know. Women with either of these conditions suffer from:9,10

Pain during sexual intercourse

Painful periods or dysmenorrhea (severe cramping or sharp and/or knife-like pelvic pain during menstruation)

Pelvic pain

Excessive, heavy or prolonged bleeding such as menorrhagia (occasional heavy periods) or menometrorrhagia (bleeding between periods)

With these similarities, there are also differences. If you notice that your lower abdomen seems bigger or tender, this is a major hallmark of adenomyosis, because your uterus enlarges. In some cases, women might have blood clots that pass during their periods.11 For women with endometriosis, they may experience infertility and other illnesses such as fatigue, diarrhea or nausea during their monthly period.12

Age Groups Usually Affected With These Conditions

Endometriosis and adenomyosis seem to target different age groups as well. Endometriosis commonly occurs in women between the ages of 30 and 40 who have not given birth yet.13 According to the University of California, Los Angeles (UCLA) Obstetrics and Gynecology department, endometriosis affects roughly 3 to 10 percent of reproductive-aged women.14

On the other hand, adenomyosis affects women who are 40 to 50 years old and have experienced childbirth and/or uterine surgery like a Caesarean section or fibroid removal.15

These Complications Could Be Catastrophic

Both of these diseases could spur complications if not diagnosed and treated immediately. Patients with endometriosis often experience:16,17

Formation of endometriomas: these are cysts that develop when the condition spreads to the ovaries. This occurs because the tissue does not have a way to exit your body. In other instances, the surrounding tissue could be irritated and trigger the formation of scar tissue and adhesions (abnormal tissue that binds your organs together).

Infertility: endometriosis may lead to women having difficulties in getting pregnant.18 It’s said that around one-third to one-half of women with endometriosis experience infertility.

Ovarian cancer or (rarely) endometriosis-associated adenocarcinoma: these diseases can develop later in life in women who have had endometriosis. However, the risk for ovarian cancer is already low to begin with.

If you have adenomyosis, you may be predisposed to:19,20

Chronic anemia: prolonged and heavy bleeding during your periods raises your risk for chronic anemia, which then causes fatigue, dizziness and moodiness. Anemia develops because your body’s iron levels are depleted when you shed blood. If your body has insufficient iron, production of red blood cells that carry oxygen to your body’s tissues is greatly affected.

Negative effects to your lifestyle: even if this condition is not extremely harmful, the pain that arises could prevent you from participating in normal activities.

Feelings of helplessness, depression and irritability: having adenomyosis can put a strain in your current relationships, and these could trigger the development of negative thoughts and feelings.

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