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Menstrual cramps, Painful periods | Is it endometriosis or adenomyosis?

UPDATED ON 08th AUG. 2023


Dr Jay Mehta

Scientific Director & IVF Specialist with 10+ years of experience




Dysmenorrhea is the medical term for menstrual cramps, described as throbbing or cramping discomfort in the lower abdomen. Menstrual cramps affect a significant percentage of women in the days leading up to and during their periods. 

Some women find the pain to be mild and irritating. Some women get severe menstrual cramps every month, making it difficult to function normally for a few days. It is not typical to have severe discomfort during your period. 

Adenomyosis and endometriosis are the leading causes of severe menstrual cramping in women. Let’s learn more about adenomyosis.

If you know about adenomyosis you can skip next section on difference between adenomyosis & endometriosis.

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What is Adenomyosis?

Adenomyosis is a disorder that occurs when the inner lining of the uterus (the endometrium) bursts through the muscular wall of the uterus (the myometrium).

Menstrual pains, lower abdomen pressure, and bloating before menstruation are all symptoms of adenomyosis, as are heavy periods.

There may be widespread involvement of the uterus, or it may be limited to a specific area.

Adenomyosis is not life-threatening, but the severe pain and bleeding it causes may significantly diminish a woman’s standard of living.

The severity of period discomfort, known medically as severe dysmenorrhea, worsens as adenomyosis progresses because of an abnormal increase in the thickness of the uterine muscles.

No medication can control muscle thickness; thus, the discomfort will only become worse as the muscle thickness develops.

Adenomyosis vs. Endometriosis | The Difference

Both adenomyosis and endometriosis are conditions affecting the uterine lining. Pain is a common symptom of both illnesses.

Adenomyosis is a leading cause of abnormally excessive menstrual flow. The location of endometrial tissue growth distinguishes these disorders.

  • Adenomyosis : 
    The uterine muscle is incorporated into the endometrial tissue over time.

  • Endometriosis : 
    The ovaries, fallopian tubes, pelvic side walls, and colon may all get involved when endometrial tissue spreads outside the uterus.

Symptoms of Adenomyosis

Many people with adenomyosis don’t experience any discomfort. Certain individuals go through:

  • Excessive menstrual bleeding (menorrhagia)
  • Irregular menstruation
  • Discomfort in the pelvic region
  • Discomforting sexual encounters (dyspareunia)
  • Infertility
  • Uterine enlargement

Many times, it also happens that some women have a lot of pain during periods, called dysmenorrhea.

Dysmenorrhea (period cramps) refers to pain associated with menstruation. This happens for two reasons:

Spasmodic dysmenorrhea occurs when a woman has painful menstrual cramps but cannot endure the contractions of her uterine muscle. Beginning on day one of your period, the pain will increase until it finally decreases.

During their periods, women experience severe discomfort. Adenomyosis and endometriosis are two of the most common causes of this.

Diagnosing of Adenomyosis

Adenomyosis may be diagnosed by a doctor based on the patient’s symptoms. Following are one or more tests a doctor can recommend:

  • Pelvic Exam :
    Your doctor may detect changes in the size, softness, or discomfort of your uterus during a pelvic exam.

  • Ultrasound :
    During a transvaginal ultrasound, the pelvic area is imaged using sound waves. Muscle thickening in these photos is suggestive of adenomyosis.

  • Imaging Scans :
    Uterine growth and thickening in particular places may be seen on MRI scans, which may be symptomatic of adenomyosis.

  • Biopsy :
    The only method to biopsy tissue is after a hysterectomy, which eliminates the uterus since tissue develops inside its walls.

If you want to know about treatments for adenomyosis, click here

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    Causes of Adenomyosis

    Unfortunately, the cause of adenomyosis is unknown. Numerous explanations have been proposed, such as:

    • Invasive Tissue Expansion : 
      Some researchers have hypothesized that endometrial cells from the uterine lining enter the uterine muscle. Endometrial cells may be more likely to invade the uterine wall immediately after a C-section, which involves making an incision in the uterus.

    • Origins in Early Development : 
      Some researchers believe that endometrial tissue is deposited in the uterine muscle during fetal development.

    • Birth-related Uterine Inflammation : 
      There’s also the possibility that adenomyosis occurs during pregnancy or after delivery. During the postpartum period, swelling of the uterine lining may disrupt the usual border of uterine lining cells.

    • Origins in Stem Cells : 
      Recent research suggests that stem cells from the bone marrow could infect the uterine muscle, leading to adenomyosis.

    Adenomyosis development depends on the amount of estrogen circulating in the body.

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    Risk Factors of Adenomyosis

    Adenomyosis may be caused by several things, some of which are:

    • Estrogen : 
      Menopause, a high body mass index, and hormone contraceptives may lengthen a woman’s contact with estrogen.

    • Age : 
      People of all ages are susceptible to developing this illness. Despite this, adenomyosis is often misdiagnosed until menopause or after a hysterectomy has been performed.

    • Pregnancy : 
      Most women who suffer from adenomyosis are mothers of more than one child.

    • Surgery : 
      Adenomyosis is more likely among women who have had uterine surgery, especially a cesarean section.


    The presence of adenomyosis may go unrecognized. Symptoms aren’t always present with the illness. Heavy periods, cramps, and painful sexual activity are just a few symptoms that may make daily living difficult.

    Discuss potential treatment options with your doctor. Medications targeting certain hormones may be useful. Removing the uterus (hysterectomy) cures the problem if you don’t want children.


    Dr Jay Mehta

    Scientific Director & IVF Specialist with 10+ years of experience



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