Adenomyosis vs Endometriosis: How Can Women’s Health Physio Help?

It starts off small. Maybe your period gets a little heavier than it used to be. You tell yourself it’s just stress, or hormones, or one of those months.

Then it happens again. And again.

You begin planning your days around it—wearing darker clothes, checking where the nearest bathroom is, cancelling plans when the cramps hit harder than expected. Some days feel manageable. Others completely throw you off.

You might even hear yourself say, “This is just how my body is.” But deep down, it doesn’t feel quite right.

For many women, this is what living with adenomyosis symptoms can look like. And when conditions like endometriosis and adenomyosis share similar symptoms, it can feel even more confusing to understand what’s really going on.

Adenomyosis and endometriosis are two common and often misunderstood conditions that can deeply impact a woman’s day-to-day life.

While these conditions can feel similar, understanding the difference between adenomyosis vs endometriosis is an important step towards finding the right support and finally feeling more in control of your health.

What is adenomyosis?

Adenomyosis is a benign (non-cancerous) condition where tissue similar to the lining of the uterus grows within the muscular wall of the uterus.

This can cause the uterus to become enlarged (often described as ‘bulky’ on an ultrasound), tender, and more reactive, especially during your menstrual cycle.

Adenomyosis is more commonly diagnosed in women in their 30s to 50s, particularly if you’ve had children or previous uterine procedures like a caesarean section.

It’s also important to know that endometriosis and adenomyosis can exist at the same time, which can make symptoms feel more intense or harder to pinpoint.

Adenomyosis symptoms

Not everyone with adenomyosis will have noticeable symptoms. But for many women, it can significantly affect daily life.

Common adenomyosis symptoms include:

• Heavy menstrual bleeding

• Prolonged periods with more days with darker light bleeding at the end

• Painful periods (that may worsen over time)

• Pain during sex (dyspareunia)

• Ongoing pelvic pain or pressure

• A feeling of heaviness or fullness in the lower abdomen

If your periods feel like they’re changing, becoming more intense, or starting to impact your routine, it’s worth paying attention to.

What causes adenomyosis?

What causes adenomyosis isn’t fully understood, despite how common it is.

Current theories include:

• Invasive tissue growth: Cells from the uterine lining grow into the muscle wall, sometimes linked to surgeries like C-sections

• Developmental origins: Tissue may be deposited in the uterus before birth

• Postpartum inflammation: Changes after pregnancy may disrupt the uterine lining

• Stem cell activity: Bone marrow stem cells may contribute to abnormal tissue growth

What we do know is that adenomyosis is influenced by oestrogen, which is why symptoms often change across different life stages.

How is adenomyosis diagnosed?

A proper diagnosis is key, especially when comparing adenomyosis vs endometriosis, as they can seem very similar.

Your healthcare provider may recommend:

• Pelvic examination to assess uterine size and tenderness

• Ultrasound to identify structural changes

• Magnetic resonance imaging (MRI) for more detailed imaging

• Hysteroscopy or biopsy in some cases

Getting clarity here can be a turning point because it opens the door to more targeted care.

Adenomyosis treatments

There’s no one-size-fits-all approach when it comes to adenomyosis treatments.

The right option depends on your symptoms, goals, and whether fertility is a consideration.

Medical treatment

Often the first step, focusing on symptom relief:

• Anti-inflammatory medications

• Hormonal treatments (like the oral contraceptive pill)

These treatments aim to reduce bleeding and pain. They do not cure adenomyosis, but they can help to improve day-to-day symptoms.

Surgical Treatment

In some cases, surgery may be recommended:

• Conservative procedures (aimed at preserving the uterus)

• Endometrial ablation (not suitable if planning pregnancy)

• Hysterectomy (removal of the uterus), considered a definitive option for those not wanting future fertility

Non-surgical Interventions

Emerging options include:

• High-intensity focused ultrasound

• Uterine artery embolisation

These may reduce symptoms, but more research is still needed, especially around long-term outcomes and fertility.

Is adenomyosis a form of cancer?

Although adenomyosis is not cancer, many women search for ‘adenomyosis cancer symptoms’ due to overlapping symptoms such as pelvic pain and abnormal bleeding.

But here’s the key point: Adenomyosis is not cancer. It is a benign condition.

That said, any unusual bleeding or significant changes in your cycle should always be assessed by a healthcare professional to rule out other causes.

Does adenomyosis affect fertility?

Having adenomyosis does not mean you cannot get pregnant. Many women with adenomyosis do successfully

conceive, either naturally or with fertility treatment.

Fertility can be influenced by:

• Age

• Severity of adenomyosis

• Whether endometriosis is also present

• Overall reproductive health

The important thing to know is pregnancy is still possible, and support is available if you need it.

How can a women’s health physio help with adenomyosis?

There is no standard treatment for adenomyosis because it affects each person differently. For many women, treatment focuses on managing symptoms, especially heavy or painful periods.

While physiotherapy doesn’t “cure” adenomyosis, it plays a powerful role in helping you feel more in control of your body again.

At Women’s Health Hub, we take a personalised approach, looking at how your symptoms are showing up for you and what your body actually needs.

1. Pain management

Pelvic pain associated with endometriosis and adenomyosis can be complex and persistent.

We use a range of techniques to help manage this, including:

• Manual therapy (hands-on treatment to reduce muscle and joint tension)

• TENS (Transcutaneous Electrical Nerve Stimulation)

• Acupuncture and LASER therapy

• Heat or cold therapy

These approaches aim to reduce pain sensitivity, improve circulation, and help your body feel less reactive over time.

2. Pelvic floor rehabilitation

Adenomyosis symptoms can affect how your pelvic floor muscles function, sometimes becoming tight, overactive, or weak.

This can contribute to:   

• Pelvic pain

• Bladder urgency or frequency

• Bowel discomfort

We assess your pelvic floor in detail and guide you through rehabilitation strategies to:

• Improve muscle coordination

• Reduce tension

• Restore strength where needed

3. Exercise prescription

   
   

Movement matters, but it needs to be the right kind for your body.

We design tailored exercise programs that:

• Support your pelvic and core function

• Improve overall strength and endurance

• Help reduce pain flare-ups

This isn’t about pushing through discomfort, it’s about building capacity safely and gradually.

4. Postural correction and movement retraining

Over time, pain can change the way your body moves and holds itself.

We look at:

• Your posture

• Movement patterns

• Daily habits

Then guide you through adjustments that reduce strain on your pelvis and lower back, helping ease discomfort and improve function.

5. Scar tissue management

If you’ve had surgery related to adenomyosis treatments or endometriosis, scar tissue can sometimes contribute to ongoing pain or restriction.

We use techniques such as:

• Scar massage

• Stretching

• Acupuncture and LASER therapy

to help improve tissue mobility, reduce sensitivity, and support healing.

6. Support, education, and long-term management

Understanding what adenomyosis is and how it affects your body can be a powerful part of recovery.

We work with you to:

• Make sense of your symptoms

• Identify triggers or patterns

• Build sustainable self-management strategies

Because long-term change doesn’t come from one session. It comes from knowing what your body needs and how to support it.

Physiotherapy is often part of a broader, multidisciplinary approach, especially when navigating adenomyosis or endometriosis, or when both conditions coexist. It’s important for individuals with these conditions to work closely with their healthcare team to develop a comprehensive treatment plan. 

Adenomyosis vs endometriosis: what’s the difference?

Both conditions involve tissue similar to the uterine lining, but where that tissue grows is what sets them apart.

Adenomyosis: Tissue grows within the muscle of the uterus

Endometriosis: Tissue grows outside the uterus, often on the ovaries, fallopian tubes, or other pelvic structures

Because of this, symptoms can overlap, but the way they affect your body and how they’re treated can be quite different, emphasising the need for proper diagnosis. 

Do you think you might have adenomyosis?

If something doesn’t feel right, if your periods are heavier, more painful, or starting to shape your life around them, it’s worth listening to that.

Because often, women wait years before getting answers. Let’s talk about what you’re experiencing.

Recognising adenomyosis symptoms early means you can access the right support sooner, explore appropriate adenomyosis treatments, and stop second-guessing what your body is trying to tell you.

At Women’s Health Hub, we don’t take a one-size-fits-all approach. Your symptoms, your goals, and your body all shape the way we support you. We take the time to understand what you’ve been dealing with, not just the diagnosis but how it’s been affecting your everyday life.

Our team of women’s health physiotherapists and an exercise physiologist can help you make sense of it and figure out what support actually looks like for you. 

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