Adenomyosis & Endometriosis are not the same condition

Jun 15, 2021 | Adenomyosis, Endometriosis, Hormones

It seems there is a lot of confusion on what the difference is between adenomyosis and endometriosis. Many people including doctors tend to classify both conditions as one and that is not simply right. They may share some symptoms but the location, pain experience, risk factors and cure are different.

According to Endometriosis UK, 176 million women across the world have endometriosis. Roughly the same figure is estimated to have adenomyosis and there is even less known about it than about endometriosis. The average diagnosis time for both conditions is over 7 years.

Unfortunately, many women go for a long time without a diagnosis for both conditions. This is in because women with adenomyosis and endometriosis may have different symptoms, or because the pain in the pelvic area, may be considered as ‘normal’ by some practitioners.


Adenomyosis and endometriosis share a number of features and it was found that, they tend to occur together, so much so that for a long time adenomyosis had been named as endometriosis interna. They are both inflammatory conditions and they are oestrogen dependent.

In both conditions, a tissue similar to the endometrium which lines the uterus wall spreads to places it shouldn’t, experiencing cyclic bleeding. This results in both conditions sharing similar symptoms like: 

– Heavy bleeding

– Chronic pelvic pain

– Painful bowel movement

– Painful sex

– Fatigue

– Infertility

They also have similar management methods in a conventional medicine. They are both managed with the help of anti-inflammatory drugs (NSDAIDs) to reduce pain and hormone medicines like birth control pills, progestins and progesterone and gonadotropin-releasing hormone (GnRH) agonists.



In endometriosis the endometrial cells grow outside the uterus and usually in the ovaries, Fallopian tubes, and the cavities of the pelvis. You can also find them on the outside of the womb or the ligaments (which hold the womb in place), or the area between your rectum and your womb, called the Pouch of Douglas. Sometimes endometrial cells grow directly on a rectum and in less common places like lungs or eyes.

In adenomyosis, the cells grow within the walls of the uterus, deep in the muscular wall and make it really thick. Adenomyosis doesn’t go past the uterus itself. 


Endometriosis pain causes mild-to-severe discomfort in any areas where the endometriosis is planted.

But in adenomyosis the menstrual pain is usually confined to uterus. So the pain there can be felt in the central pelvis and sometimes radiating to lower back and inguinal areas.

Risk Factors

There is not known cause or definitive risk factors for either endometriosis or adenomyosis. But some factors may influence their occurrence.
Possible risk factors for endometriosis are if:
  • Are in your 30s or 40s and never had children
  • It runs in your family.
  • You have heavy periods that last more than 7 days.

Risk factors for adenomyosis are if you:

  • Are in your 40s or older; women diagnosed with adenomyosis tend to be older than those who have endometriosis.
  • Have given birth at least once
  • C-section birth

These risk factors are slowly changing with more research being done. We need to take it into consideration that with growing awareness for both conditions we will be growing our knowledge around their cause.


It takes an average of 7 years to diagnose both conditions. They can be diagnosed solely based on symptoms (if you have a well informed doctor) , but they can also mimic other illnesses such as fibroids in adenomyosis, or IBS in endometriosis so further testing is necessary.

In adenomyosis a pelvic exam may show an enlarged and tender uterus. The next step is to do an ultrasound of the uterus and/or magnetic resonance (MRI) of the uterus. If hysterectomy is a choice, then  a sample of uterine tissue for testing (endometrial biopsy) is collected.

In endometriosis, ultrasound might help in identifying endometriosis showing ‘chocolate cysts’ in ovaries. However, not all women with endometriosis have them and ultrasound might not be enough to identify it. MRI can also be used but early stages of endometriosis will not be found using this method. That it is why, the only reliable diagnostic method is laparoscopy, which is a procedure under an anesthetic, where the surgeon has a view of the inside of your abdomen and collects tissue samples which then confirm an endometriosis diagnosis.

If you suspect you have either or both conditions, please speak to a specialistic doctor in area of endometriosis and adenomyosis to make sure the right diagnostic tools are recomennded for you. This will speed up the process of the diagnosis. 


There is not known cure for endometriosis. Laparoscopy can be an effective method to remove endometrial tissue but it doesn’t guarantee it never coming back. On the other hand, the known cure for adenomyoisis is hysterectomy, which is a surgical removal of uterus.

Unfortunately, there are a lot of women going through hysterectomy to ‘cure’ endometriosis. Yes, the removal of uterus can improve pain, but there will be a number of women who will experience a recurrence of their symptoms even with this drastic move.  If the ovaries are left in place, the endometriosis is more likely to return, as oestrogen, which in large part is responsible for endometriosis growth, is produced in there.

Natural Approach For Endometriosis & Adenomyosis

There are many factors which might impact both conditions but the clear one is oestrogen dominance. This happens when there isn’t enough progesterone in the system to balance the oestrogen. High oestrogen levels lead to higher inflammation worsening the symptoms especially pain. Reduction in exposure to oestrogen would be a first step to reduce some of the symptoms.

This will include:

✨Eat a nutrient rich diet which will provide vitamins, minerals and fibre needed to mobilise oestrogen. Download my free guide on 8 ways how to reduce pain with diet. See below.

✨Reduce xenoestrogens; “outside” hormones which imitate estrogen when in our body. They are found in tap water, plastic bottles, make up, personal care products, home cleaning products. Try to use water filters and go for natural products.

✨Reduce stress. More stress creates more inflammation, which produces more oestrogen, which then leads to more stress and even more inflammation. It is an awful vicious cycle.

Download My Free Guide On How To Manage Pain With Diet

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