Adenomyosis is a condition in which glands found in the innermost lining of the uterus, called the endometrium, enter the muscular layer (aka myometrium).

It's associated with a higher risk of fibroids as well as more inflammatory compounds in the uterus during menstruation.

It's not as widely known compared to other menstrual health conditions.

Adenomyosis can be fairly asymptomatic (in around 30% of people). It can also be quite symptomatic. There's a broad spectrum. Symptoms can look fairly similar to endometriosis symptoms:

• heavy period flow or prolonged flow

• clots in menstrual blood

• period pain

• mid-cycle spotting

• chronic pelvic pain

• painful penetrative intercourse

• sub- or infertility

How is it diagnosed?

Adenomyosis is diagnosed through transvaginal ultrasound or MRI. Usually, ultrasound is the starting point for investigating gynaecological and menstrual issues. Sometimes, an enlarged uterus on ultrasound prompts further investigation in the absence of other findings on the image; this is because an enlarged uterus is associated with adenomyosis.

Who's at a higher risk of having adenomyosis?

Here are some of the risk factors:

• past abortion

• C-section history

• higher parity (higher amount of pregnancies and births)

• tissue removal from the uterus in the past

• age

How is adenomyosis treated?

It really depends on what (y)our goals are and what you're experiencing.

There are lots of conventional and naturopathic options out there, but it really depends on what we're hoping to accomplish with treatment: support fertility, decrease heavy bleeding, improve pain, etc.

Chapter 18 of "The Period Literacy Handbook" talks about adenomyosis in a bit more details and has some considerations for treatment as well.