Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
When a patient presents with pelvic pain, key clinical features that may suggest a diagnosis of adenomyosis include:
- Dysmenorrhoea: This refers to painful periods, which is a very common and often severe symptom of adenomyosis Bourdon et al. 2021Moawad et al. 2023.
- Chronic Pelvic Pain: Persistent pelvic pain, which may not be limited to menstruation, is another significant indicator Bourdon et al. 2021Moawad et al. 2023. This can overlap with symptoms seen in conditions like endometriosis NICE NG73.
- Heavy Menstrual Bleeding (HMB): While the query focuses on pain, HMB is a hallmark symptom of adenomyosis and frequently co-occurs with pelvic pain Bourdon et al. 2021Moawad et al. 2023. NICE guidelines provide assessment and management strategies for HMB NICE NG88.
- Dyspareunia: Painful sexual intercourse can also be a presenting symptom in patients with adenomyosis Bourdon et al. 2021Moawad et al. 2023.
These symptoms arise from the presence of endometrial tissue within the muscular wall of the uterus (myometrium) Bourdon et al. 2021.
Key References
- NG73 - Endometriosis: diagnosis and management
- NG88 - Heavy menstrual bleeding: assessment and management
- (Bourdon et al., 2021): Adenomyosis: An update regarding its diagnosis and clinical features.
- (Moawad et al., 2023): Adenomyosis: An Updated Review on Diagnosis and Classification.
- (Fiorillo et al., 2024): Inflammatory Bowel Disease and Endometriosis: Diagnosis and Clinical Characteristics.