Endometriosis and adenomyosis are separate conditions with many similarities. Both diseases involve abnormalities of the tissue that lines the uterus – the endometrium. In endometriosis, tissue resembling the endometrium spreads outside the uterus, causing inflammation, implants, and adhesions on the organs and surfaces of the pelvic cavity. In adenomyosis, endometrial tissue remains within the uterus, but infiltrates the muscular walls of the womb and grows in pockets within the wall.
It is not uncommon to have both adenomyosis and endometriosis at the same time. Approximately 40 to 50 percent of women with adenomyosis also have endometriosis.
How to tell the difference between adenomyosis and endometriosis
The easiest way to describe the difference between the diseases is that adenomyosis is only inside the uterus, while endometriosis is only outside the uterus.
While endometriosis is most common in women of childbearing age and is frequently diagnosed in women who have not given birth, adenomyosis typically develops in women in their 40s and 50s who have had children. It is possible that adenomyosis may be present in younger women but not be detected as often.
Symptoms of adenomyosis vs endometriosis
Endometriosis and adenomyosis share many symptoms, including intensely painful menstrual periods with very heavy flow. Like endometriosis, adenomyosis can also cause pain during sexual intercourse and negatively affect fertility. Both conditions may also cause abdominal bloating.
Read more details about endometriosis symptoms.
Causes of adenomyosis vs endometriosis
The root causes of endometriosis and adenomyosis are unknown. Risk factors for adenomyosis are different than those for endometriosis. Risk factors for adenomyosis include being middle-aged, having given birth, and having undergone invasive uterine surgery such as a cesarean section (C-section) or fibroid removal.
Read more details about endometriosis causes and risk factors.
Diagnosis of adenomyosis vs endometriosis
Adenomyosis may be suspected after a pelvic exam showing an enlarged and tender uterus. The doctor may perform ultrasound and magnetic resonance imaging (MRI) scans or take a biopsy of endometrial tissue to check for signs of adenomyosis. However, a confirmed diagnosis of adenomyosis is only possible after hysterectomy (removal of the uterus) and laboratory examination of the tissue.
Treatment of adenomyosis vs endometriosis
Like endometriosis, adenomyosis symptoms may improve with hormonal treatment. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (Ibuprofen) and Celebrex (Celecoxib) may be taken to ease pain and inflammation.
Adenomyosis is cured by hysterectomy. Endometriosis symptoms may or may not improve with hysterectomy.
Read more details about endometriosis treatments.