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., 2021; Moawad et al., 2023].
- Chronic Pelvic Pain: Persistent pelvic pain, which may not be limited to menstruation, is another significant indicator [Bourdon et al., 2021; Moawad 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., 2021; Moawad 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., 2021; Moawad 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.