Adenomyosis: What is it & Treatment

Do you have heavy & painful periods? Did you know that these are two symptoms of Adenomyosis? Maybe you are curious if you have Adenomyosis? Perhaps you have already been diagnosed with it? And you would like to know what is Adenomyosis and what are some natural treatment options.


Let’s talk about ‘Adenomyosis: What is it & Treatment’.


Hello, I am so thrilled to be here.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release (NER) Practitioner. I help women struggling with their menstrual cycles, have easy, pain-free periods, balanced hormones & emotional wellbeing. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.


What is Adenomyosis?


Adenomyosis is when the endometrium (lining of the uterus) grows between the muscular wall of the uterus (myometrium). They are known as Adenomyosis lesions. There is muscle hyperplasia (enlargement) & destruction to the normal myometrium.


Lesions inside the uterine muscle wall bleed with the period causing pain and heavy periods.


The prevalence is  difficult one to estimate because there are asymptomatic types of Adeonomyosis (no symptoms). One study had a rough estimate of 20-30% of women experience this based on ultrasound diagnosis. It is highly dependent on the age group. Another study which used MRI to diagnose revealed that in women less than 42 years old, Adenomyosis was present in 59.9% of that study.


Symptoms of Adenomyosis


  • Heavy periods (menorrhagia)

  • Long periods

  • Intermenstrual bleeding: pre period, post period, around ovulation, after sex

  • Pelvic pain

  • Painful periods (dysmenorrhoea)

  • Blood clots during your period (large sized)

  • Painful sex (dyspareunia)

  • Approximately 30% can be asymptomatic (no symptoms)


 How is Adenomyosis diagnosed?


Usually via: transvaginal pelvic ultrasound or pelvic MRI. They may see that the uterus is enlarged, or bulky in some areas & the lesions etc..



Risk factors


  • Prior pregnancies (however it has also been found in women without history of pregnancy)

  • Miscarriages

  • Voluntary pregnancy terminations

  • Uterine surgery including caesarean (however, it has also been found in women without uterine surgery history)

  • Increased age (however it is also possible for it to occur in young women of reproductive age)

  • Endometriosis

  • Uterine Fibroids


A note on Endometriosis: Adenomyosis and Endometriosis will often coexist together. The estimated prevalence of having Adenomyosis when you have Endometriosis is variable. In one research paper the prevalence of women with Endometriosis also having Adenomyosis was 80-90%. Similar to another author who found more than 90% of patients having Adenomyosis as well as Endometriosis. Another study suggested that less than half of the Endo patients had Adenomyosis. Another paper suggested there was no relationship between the two.


A note on Uterine Fibroids: Adenomyosis and Fibroids can frequently coexist together.



Types of Adenomyosis


There are many different classifications of Adenomyosis.


One type of classification is:


  • Focal Adenomyosis:

  1. The lesions are not encased – >25% of the circumference of the lesion is surrounded by normal myometrium (muscular wall of uterus)

  2. The lesions are clearly encased & myometrium is hypertrophic (enlarged) known as Adenomyoma- >25% of the circumference of the lesion is surrounded by normal myometrium (muscular wall of uterus)


  • Diffuse Adenomyosis: <25% of the lesion is surrounded by normal myometrium (muscular wall of uterus)


  • Mixed-type Adenomyosis: presence of both focal & diffuse adenomyosis lesions


Then it needs to be determined to be:


  • Cystic (largest diameter > 2mm)

  • Non-cystic


Where is it in uterine muscular wall?


  • Inner myometrium – closest to the endometrium (lining of the uterus)

  • Middle myometrium

  • Outer myometrium – subserosa layer


How bad is it?


  • Mild – < 25% of myometrium (muscular wall of uterus)

  • Moderate – 25-50% of myometrium

  • Severe – > 50% of myometrium


What causes Adenomyosis?


It is largely unknown, however there a few theories.


 Natural remedies for Adenomyosis


We need to remember that these suggestions are just going to help ease some of the symptoms that you may experience. But it not the complete solution & it is best to see a Naturopath that specialises in periods & hormones (like myself) to help & guide you with an individualised treatment that addresses the underlying causes & issues for you.


  1. Increase omega 3 foods in your diet:

These are anti-inflammatory & will help to reduce the inflammation & pain associated with Adenomyosis.


Oily fish: mackerel, sardines, salmon

Plant sources: omega 3, hemp seeds


But the highest source of omega 3 is generally non-plant sources. As plant sources are typically higher in omega 6.


  1. Have an Epsom salt bath:

Take a warm bath & pour in approximately 500grams of some Epsom salts which contain magnesium sulfate.


Magnesium has been show to be beneficial for relaxing your muscles including the uterine muscle, easing period pains, cramps & uterine spasm.



  1. Include Rosemary in your diet:

Rosemary helps with phase 2 liver detox (makes the toxins water soluble so that they can be excreted effectively through poo and wee) so can be useful in removing oestrogen from the body once it has done its job. Remember your liver is important in hormone balance too.


You can either have this in your food or you can have it as a tea. It is rather strong so you might like to mix it with other herbal teas too (organic preferably).



Can a Naturopath help with Adenomyosis?


Yes, absolutely. I would suggest seeing a Naturopath that specialises in Periods & Hormones like myself; to help support you. Perhaps you suspect you have Adenomyosis or have been told that this is the case for you.


Treatment wise, we would be using Natural medicine: including herbal medicine & nutritional medicine based on pathology findings, symptoms & signs, diet & lifestyle. I also use NER (Naturopathic Emotional Release) to look at underlying emotional contributors.


The treatment aims depends on your presentation but generally it would be things like:


  • Reducing inflammation – diet, lifestyle, natural medicines (herbal medicines, nutritional medicines)

  • Hormone balance & support (particularly oestrogen / progesterone ratio) – diet, lifestyle, natural medicines)

  • Management of oestrogen levels:

High oestrogen can drive Adenomyosis

  1. Good liver function: making sure liver is working properly to break down & clear hormones

  2. Good bowel function: making sure you are doing a poo every day and not constipated to remove oestrogen that has done its job in the body

  • Gut health – Addressing any gut bacterial imbalance (whether that is normally good bacteria commensal suddenly turning bad or whether it is bad bacteria causing havoc) because some bacteria can produce endotoxins known as LPS (Lipopolysaccharides) which have been shown to go on a journey from the gut through the blood stream & into the pelvic area causing inflammation & adding to the nasty symptoms of Adenomyosis




  • Nutritional Deficiencies

  • Hormonal imbalance: Girly Hormones (oestrogen, progesterone, testosterone etc.), Thyroid, Pancreas, Adrenals

  • Assessing gut health: might include microbiome testing for large bowel, SIBO testing for small bowel (can cause high histamine & period pain)

  • Assessing liver function: remember this is key along with gut health for hormonal balance too. 


If you would like support with your heavy & painful periods, Adenomyosis or if you are experiencing period issues, I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit.

If you have any questions or comments, pop them in the comments box below 🙂