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Adenomyosis: Heavy, Painful Periods and an Enlarged Uterus

What is adenomyosis?

Adenomyosis occurs when tissue similar to the lining of the uterus (endometrium) grows into the muscle wall of the uterus (myometrium). This tissue responds to monthly hormones, which can make the uterine wall thicker and the uterus larger and tender. Adenomyosis can affect the whole uterus (diffuse) or one area (focal, sometimes called an adenomyoma).

It is most often diagnosed in people in their late 30s and 40s, and it often occurs together with endometriosis or uterine fibroids.

What are the symptoms of adenomyosis?

• Heavy or long menstrual bleeding, sometimes with large clots
• Painful periods that become more severe over the years
• Chronic pelvic pain or pressure
• Pain during sex
• Tiredness, dizziness, or shortness of breath from iron-deficiency anemia caused by heavy bleeding
• A feeling of fullness in the lower abdomen

About one in three people with adenomyosis have no symptoms, and it is found during a routine ultrasound.

What causes adenomyosis?

The exact cause is unknown. Factors linked with adenomyosis include previous pregnancies and childbirth, previous uterine procedures (such as a cesarean section or removal of fibroids), and long-term exposure to estrogen. Symptoms usually improve after menopause, when estrogen levels fall.

When should I see a doctor?

Book a visit if your periods are heavier or more painful than before, if you soak through a pad or tampon every hour or two, if you pass large clots, or if you feel tired and weak during your period.

Seek emergency care (call 119) if you have:

• Very heavy bleeding that soaks a pad every hour for two hours or more
• Fainting, a racing heartbeat, or severe dizziness
• Sudden, severe pelvic pain
• Heavy bleeding with a positive pregnancy test

How is adenomyosis evaluated at the clinic?

Dr. Eun will review your menstrual history and symptoms and perform a pelvic exam if appropriate. A transvaginal ultrasound can show typical signs, such as an enlarged, rounded uterus, a thickened and uneven muscle wall, and small cysts in the muscle. A pelvic ultrasound through the abdomen is an option for people who prefer not to have a vaginal exam. A blood test for anemia may be recommended if bleeding is heavy. In some cases, an MRI at a hospital may be suggested to confirm the diagnosis.

What are the treatment options for adenomyosis?

Treatment is based on the severity of symptoms, your age, and whether you plan to become pregnant.

•  Pain relief: NSAIDs can reduce period pain and may reduce bleeding.
• Hormonal treatment: a levonorgestrel-releasing hormonal IUD (such as the Mirena IUD) is commonly used to reduce heavy bleeding and pain. Progestin pills, combined hormonal contraceptives, and GnRH-based medicines are other options.
• Non-hormonal medicines: tranexamic acid may be used to reduce heavy bleeding.
• Iron: iron supplements or treatment for anemia if blood tests show low iron.
• Procedures and surgery: when medicines do not control symptoms, options include uterine artery embolization, adenomyoma removal, or hysterectomy (removal of the uterus). These are performed at a hospital. Eunice Women's Clinic does not perform surgery; Dr. Eun refers patients to a hospital when needed.

Individual results vary, and it may take a few months to know how well a treatment works for you.

Getting care in English near Seongsu Station

Eunice Women's Clinic is on the 8th floor of Bethel Place, 120 Achasan-ro, Seongdong-gu, Seoul. The building is across the crosswalk from Seoul Subway Line 2 Seongsu Station Exit 3, about a 1-minute walk ( directions). Dr. Eun Mi-na, a female board-certified OB-GYN, holds consultations about adenomyosis and heavy periods in English.

   

Day	Hours
Mon, Wed, Fri	10:00–19:00 (lunch 13:30–14:30)
Tue, Thu	10:00–20:00 (lunch 13:30–14:30)
Sat	10:00–14:00 (no lunch break)
Sun and public holidays	Closed

Booking is recommended. You can book through Naver Booking, the KakaoTalk channel (search "유니스산부인과"), or by phone at +82-2-467-3100 ( how to book). Call or message to check same-day availability.

Frequently asked questions

What is the difference between adenomyosis and endometriosis?

In adenomyosis, endometrium-like tissue grows into the muscle wall of the uterus. In endometriosis, similar tissue grows outside the uterus, such as on the ovaries or pelvic lining. The two conditions often occur together and can cause similar pain.

Can a Mirena IUD help adenomyosis?

A levonorgestrel-releasing IUD such as Mirena is a commonly used, evidence-based option to reduce heavy bleeding and period pain from adenomyosis. It is not suitable for everyone. The listed out-of-pocket price at the clinic is 350,000 KRW; prices may change, so confirm with the clinic.

Does adenomyosis go away?

Adenomyosis usually does not go away on its own during the reproductive years, but symptoms often improve after menopause as estrogen levels fall. Until then, medicines can help control bleeding and pain for many people. Individual results vary.

Is adenomyosis dangerous?

Adenomyosis is not cancer and is not life-threatening in most cases. However, heavy bleeding can cause anemia, and pain can affect quality of life. Regular follow-up helps monitor changes and manage symptoms.

Can I get pregnant with adenomyosis?

Many people with adenomyosis become pregnant. Some studies link adenomyosis with lower fertility and a higher risk of some pregnancy complications. If you plan to conceive, discuss this with your doctor before choosing a treatment.

Related pages

•  Transvaginal Ultrasound
• Mirena IUD
• Endometriosis
• Heavy Periods
• Uterine Fibroids

This page provides general health information for patients and does not replace a consultation with a doctor. Individual results vary. If you have severe pain, heavy bleeding, fainting or other urgent symptoms, call 119 or go to the nearest emergency room. Page updated September 2026.