Having heavy periods and severe cramps? It could be adenomyosis

By Joan Oyiela | 4 hours from now | 3 Min read

Many women grow up believing that painful, heavy periods are simply part of being female. Every month, they push through severe cramps, carry extra sanitary products everywhere they go and adjust their lives around menstrual pain.

Yet for some, these symptoms are not normal at all; they are signs of adenomyosis, a little-known condition that can significantly affect a woman’s quality of life.

Adenomyosis is a condition in which tissue similar to the lining of the uterus grows into its muscular wall, causing chronic pain, heavy menstrual bleeding and, in some cases, fertility challenges.

Although adenomyosis is becoming more widely recognised, many women still go undiagnosed for years because its symptoms are often mistaken for fibroids, endometriosis or ordinary menstrual pain. The delay in diagnosis means many continue to suffer in silence, believing their pain is something they simply have to endure.

According to consultant gynaecologist at Calvary Healthcare, Dr Alfred Kairithia, adenomyosis occurs when tissue similar to the lining of the uterus grows into the muscular wall of the womb.

“This causes the uterus to become enlarged and inflamed, leading to heavy menstrual bleeding, severe cramping and chronic pelvic pain. Many women assume these symptoms are normal, but persistent pain and excessive bleeding should always be evaluated by a healthcare provider,” he explains.

For 42-year-old Davina Nekesa, the symptoms began in her early thirties. Every month, her periods became heavier and more painful. She frequently missed work, struggled with overwhelming fatigue and constantly worried about bleeding through her clothes while in public.

At first, Davina dismissed the excessive bleeding as a consequence of the physically demanding nature of her job at a sugar factory. She believed the long hours and strenuous work were taking a toll on her body and never imagined there could be an underlying medical condition causing her symptoms.

Keep Reading

“I thought the heavy bleeding and constant pain were simply because of the physically demanding work I was doing at the Sugar Company. I convinced myself that my job was the reason I was experiencing all those issues. But after years of struggling, doctors finally diagnosed me with adenomyosis. That diagnosis made me realise the problem had never been my work; it was a medical condition I didn’t know I had.”

Dr Alfred says Davina’s experience is common. While the exact cause of adenomyosis remains unknown, experts believe it may develop when tissue similar to the uterine lining grows into the muscular wall of the uterus. Previous uterine surgeries, such as caesarean sections, hormonal factors and pregnancy history may play a role in its development.

The condition can affect women of reproductive age, particularly those in their late thirties and forties, although younger women can also develop it. Risk factors may include previous pregnancies, uterine surgery and increasing age, though the exact cause remains unclear.

The symptoms vary from one woman to another. Some experience prolonged and extremely heavy menstrual bleeding, while others suffer severe pelvic pain, painful sexual intercourse, bloating and persistent pressure in the lower abdomen. Heavy bleeding may also lead to iron-deficiency anaemia, causing fatigue, dizziness and shortness of breath.

Because adenomyosis is influenced by oestrogen, symptoms often improve after menopause when hormone levels decline. Before then, several treatment options can help manage pain, heavy bleeding and other symptoms.

Diagnosis can be challenging because symptoms often overlap with other gynaecological conditions. Doctors may use pelvic examinations, ultrasound or MRI scans alongside a woman’s medical history to help confirm the condition.

Davina says receiving a diagnosis transformed her life.

“The biggest relief was finally knowing I wasn’t imagining the pain. Once I started treatment, I could plan my life without constantly fearing my next period. The symptoms eventually stopped when I entered menopause,” she says.

Treatment for adenomyosis depends on the severity of symptoms, a woman’s age and whether she hopes to have children in the future. Doctors may recommend pain-relieving medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and naproxen, to help ease painful menstrual cramps.

Hormonal treatments can also help regulate menstruation and reduce heavy bleeding. These include birth control pills, the Depo-Provera injection and hormonal intrauterine devices (IUDs).