Adenomyosis vs. Fibroids Understanding the Difference for Better Treatment

Adenomyosis and fibroids are two common uterine conditions with overlapping symptoms, such as heavy bleeding and pelvic pain. Despite these similarities, they have distinct causes and risk factors. 

Accurately diagnosing the difference between adenomyosis and fibroids ensures you receive the proper treatment plan. USA Fibroid Centers’ interventional radiologists can help determine the cause of your symptoms and create a personalized treatment plan to improve your condition and quality of life.

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What Are Adenomyosis and Fibroids?

What Are Adenomyosis and Fibroids?

Uterine Fibroids

Fibroids are noncancerous tumors in the uterus’ smooth muscle. Depending on their size and location, fibroids can cause symptoms ranging from mild discomfort to severe issues.

Symptoms Specific to Fibroids 

  • Heavy, frequent and prolonged menstrual periods
  • Lower back or leg pain 
  •  anemia 
  • Bloating
  • Fatigue

Adenomyosis

Uterine adenomyosis occurs when the inner uterine lining (endometrium) grows into the muscular wall, causing pain, inflammation, and other symptoms. Because this condition can impact daily life, recognizing the symptoms can help in seeking early treatment.

Symptoms Specific to Adenomyosis

  • Heavy or prolonged bleeding
  • Painful periods 
  • Pelvic pain
  • Pain during sex
  • Painful bowel movements

Who Can Have Adenomyosis and Uterine Fibroids?

Adenomyosis Risk Factors

Women between 35-50 years old are more likely to develop adenomyosis, although further research is needed to define the exact causes.

Potential adenomyosis risk factors include: 

  • Having multiple children 
  • Having cesarean sections (C-Sections)
  • Dilation and curettage (D&C) dilates the cervix for tissue removal from the uterine lining using a scraping instrument called a curette. 
  • Having high levels of estrogen

Fibroid Risk Factors

Fibroids can affect women of any reproductive age, with African-American women having a three times higher risk than other racial groups. 

Other fibroid risk factors include:

  • Family history
  • Obesity 
  • High blood pressure
  • High levels of estrogen and progesterone

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What is the Difference Between Adenomyosis and Fibroids?

Category Adenomyosis Fibroids
Location Uterine wall   Inside or outside the uterus
Symptoms
  • Painful periods
  • Heavy bleeding during or in between periods
  • Abdominal pressure and bloating
  • Heavy or prolonged periods
  • Pelvic pain or pressure
  • Lower back or leg pain
  • Bloating or enlarged uterus
  • Bladder or bowel problems
  • Pain during sex
  • Anemia
  • Infertility
Potential Causes
  • Hormonal changes like increased estrogen and progesterone
  • Link between adenomyosis and childbirth  
  • Bone marrow stem cells invading the uterine muscles    
Appearance on Imaging
  • Typically heterogeneous myometrium1 
  • Uterus often appears globular and enlarged
  • Indistinct borders between the endometrium and myometrium, creating a “shaggy” appearance 
  • Well-defined, solid, round masses within the uterine wall2
  • Darker appearance than the surrounding tissue 
  • Distinct appearance makes fibroids relatively easy to identify
Treatment Options
  • Uterine Artery Embolization (UAE)
  • Hormonal contraceptives
  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • Extreme cases may involve surgery such as a hysterectomy
  • Uterine Fibroid Embolization (UFE)
  • Medication
  • Anti-inflammatory painkillers, such as ibuprofen or naproxen 
  • Hormonal birth control can reduce bleeding 
  • Gonadotropin-releasing hormone (GnRH) 
  • Surgery such as a hysterectomy or myomectomy 
Impact on Fertility  Adenomyosis may distort the uterine cavity with a thickened wall, impair endometrial function, and interfere with uterine contractions.  Fibroids can block fallopian tubes or cervix, distort the uterine cavity, and impair blood flow to the uterine lining. 

 

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Similarities Between Adenomyosis and Fibroids

Similarities Between Adenomyosis and Fibroids

Adenomyosis vs. Fibroids: Impact on Quality of Life

Adenomyosis and fibroids can cause symptoms resulting in anemia, fatigue, and chronic discomfort, often disrupting daily activities, work, and social interactions. 

These physical changes can take an emotional toll, causing anxiety, depression, social isolation, and body image concerns. While symptom severity varies, untreated cases can lead to missed workdays, limited physical activity, and emotional distress. 

Since these conditions can present in similar ways symptomatically, adenomyosis is often misdiagnosed as fibroids. This overlap makes it important to consult a knowledgeable interventional radiologist for the best treatment.

Adenomyosis vs. Fibroids: Diagnosis Methods

Diagnosing adenomyosis and fibroids involves imaging techniques and physical examination. Transvaginal ultrasound (TVUS) is often the first-line diagnostic tool, as it can identify abnormal uterine growths or thickened tissue. 

Magnetic resonance imaging (MRI) provides detailed images to distinguish adenomyosis from fibroids. Pelvic exams can offer further insight by detecting an enlarged or tender uterus. Color Doppler ultrasounds can assess the blood flow within fibroids, aiding in diagnosis and treatment planning.

Physicians also consider clinical symptoms of adenomyosis and fibroids, such as pelvic pain, heavy bleeding, and infertility, when interpreting results. In rare cases, the healthcare provider may perform a biopsy to rule out other conditions like endometrial cancer.

Treatment for Adenomyosis and Uterine Fibroids

Treatment for Adenomyosis and Uterine Fibroids

Treatments for adenomyosis and fibroids range from hormonal therapy to surgical interventions. However, non-surgical treatments, such as uterine artery embolization (UAE) for adenomyosis and uterine fibroid embolization (UFE) for fibroids, offer effective, minimally invasive alternatives. 

At USA Fibroid Centers, we specialize in these procedures that alleviate symptoms of adenomyosis and fibroids without surgery. If you’re seeking relief from heavy bleeding, pelvic pain, or other related symptoms, contact us today by calling 855.615.2555 or using our online scheduler to make an appointment.

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FAQs

Can You Have Both Adenomyosis and Fibroids?

It is possible to have adenomyosis and fibroids simultaneously, although fibroids are more common, particularly among women aged 35 to 54. Due to overlapping symptoms, adenomyosis is often misdiagnosed as fibroids, so an accurate diagnosis requires a fibroid specialist and diagnostic imaging. 

How Do Adenomyosis and Fibroids Affect Fertility?

Adenomyosis and fibroids can affect fertility by altering the uterine environment, potentially disrupting implantation, sperm transport, and blood flow. The severity of fertility issues depends on the size, location, and extent of these conditions. 

Are Adenomyosis and Fibroids Cancerous?

Adenomyosis and fibroids are benign and not considered cancerous. Adenomyosis is when the uterine lining (endometrium) grows into the uterine muscle wall, causing thickening and discomfort, but it does not progress into cancer. Fibroids are non-cancerous tumors that form inside or outside the uterus. 

While these conditions are rarely cancerous, they can cause significant symptoms, such as heavy bleeding and pelvic pain, requiring a consultation with a fibroid specialist for treatment. 

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