Adenomyosis and Endometriosis: What’s the Difference?

Adenomyosis and endometriosis are two different gynaecological conditions that often get confused. Both can lead to heavy periods, pelvic pain, and fertility concerns. But they differ in where the tissue grows, how they affect your body, and how doctors diagnose and treat them.

If you’re in Singapore and dealing with ongoing menstrual pain or fertility issues, understanding the difference between these two conditions can help you ask the right questions and get the right care.

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What Is Adenomyosis?

Adenomyosis happens when tissue that normally lines the uterus starts growing into the muscle wall of the uterus. This can cause the uterus to become enlarged, heavy, and especially painful during periods.

Common symptoms include:

Painful periods that worsen over time
Heavy or prolonged menstrual bleeding
Pelvic pressure or bloating
Pain during intercourse
Difficulty getting pregnant

Doctors aren’t entirely sure what causes adenomyosis. It may be linked to hormonal changes, inflammation, or past uterine surgery such as a C-section.

What Is Endometriosis?

Endometriosis is when similar tissue grows outside the uterus, on organs like the ovaries, fallopian tubes, or even the bowel and bladder. It’s more difficult to diagnose and manage because it can spread beyond the reproductive system.

Symptoms may include:

Pelvic pain that can happen even outside your period
Pain during bowel movements or urination
Pain during or after sex
Feeling tired all the time
Fertility issues

In Singapore, many women wait years before getting a proper diagnosis, often because the symptoms are mistaken for ‘normal’ period pain.

Adenomyosis vs Endometriosis: Key Differences

Adenomyosis and endometriosis share many symptoms, which is why they’re often mistaken for one another. But there are clear differences when you look at where the tissue grows, how the pain feels, and how each condition is diagnosed and treated. Here’s a quick comparison:

Feature	Adenomyosis	Endometriosis
Location	Tissue grows into the uterine wall	Tissue grows outside the uterus
Uterus size	Often enlarged	Usually normal in size
Pain	Often linked to menstruation; dull, heavy	Can occur anytime; sharp or radiating
Fertility Impact	Less direct, but may complicate pregnancy	Strongly linked to infertility
Diagnosis	Transvaginal ultrasound or MRI	Laparoscopy (surgical diagnosis)
Treatment	Hormonal therapy, IUD, hysterectomy (severe cases)	Hormonal therapy, surgery, pain management

Can You Have Both at the Same Time?

Yes. Studies show that 30–50% of women with adenomyosis may also have endometriosis. When this happens, symptoms may overlap, and diagnosis can take longer.

If your period pain feels extreme or doesn’t improve with over-the-counter medication, it’s a good idea to see a specialist.

How Are These Conditions Diagnosed in Singapore?

Adenomyosis is often picked up through a transvaginal ultrasound or MRI scan.
Endometriosis usually requires a laparoscopy — a small surgical procedure to look inside the pelvis.

If you’re speaking with a GP first, make sure to describe all your symptoms in detail and request a referral to a gynaecologist who has experience with menstrual health.

Treatment Options in Singapore

In Singapore, women diagnosed with adenomyosis or endometriosis have access to a range of treatment options depending on their symptoms, age, and future plans for pregnancy.

For Adenomyosis:

Hormonal IUDs like Mirena
Birth control pills
GnRH medications to reduce oestrogen
Hysterectomy (only if other treatments don’t work and family planning is complete)

For Endometriosis:

Pain relievers like NSAIDs
Hormone therapy
Laparoscopic surgery to remove lesions
Fertility treatments if you’re trying to conceive

Some women also try complementary therapies like Traditional Chinese Medicine (TCM), acupuncture, or anti-inflammatory diets to manage symptoms.

Connect with A Gynaecologist Today

Too often, women are told that painful periods are “normal.” But adenomyosis and endometriosis are real conditions that can be treated. The first step is recognising the symptoms and getting help.

If you’re based in Singapore and struggling with menstrual or pelvic pain, click the button below to book a consultation with a specialist. You don’t have to suffer in silence. Support and treatment are available.

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