The short explanation
Both are non-cancerous conditions of the womb that commonly cause heavy, painful periods. Fibroids are growths of muscle in or on the womb; adenomyosis is when the lining tissue grows into the muscle wall, making the womb bulky and tender. Many women have one or both without symptoms and need no treatment at all. When they do cause problems, there are options ranging from medicines to reduce bleeding and pain, to hormonal treatments, to procedures and surgery. The choice depends on your symptoms, the size and position, and whether you want a pregnancy in future.
What depends on your situation
The parts of this that change from woman to woman. Uncertainty is stated, not hidden.
- Heavy bleeding over months often leads to iron-deficiency anaemia, which can cause tiredness and breathlessness and is worth checking. Fibroids that press on the bladder or bowel can cause frequent urination or constipation.
- Surgery to remove the womb is one option among several, not the only one, and it is reasonable to ask about alternatives and a second opinion before agreeing to it.
What this answer cannot determine
The boundary of online education. These need a clinician who can see you.
- This cannot tell you what your scan means for you, whether treatment is needed, or which option would suit you. A report read on its own can sound more alarming than the situation is.
Questions for your clinician
Take these with you. You can add any of them to an appointment card.
- What exactly does my scan show, and is it causing my symptoms?
- Should my iron levels be checked?
- What are all my treatment options, including ones that keep my womb?
- How does each option affect future pregnancy?
When to seek help
Clinician-approved guidance for this topic. When in doubt, being seen is never the wrong choice.
- Get emergency care now (call 112 or 108) for bleeding that soaks a pad every hour for several hours, or bleeding with dizziness, fainting or breathlessness.
- See a clinician within days for severe pain, very heavy bleeding with tiredness, or bleeding after menopause.
- Book a routine appointment for heavy or painful periods that are affecting your life.
Sources
The evidence this explanation is built on.
- Fibroids NHS
- Adenomyosis Cleveland Clinic
- Heavy periods NHS
- Uterine fibroids MedlinePlus (NIH)
Who wrote and reviewed this
Every AskHer answer names its author. A clinically reviewed answer also names the clinician who signed it off — if no clinician is named below, it has not been clinically reviewed.
- Author
- AskHer Editorial (AI-assisted draft) AskHer's editorial team — not an individual clinician Works in English, தமிழ், हिन्दी
- Clinical reviewer
- Nobody yet No clinician has signed this answer off, and no person on the editorial team has read it yet. That is what the “Written with AI assistance” label means. It is queued for an editor to read, and then for a clinician who works in this area. The sources it was drafted against are listed above.
- Review status
- Written with AI assistance — not yet reviewed by a person
- Last reviewed
- Not yet reviewed by a person
- Version
- 1
Correction history
Substantive changes are listed, not quietly edited away.
No corrections have been made since this answer was first published.
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