Grab your tea and settle in. This one’s a 13-minute read — and it might be one of the most validating things you’ve read in a long time.
There’s a particular kind of exhaustion that comes from years of not knowing what is going on with your body, but knowing that something is going on. From hitting closed doors with every medical provider you see. No answers uncovered — no ideas explored.
You’ve had heavy periods. Brutal ones. The kind where you’re counting hours until you can change again, planning your life around your cycle, canceling things you wanted to do. You’ve had cramps that feel less like cramps and more like something is wrong — and yet, every time you’ve mentioned it, you’ve been handed a prescription, a pamphlet, or a gentle suggestion to “track your symptoms.”
Maybe you’ve been told it’s just your hormones. Maybe someone mentioned fibroids. Maybe you’ve been told this is just what periods are like and you need to manage your stress better.
And somewhere in the back of your mind — because you know your body, even if no one else has been listening — you’ve wondered: Is this actually normal? Or is something else going on?
If that resonates, I want to talk to you about adenomyosis.
Not because I want to alarm you. But because I think far too many women are walking around with this condition undiagnosed, unvalidated, and unsupported — and that’s something I care deeply about changing.
Because it’s my story. One I’ve held close for seven years, before it was officially diagnosed.
So What Is Adenomyosis, Exactly?
It’s a mouthful. Let’s start with that. I spent a few days figuring out exactly how to pronounce it, because I’d never heard of it.
Here’s the simple version: your uterus has two layers. The inner layer is called the endometrium — that’s the tissue that builds up and sheds every month during your cycle. The outer layer is muscle, called the myometrium.
With adenomyosis, endometrial tissue grows into the muscle wall. It doesn’t belong there. But there it is, thickening and bleeding just like it does on the inside — except it has nowhere to go. That trapped blood creates inflammation, pressure, and pain from within the uterine muscle itself.
I like to best explain it like cells going rogue. It essentially mimics the cells that operate and keep your uterus functioning. They duplicate, and embed themselves in a different part of your uterus.
And then they grow.
The result is a uterus that becomes enlarged, boggy (yes, that’s actually the clinical term), and inflamed. And because that tissue is still responding to your hormones, it tends to behave worse at certain points of your cycle — and can escalate significantly during perimenopause.
This is not a rare condition. Estimates of how many women are affected vary widely — anywhere from 5% to as high as 70% depending on the population studied and the diagnostic method used — but what researchers consistently agree on is that it is almost certainly underdiagnosed.
A recent scoping review examining women’s lived experiences with adenomyosis found that diagnostic journeys were often long, dismissive, and deeply frustrating.
In other words: you may have been asking the right questions for years. The system may simply not have been equipped to answer them.
The Symptoms That Get Overlooked (Or Blamed on Something Else)
One of the most challenging things about adenomyosis is that its symptoms overlap significantly with other conditions — which makes it easy to miss, easy to misattribute, and easy to dismiss.
Here are the signs that are worth paying attention to:
Heavy, prolonged periods. Not just a heavy day or two — but soaking through pads or tampons faster than feels reasonable, passing clots, and bleeding that goes on for seven, eight, nine days or more. Some women with adenomyosis bleed for up to two weeks in a cycle.
Severe menstrual cramps. Not uncomfortable — incapacitating. Pain that doesn’t respond to ibuprofen the way it used to. Pain that feels like pressure, burning, or sharp stabbing rather than the typical dull ache.
Chronic pelvic pressure or pain. A feeling of heaviness, fullness, or pressure in the lower abdomen that doesn’t go away between periods.
Painful intercourse. Deep pelvic pain during or after sex, which is often attributed to other causes — or worse, not addressed at all.
An enlarged uterus. Your doctor may note this during a pelvic exam. Your uterus may feel larger and tender to the touch.
Anemia symptoms. This one is sneaky and important — and we’ll come back to it in a moment.
Fatigue and brain fog. Often written off as stress, poor sleep, or “just getting older.” But when you’re losing significant blood every month and living with chronic inflammation and pain, your body is carrying a heavy load.
The Anemia Connection Nobody Talks About Enough
Let’s spend a moment here, because this piece often gets buried.
When you’re bleeding heavily month after month, your body loses iron. Iron is what your red blood cells use to carry oxygen throughout your body.
When iron drops low enough, you become anemic — and iron deficiency anemia has symptoms that can quietly take over your quality of life without ever being traced back to their origin.
We’re talking about: deep, persistent fatigue that sleep doesn’t fix. Shortness of breath doing things that shouldn’t wind you. Difficulty concentrating. Headaches. Cold hands and feet. An overall sense of depletion that just won’t lift.
Sound familiar?
Here’s what happens: a woman comes in reporting exhaustion, brain fog, and low energy. She’s tested for thyroid dysfunction, checked for depression, maybe evaluated for sleep apnea.
Her iron is low — and she’s told to take a supplement. But nobody asks why her iron is low. Nobody connects the dots back to those heavy periods she mentioned almost as an afterthought.
The supplement helps a little. And then her period comes, and it starts all over again.
If you’re regularly dealing with heavy menstrual bleeding and you have unexplained fatigue, please ask your doctor to check your iron levels — specifically your ferritin (stored iron), not just your hemoglobin.
And please advocate for an investigation into why you are losing that much blood each month.
Why Adenomyosis Gets Misdiagnosed So Often
This is where I want to get a little direct with you, because I think you deserve honesty here.
Adenomyosis gets missed for several reasons — and not all of them are about imaging quality or diagnostic complexity.
First, the symptoms overlap with almost everything. Heavy periods? Could be fibroids. Pelvic pain? Could be endometriosis, IBS, pelvic floor dysfunction. Fatigue? Could be a hundred things. When your symptoms match six different conditions, it’s easy for the investigation to stop at the first plausible explanation.
Second, the traditional gold standard for diagnosis was a hysterectomy. For a long time, adenomyosis could only be definitively confirmed by examining uterine tissue under a microscope after the uterus was removed.
That’s a significant barrier. The good news is that advances in transvaginal ultrasound and MRI imaging have made it increasingly possible to identify adenomyosis without surgery — but not every provider has the training or equipment to read these images well.
Third, women’s pain has historically been dismissed and normalized. This one isn’t comfortable to say, but it’s true and well-documented. Heavy periods have been called “just part of being a woman.”
Severe cramps have been explained away as “just how it is for some people.” Gabrielle Union — more on her in a moment — had symptoms beginning in her early twenties. She bled through overnight pads. Her periods lasted nine or ten days. And she was told, repeatedly: here’s birth control.
Fourth, adenomyosis often coexists with other conditions. It’s frequently found alongside endometriosis, uterine fibroids, or both. When multiple conditions are present, the picture gets complicated, and adenomyosis may not be the one that gets named.
I like to say that adenomyosis is endometriosis’ big sister.
Adenomyosis vs. Endometriosis: They’re Not the Same Thing
Because these two conditions are so often mentioned together — and because even some healthcare providers conflate them — let’s take a moment to understand the difference. It matters, because the experience, the risks, and the holistic support needed can look quite different.
Here’s the clearest way I can put it: think of endometriosis as invasive vines growing outside and beyond the garden. Think of adenomyosis as roots growing so deep into the soil that the ground itself becomes thickened and disrupted.
Adenomyosis stays within the uterus. The displaced tissue grows into the muscle wall, causing the uterus to enlarge and become inflamed.
Because everything is happening inside the uterine muscle, the primary symptoms tend to be heavy bleeding, pelvic pressure, and a tender, enlarged uterus. The pain is often local to the pelvis and often present throughout the cycle, not just during menstruation.
Endometriosis involves tissue growing outside the uterus entirely — on the ovaries, the fallopian tubes, the bowel, the bladder, sometimes on other organs. That misplaced tissue bleeds during the menstrual cycle just like the uterine lining does, but the blood has nowhere to go, which causes inflammation, adhesions, and scar tissue.
Because endometriosis can affect other structures throughout the pelvic cavity, its symptoms are often more widespread and varied — bladder pain, bowel changes, and deep pain during sex that feels different from the pelvic heaviness of adenomyosis.
Both conditions involve tissue that responds to estrogen. Both can cause pain and bleeding. Both can affect fertility. And both are frequently underdiagnosed.
One important distinction: adenomyosis pain is often described as burning, constant, or pressure-like — an internal fire. Endometriosis pain may be more closely correlated with the menstrual cycle and can affect more areas depending on where the tissue has implanted.
Many women have both simultaneously, which makes the diagnostic picture even more complex. If you suspect either condition, advocate for imaging with a provider who specializes in gynecological conditions — and do not let “your symptoms are common” be the end of the conversation.
I had two imaging providers. The first one missed the adenomyosis, and it wasn’t until I had someone else do the exact same tests seven years later, did I finally get a diagnosis. It’s worth the energy to ensure you have the right provider.
Why Middle Age Is When Adenomyosis Often Shows Up (Or Speaks Up)
Most adenomyosis diagnoses occur in women in their 40s and 50s — and there’s a real hormonal reason for this that I want you to understand.
Adenomyosis is an estrogen-dependent condition. It grows in the presence of estrogen, and it tends to quiet down (or in some cases, resolve) after menopause, when estrogen levels fall.
This means that the years when estrogen is most active — and especially the perimenopausal years when hormone fluctuations become more pronounced — are often when symptoms escalate most dramatically.
Here’s the specific piece of the puzzle that doesn’t get enough attention: during perimenopause, progesterone often begins declining before estrogen does. Progesterone is the hormone that counterbalances estrogen. It helps regulate the shedding of the uterine lining.
When progesterone falls and estrogen remains relatively elevated — a state often called estrogen dominance — the conditions that fuel adenomyosis become more pronounced.
Progesterone resistance, where the body stops responding normally to progesterone, may interfere with regular menstrual shedding, leading to more buildup, more inflammation, and worsening symptoms over time.
This also explains why a woman might have had manageable symptoms for years — maybe heavier periods than average, some cramping — and then in her late 30s or 40s, things shift. What was uncomfortable becomes debilitating. What was heavy becomes alarming.
It’s not that adenomyosis suddenly appeared. Often, it’s been there. The hormonal landscape of perimenopause simply turned up the volume.
Add to this the cumulative estrogen exposure that comes with age (more years of cycling = more exposure), and the fact that prior uterine surgeries or childbirth can create conditions where adenomyosis is more likely to develop — and you start to understand why this is very much a condition of midlife.
You are not imagining things. Your body is not turning against you. Something real is happening, and it has a name.
Gabrielle Union’s Story: When a Famous Voice Finally Gets Heard
In 2018, actress Gabrielle Union publicly shared her adenomyosis diagnosis — and in doing so, gave language to something millions of women had been experiencing without a name.
Union had endured eight or nine miscarriages over the course of her fertility journey. For three years, she described her body as “a prisoner” of IVF cycles.
All the while, people around her told her she had simply waited too long to have children. That her career had come at a cost. That her age was the problem.
The doctors agreed. And they were wrong.
When Union finally received her adenomyosis diagnosis toward the end of her fertility journey, she described it as the answers she had been waiting for.
Looking back, she said the signs had been there since her early twenties — periods lasting nine or ten days, bleeding through overnight pads. The response she got at the time? Birth control. Every doctor. Just birth control.
Her story is not an outlier. It is the norm for far too many women.
What Union’s experience illustrates so painfully is the cost of the diagnostic gap. Years of unexplained miscarriages, years of invasive treatments, years of absorbing blame for something that was never her fault — all because a condition was not recognized in time.
She has since used her platform to speak about the importance of women advocating for themselves, pushing for answers, and refusing to accept “you’re fine” when your body is telling you otherwise.
I want to say that to you directly: if something feels wrong, it’s worth pursuing. You deserve a provider who will listen and investigate — not one who offers reassurance without curiosity.
The Inflammation and Nervous System Layer
Here’s something that doesn’t get discussed enough in the context of adenomyosis: the role of chronic inflammation, and how it connects to your nervous system.
Adenomyosis is, at its core, an inflammatory condition. The displaced tissue inside the uterine wall triggers an ongoing inflammatory response.
Prostaglandins — inflammatory chemicals — are produced in higher quantities, which is part of why the cramping is so severe. The body is essentially responding to something it recognizes as an intrusion.
But chronic inflammation doesn’t stay contained to one area.
Over time, chronic pelvic inflammation can affect pain perception throughout the body, can dysregulate the immune system, and can contribute to a state of nervous system hypervigilance — where your pain signals are amplified because your nervous system has been on high alert for so long.
This is why women with adenomyosis often describe their pain as disproportionate — why a treatment that should help only does so much, why the fatigue feels bigger than the blood loss alone accounts for. The body has been in a state of chronic stress response, and the nervous system has been bearing that weight.
Anti-inflammatory lifestyle support — reducing processed foods and refined sugar, prioritizing sleep, managing stress, supporting the gut microbiome — is not a cure for adenomyosis, but it is a meaningful layer of support. And it is something you have significant agency over.
Conventional Medical Approaches: What You May Be Offered
I want to give you a clear picture of what conventional medicine currently offers for adenomyosis, because understanding your options matters — and so does knowing their limitations.
Hormonal management is typically the first approach. Hormonal birth control (pills, patch, ring) or progestin-containing IUDs are often used to thin the uterine lining and reduce bleeding and pain.
For some women this provides meaningful relief. For others, it manages symptoms without addressing the underlying condition — or comes with side effects that create new challenges.
GnRH agonists can suppress estrogen production, effectively creating a temporary medical menopause. This can reduce symptoms significantly, but is generally not a long-term solution and comes with significant side effects.
Anti-inflammatory medications (NSAIDs like ibuprofen) can help manage pain by reducing prostaglandin levels — but again, they address the symptom rather than the source.
Hysterectomy remains the only definitive cure. Because adenomyosis is confined to the uterus, removing the uterus eliminates the condition.
For women who are done with childbearing and whose symptoms are severely impacting their quality of life, this may be the right choice. But it should not be the first one offered, and it isn’t the only one.
There are also emerging nonsurgical approaches, including uterine artery embolization (UAE), that can reduce blood flow to adenomyotic tissue. These deserve a conversation with a specialist.
What I want you to hear: you have options, and hysterectomy is not your only path forward. Please work with a provider who is knowledgeable about adenomyosis specifically and who will present you with the full spectrum of possibilities.
How Mayan Abdominal Therapy Offers Support
This is where I get to talk about something close to my heart and my practice.
The Arvigo Techniques of Maya Abdominal Therapy — the approach I use in my work — is a non-invasive, external massage technique focused on the abdomen, pelvis, lower back, and sacrum.
Its purpose is to restore optimal blood flow, lymphatic circulation, and nerve supply to the pelvic and reproductive organs, and to support the organs of the digestive and reproductive system in their proper position and function.
In the context of adenomyosis, Mayan abdominal therapy is not a cure. I want to be clear about that, because I believe honesty serves you better than overstatement.
What it is is a meaningful, body-honoring form of support that addresses several of the key physiological challenges that adenomyosis creates.
Circulation support. One of the primary goals of Mayan abdominal therapy is to increase blood and lymphatic circulation to the uterus and surrounding organs. Chronic pelvic congestion — stagnant blood flow in the pelvic region — is common in conditions like adenomyosis, and it contributes to pain, heaviness, and tissue dysfunction.
By gently encouraging circulation, this work helps nourish uterine tissue and support the body’s natural clearing processes.
Scar tissue and adhesion work. Old adhesions from surgeries (C-sections, fibroid removals, laparoscopies) or chronic inflammation can restrict the movement of pelvic organs and create additional sources of pain.
Mayan abdominal therapy has a long tradition of helping to soften and reduce adhesions in the pelvic and abdominal area — work that can directly support women living with adenomyosis.
Uterine positioning. When the uterus is displaced from its optimal position — tilted, compressed, or pulled by adhesions — it can restrict blood and lymphatic flow and increase pain and dysfunction.
Mayan abdominal therapy works gently to support optimal uterine positioning through massage of the ligaments and surrounding tissues.
Nervous system regulation. This work is slow, intentional, and deeply responsive to your body. For a nervous system that has been in a chronic stress and pain response, that kind of attentive, unhurried touch carries its own medicine.
Many women leave a session feeling a release not just in their bodies but in their overall sense of ease.
Empowerment through self-care. One of the things I love most about this tradition is the self-massage component. Every client leaves knowing how to care for their own abdomen between sessions — how to encourage circulation, how to support their own pelvic health.
That sense of agency matters deeply when you have a condition that has so often left you feeling powerless.
How CranioSacral Therapy Fits In
CranioSacral therapy works with the craniosacral system — the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord. Through very gentle, light-touch techniques, CST supports the nervous system in releasing restrictions and tension patterns that interfere with overall function.
For women with adenomyosis, there are several meaningful ways that CranioSacral therapy can support the healing process.
Nervous system regulation. As I mentioned earlier, chronic pain creates a nervous system that is perpetually on guard — hypervigilant, sensitized, braced. CranioSacral therapy is one of the most effective tools I know for helping the nervous system drop out of that state.
When the nervous system can finally move from fight-or-flight into rest-and-digest, the body’s capacity to heal, regulate hormones, and process inflammation improves significantly.
Sacral and pelvic release. The sacrum — the triangular bone at the base of your spine — is directly connected to the uterus through its ligaments and fascia. Tension patterns held in the sacrum and surrounding structures can create or amplify pelvic pain.
CranioSacral therapy addresses these connections gently and effectively.
Supporting the hormonal system. The pituitary gland — the master regulator of your hormonal cascade — sits at the base of the brain. CranioSacral therapy works along the entire central nervous system, including supporting optimal function of the structures involved in hormonal communication.
This is not a replacement for medical hormonal support, but it is a meaningful complement to it.
Processing stored tension. Many women who have been living with chronic pain, repeated medical procedures, or years of feeling dismissed carry significant stored tension in their bodies — not just muscularly, but somatically and emotionally.
CranioSacral therapy creates a safe, quiet space for that tension to move and release.
When I work with a client navigating adenomyosis, these two modalities — Mayan abdominal therapy and CranioSacral therapy — often work beautifully together. One nourishes and supports the pelvic organs and circulation directly. The other helps the nervous system find its way back to safety and ease.
What Lifestyle Support Looks Like
Alongside professional care — both medical and holistic — there are meaningful lifestyle choices that can support a body navigating adenomyosis. These are not replacements for diagnosis and treatment. They are supporting layers.
Reduce inflammatory foods. Processed foods, refined sugar, and alcohol can fuel systemic inflammation. Emphasizing whole, plant-rich foods — deeply colored vegetables, omega-3-rich seeds, fiber-rich grains — supports the body’s ability to regulate inflammation.
Support iron levels intentionally. If heavy bleeding is part of your experience, iron-rich foods and targeted supplementation (under the guidance of your provider) are important.
Foods like leafy greens, legumes, pumpkin seeds, and (if you eat animal products) red meat and organ meats can help replenish what is being lost. Vitamin C alongside iron-rich foods improves absorption significantly.
Move gently. This is not the moment for aggressive, high-intensity exercise if your body is inflamed and depleted. Gentle movement — walking, yoga, swimming, qigong — supports lymphatic circulation, hormone regulation, and nervous system health without adding physiological stress.
Prioritize sleep as medicine. Deep, restorative sleep is when your body does its repair work. Supporting your sleep with consistent timing, reduced light exposure in the evening, and a wind-down ritual is not a luxury — it’s a clinical need.
Reduce chronic stress. I know. You’ve heard this before. But the connection between stress, cortisol, inflammation, and estrogen metabolism is real.
Supporting your nervous system through practices like breathwork, somatic awareness, time in nature, and creative expression isn’t soft advice — it’s physiology.
A Few Signs It’s Time to Advocate for Yourself
I want to leave you with this, because it matters.
If you are experiencing heavy periods that disrupt your life, severe menstrual pain, chronic pelvic pressure, painful sex, or unexplained fatigue and anemia — please do not let these be minimized.
Ask your doctor specifically about adenomyosis. Ask for a transvaginal ultrasound performed by someone with expertise in gynecological imaging. Ask for your ferritin to be checked if fatigue is part of your picture. Ask what other conditions might be contributing, and whether a referral to a specialist is appropriate.
And if you feel dismissed, find another provider. You deserve someone who takes your experience seriously.
Gabrielle Union spent years being told her body was the problem. It wasn’t. She had a condition — a real, diagnosable, treatable condition — that nobody had been curious enough to look for.
You deserve that curiosity directed at you.
Where Holistic Support Fits Into the Picture
Here at RELEASE Embodied Wellness, I work with women who are navigating exactly this kind of complexity — conditions that live in the body, that intersect with hormones and the nervous system and years of accumulated tension, and that deserve more than a prescription and a pamphlet.
Mayan abdominal therapy and CranioSacral therapy are not cures for adenomyosis. But they are powerful, evidence-informed forms of support for a body that has been carrying a lot, for a long time.
If you’re navigating adenomyosis — or if something in this post made you wonder whether you might be — I’d love to be part of your care team. Not as the only voice. But as a grounded, committed partner in helping your body find more ease.
You can learn more about my work [here], or reach out to schedule a conversation. I’m always happy to talk before you commit to anything.
And if you’re not in the area, you can can look up Upledger Craniosacral Therapy, or the Arvigo techniques of Mayan Abdominal Therapy for a therapist near you.
This post is for educational purposes and is not intended to replace medical diagnosis or treatment. If you are experiencing symptoms of adenomyosis or any other gynecological condition, please work with a qualified healthcare provider.
