Adenomyosis – Endo’s lesser known, but just as feisty relative

Like endometriosis, diagnosing adenomyosis can be a long and emotional process for many women. The symptoms are similar to other gynaecological conditions and the medical testing can be quite invasive, so we often see women living in pain for many years before seeking help or reaching a diagnosis. Properly tailored exercise can reduce the impact of your symptoms and improve general mood and wellbeing to support you to live your best life!

What is Adenomyosis?

Adenomyosis is a chronic health condition affecting approximately 1 in 10 people assigned female at birth. It is common to see adenomyosis co-occur with endometriosis however, there is a distinct difference between the two. Endometriosis is when the lining of the uterine wall is found outside of the uterus, usually within the pelvic region whereas, adenomyosis is when this tissue is found within the wall of the uterine muscle itself. Just like the lining of the uterus, this tissue bleeds during your menstrual period which often results in pain, fatigue and low mood.

Symptoms of Adenomyosis:

  • Lower back and/or pelvic pain
  • Dyspareunia (painful sex)
  • Dysmenorrhea (painful periods)
  • Pain during or after bladder/bowel movements
  • Fatigue
  • Abnormal bleeding
  • Infertility
  • Low mood, decreased work productivity, anxiety, depression


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How and Why Should I Exercise?

It is currently unknown whether exercise has a direct impact on the adenomyotic tissue itself, however we do know that exercise can improve your symptoms and quality of life. Common medical treatments for adenomyosis involve hormonal therapies, pain medication and/or surgery, all of which come with many side effects. Fortunately, these can also be managed by moving your body regularly!

Myofascial Stretching/Release

When faced with chronic pain, the body can ‘tighten’ as part of a protective response. Flowing stretches for the pelvis, hips and torso can assist in reducing tension and improving pain. Try gentle yoga or stretches that feel good. Ensure you can maintain your usual breathing throughout and gently move in and out of the stretch rather than holding it for greater benefit.

Low-Moderate Intensity Cardiovascular Exercise

Cardiovascular based exercise involves any repetitious movement which increases your heart rate and makes you a little puffy. To start with, try something gentle that you enjoy like bushwalking, swimming, cycling or dancing. Aim for a moderate intensity which is when you are able to talk but you cannot sing. This type of exercise has been shown to improve mood, productivity, fatigue and overall health and wellbeing. It also improves blood flow to the uterus which can manage pain and cramping.

Strength Training

Lifting weights doesn’t need to look like what you might see in a typical gym. Completing resistance exercises in a slow and controlled manner can promote lengthening which can assist in managing pain. If you’re new to lifting weights, try completing bodyweight exercises first before progressing into machine or free weights. If it doesn’t feel right, contact your local AEP to find which resistance exercises will suit you most!

Pelvic Floor Downtraining

Pain and tension in the muscles which make up the pelvic floor is common in women with adenomyosis. These muscles help to support our internal organs and play a vital role in bladder, bowel and sexual function. Specific exercises can be recommended by an Exercise Physiologist to lengthen and elongate these muscles. There are also specific tools and techniques that a Pelvic Floor Physiotherapist will be able to prescribe.

Remember that you might have to try a few different types of exercise before you find what works best. If you’re unsure where to start or would like help building your confidence with exercise and movement, your local Accredited Exercise Physiologist will be able to help!

To find an Accredited Exercise Physiologist in your area, click here.

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Written by Elisha Silcox. Elisha is a Women’s Health Accredited Exercise Physiologist at Pear Exercise Physiology