Adenomyosis is a condition where tissue similar to the lining of the uterus grows into the muscle wall of the uterus. This can cause the uterus to become enlarged, tender and is a common but often under-recognised cause of painful and heavy periods.
Dr Guy Fisher is a specialist gynaecologist in Auckland with expertise in the diagnosis and management of adenomyosis. He uses advanced pelvic ultrasound to identify the condition and guide personalised treatment.
Adenomyosis
When the uterus itself is the source of pain and heavy bleeding
How adenomyosis can affect you
Adenomyosis can present in different ways. Common symptoms include:
Heavy or prolonged periods
Severe or worsening period pain
Pelvic pain outside of your period
Fatigue or anaemia from blood loss
Fertility or implantation difficulties
Symptoms often worsen over time and may be more noticeable after pregnancy or in your 30s and 40s.
Adenomyosis and endometriosis
Adenomyosis often occurs alongside endometriosis.
These conditions can cause overlapping symptoms, including pain, heavy bleeding, and fertility difficulties.
Identifying both conditions is important, as it may influence treatment decisions and long-term outcomes.
How adenomyosis is diagnosed
Adenomyosis cannot be diagnosed by examination alone.
Specialist pelvic ultrasound is one of the most effective ways to identify adenomyosis. It detects characteristic changes in the uterine muscle, including:
Thickening or irregularity of the uterine wall
Changes in tissue texture
Small cysts within the muscle of the uterus
Because this requires specific imaging techniques and experience, adenomyosis is often missed on routine scans. My training in advanced pelvic ultrasound allows these features to be identified more reliably.
Adenomyosis and fertility
Adenomyosis can affect fertility and implantation in some patients.
It may influence the uterine environment and reduce the likelihood of successful implantation. However, the impact varies, and many women with adenomyosis can still conceive — sometimes naturally and sometimes with support.
Careful assessment helps guide decisions around timing, fertility treatment, and whether other interventions are needed.
Treatment options
Treatment depends on symptoms, age, and fertility plans.
Options may include:
Pain relief and anti-inflammatory medication
Hormonal treatments to control bleeding and pain
Management of heavy bleeding
Fertility-focused planning when pregnancy is a goal
Laparoscopic (keyhole) surgery in selected cases
The aim is to develop a plan that fits your symptoms, priorities, and stage of life.
How I can help
I specialise in the diagnosis and management of adenomyosis, using advanced ultrasound to identify the condition and guide treatment.
When surgery is needed, I use fellowship-trained minimally invasive techniques wherever possible to reduce pain, recovery time, and disruption to your life.
Book an appointment for adenomyosis in Auckland
If you have heavy, painful periods or pelvic pain that may be due to adenomyosis, you can book a consultation for specialist assessment.