Two women sit side by side on a rocky lakeshore with their backs to the camera, looking out over calm water toward a snow-capped mountain.

Adenomyosis rarely makes headlines. It does not have the same name recognition as endometriosis, and it is often dismissed as "just heavy periods" or "normal pain." But for millions of women, adenomyosis is a daily reality that affects their energy, mood, relationships, and working lives.

This condition deserves far more visibility and understanding. Not only because the symptoms can be debilitating, but because so many people are navigating it silently, unsupported, and often without a diagnosis.

Let’s change that.

What Is Adenomyosis?

Adenomyosis occurs when tissue similar to the lining of the uterus grows into the muscular wall of the uterus. Imagine the endometrium burrowing inward, thickening and enlarging the uterus, and triggering inflammation that does not belong there.

This can lead to extremely heavy periods, severe cramping, chronic pelvic pain, bloating, pressure, painful sex, painful bowel movements, and fatigue that feels bone deep. Some people describe it as living with a "bruised uterus." Others say it feels like labour contractions every month. There is no single typical experience, but the suffering is very real.

How Common Is Adenomyosis?

More common than most people realise. Research suggests that as many as one in five women may have adenomyosis, although the real number is likely higher. Many cases are missed because symptoms overlap with endometriosis, not all clinicians are trained to recognise it, and until recently diagnosis often required a hysterectomy.

Imaging is improving, and more people are finally getting answers. Even so, too many are still told that their pain is normal or something they simply have to live with.

The Symptoms People Learn to Downplay

Many people with adenomyosis minimise their symptoms because they have been conditioned to tolerate period pain. That cultural narrative of "it is just part of being a woman" is powerful and damaging.

Heavy bleeding that requires changing products every hour becomes brushed off as normal. Pain strong enough to disrupt sleep and concentration gets labelled as "bad cramps." A constant pelvic ache becomes something to endure quietly. Exhaustion that hits like a wall is dismissed as stress.

And because symptoms vary throughout the cycle, there can be days when things feel manageable followed by days when even basic tasks feel impossible. It is unpredictable, frustrating, and emotionally draining.

Adenomyosis at Work: The Hidden Struggle

Many people go to work in significant pain because they feel they have to. They use holiday or sick days simply to cope with symptoms. They struggle with energy regulation, swinging between inflammation driven fatigue and the mental load of managing a condition no one can see.

Concentration becomes harder when the body is battling pain. Brain fog is not imagined. It is a physiological response to inflammation and chronic discomfort. And many people keep all of this hidden because they fear judgement or being seen as unreliable.

Adenomyosis is a legitimate medical condition that deserves understanding and reasonable accommodation. Small adjustments such as flexible working hours, hybrid options, access to rest spaces, or adjusted expectations during flare ups can make a significant difference. Supportive workplaces retain their talent. Unsupportive ones often lose it.

Diagnosis: Finally Moving Forward

Diagnosis has historically been challenging, but things are changing. Transvaginal ultrasound can be effective when performed by someone trained to look for adenomyosis, and MRI scans offer further clarity when needed. A hysterectomy is no longer required for diagnosis.

The challenge is that not all clinicians are trained to recognise adenomyosis on scans, which contributes to delays, frustration, and misdiagnosis. Advocacy matters here. Being believed matters even more.

Treatment Options

There is no single treatment that works for everyone, but the goal is always to reduce symptoms and improve quality of life.

For some, anti-inflammatory medication or hormonal treatments such as the IUS or combined pill bring relief. Others benefit from physiotherapy, pelvic floor support, or short term hormonal suppression. In more severe cases, procedures like uterine artery embolisation, adenomyomectomy, or hysterectomy may be discussed.

What matters most is informed choice. No one should be pushed into treatment pathways that do not align with their goals, whether that is managing symptoms while keeping fertility options open or seeking a more definitive solution.

The Emotional and Mental Load

Adenomyosis is not just physical. It affects mood, self confidence, relationships, and the ability to plan. When you never quite know how bad the next cycle will be, it affects how you show up in every part of your life, including work.

Chronic pain reshapes a person’s inner world. Compassionate, psychologically informed care is essential. You cannot separate the physical symptoms from the emotional experience.

What Employers Need to Know

If you are reading this as an HR professional, manager, or wellbeing lead, here is the key message: Adenomyosis is not a performance issue. It is a health condition. And it is one that requires understanding, flexibility, and a willingness to adapt.

Simple adjustments can significantly reduce the impact of symptoms at work:

Flexibility in hours
Hybrid working
Access to rest spaces
Supportive communication
and realistic expectations during flare ups help people stay in work and stay well.

Workplaces that recognise women’s health conditions as part of everyday wellbeing do more than support individuals. They build cultures that attract and retain talent.

If You Are Living With Adenomyosis

You are not imagining your symptoms. You are not oversensitive. You are not failing. Adenomyosis is real, painful, and often misunderstood, but that does not make your experience any less valid.

You deserve proper care. You deserve a workplace that respects your health. And you deserve support that allows you not just to cope, but to thrive.

If you are struggling at work and do not know where to start, please know that you are not alone.

How We Support Organisations

At See Her Thrive, we work with organisations that want to take women’s health seriously and create environments where people can perform at their best throughout every stage of life. Our approach is evidence based, compassionate, and always practical, helping employers move beyond awareness into meaningful action.

We offer a range of support including team talks that build understanding, wellbeing series that deepen knowledge across the year, workshops designed to help women navigate symptoms at work, and specialist training for managers and champions. Every session is grounded in real insight and tailored to the realities of modern work.

Because workplaces thrive when women thrive.

If you want tailored support for your team or organisation, get in touch at hello@seeherthrive.com. We would love to hear from you.

Introducing Adenomyosis: the evil sister of Endometriosis