Can You Have Endometriosis & Adenomyosis at the Same Time?

If bouncing between appointments, taking painkillers that barely dull the cramping, and walking out of countless appointments with vague answers or a single diagnosis that doesn't quite explain everything, you may be dealing with a complex gynecological condition that requires an expert. There are two conditions that often come up when dealing with exhausting periods: endometriosis and adenomyosis. They are separate diseases that affect different parts of the body, but they overlap so frequently that one or the other is often misdiagnosed. Yet 42.3% of women with surgically confirmed adenomyosis also had endometriosis, and more than half of those women had no idea they had both conditions.

If you have ever felt dismissed, doubled over with cramps, or stuck in a loop without answers, continue reading to get a better understanding of each condition and where to find the best minimally invasive gynecologic surgeon in Los Angeles for expert treatment.

Endometriosis vs. Adenomyosis: What's the Difference?

Both endometriosis and adenomyosis start with the same kind of tissue, but the trouble is where that tissue ends up:

With endometriosis, tissue similar to the lining of your uterus grows outside of it, often on the ovaries, fallopian tubes, bowels, bladder, or the ligaments that hold the uterus in place. Each month, that misplaced tissue still tries to act like a normal period lining. It thickens, breaks down, and bleeds, but it has nowhere to go. The result is inflammation, scarring, and pain that can spread well beyond the pelvis.
Adenomyosis is different because the endometrial tissue grows directly into the muscle wall of the uterus. The uterus then thickens, swells, and can feel tender to the touch. So while both diseases involve tissue that misbehaves, endometriosis leaves the uterus, and adenomyosis stays trapped inside it.

Can You Have Both Endometriosis and Adenomyosis at the Same Time?

Yes, and it happens far more often than most women realize. Doctors used to treat the two as completely separate problems, but newer research keeps showing how often they appear together. Studies report coexistence rates anywhere from one in five women all the way up to nearly nine in 10, depending on how the research is done. This means that if a doctor finds and treats only one condition, the other can keep causing pain, heavy bleeding, or fertility struggles long after surgery or medication.

A few patterns can hint that you may have both conditions: Heavy bleeding with thick clots usually points to adenomyosis, while pain that lingers between periods or flares up during sex is more typical of endometriosis. When both signs show up, that's a strong reason to ask your doctor to look at everything going on inside your body instead of stopping at the first diagnosis that fits.

Endometriosis Symptoms vs. Adenomyosis Symptoms: How to Tell Them Apart

The symptoms of these two conditions overlap, but the way they show up in your body usually does not. Endometriosis tends to cause:

Cramping that ramps up during your period
Sharp pain during sex
Painful bowel movements or urination around your cycle
A dull, dragging ache in the pelvis that can creep into your lower back or legs

Many women also struggle with bloating so severe that it feels like an extra stomach appeared overnight, a symptom often called endo belly. Adenomyosis usually shows up differently:

Menstrual bleeding is very heavy, sometimes soaking through a pad or tampon in under an hour
Clots the size of grapes are common
Cramps feel deeper and more constant
The lower belly may feel swollen or tender even when your period is not active

Timing gives another clue. Endometriosis pain tends to follow the calendar of your cycle, while adenomyosis can ache day after day with no real break. Tracking when, where, and how your symptoms hit gives the best endometriosis excision surgeon in Los Angeles a much clearer starting point before any imaging is even ordered.

Modern Treatment Options for Endometriosis and Adenomyosis

Both conditions usually start with the same conservative treatments, like ibuprofen or naproxen for pain and hormonal birth control to quiet down the monthly cycle. From there, the paths split:

For adenomyosis, a hormonal IUD such as Mirena is often a common first choice because it can sharply cut down on heavy bleeding and cramping. Some women also consider uterine artery embolization, a procedure that limits blood flow to the affected tissue. For those who have finished having children or whose pain is severe, a hysterectomy is the only true cure for adenomyosis, since the disease lives entirely inside the uterus.
Endometriosis takes a different route. Because the lesions sit outside the uterus, removing the uterus alone will not fix the disease. The most effective surgical option is endometriosis excision surgery, where a specialist carefully cuts out each lesion rather than burning the surface.

Fertility, Pregnancy, and the Long-Term Outlook for Both Conditions

Both conditions can affect your ability to get pregnant, but they cause problems in different ways. Endometriosis can create scar tissue and adhesions that block the fallopian tubes or pull the ovaries out of position. The constant inflammation it stirs up can also lower egg quality and make it harder for an embryo to implant. According to the World Health Organization, endometriosis is associated with infertility globally, and as many as 25 to 50% of women with infertility have the condition.

Adenomyosis affects fertility from a different angle. Because the disease lives inside the uterine wall, it can interfere with how an embryo settles in and grows. Women with adenomyosis face higher rates of miscarriage, preterm birth, and IVF challenges, even when other parts of the reproductive system look normal. The good news is that pregnancy is possible with either condition, and in many cases with both.

Finding the Best Minimally Invasive Gynecologic Surgeon in Los Angeles

You don't have to spend another year chasing answers, changing doctors, or wondering if your pain is just something you have to learn to live with. Endometriosis and adenomyosis respond well to treatment when you work with the best severe endometriosis surgeon in Los Angeles. At our Beverly Hills practice, Dr. Matthew Siedhoff brings fellowship-level training in minimally invasive gynecologic surgery, advanced excision techniques, and the kind of careful listening that allows women to feel heard and understood.

Whether you are facing advanced endometriosis, adenomyosis, fibroids, pelvic adhesions, or fertility challenges that no one has fully explained, we are here to help you map out a clearer path forward.

Ready to let the best deeply infiltrating endometriosis surgeon in Los Angeles help you trade years of guessing for the answers you’ve needed all along?