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Adenomyosis Causes & Risk Factors

Adenomyosis is a gynecological condition in which the tissue inside of the uterus (endometrium) is abnormally located within the uterine wall (myometrium). This condition thickens the uterus, leading to symptoms such as heavy bleeding and painful periods. The cause of adenomyosis is still widely unknown, and studies to determine it are ongoing. In the meantime, there are several theories on the subject. While some women may be genetically predisposed to adenomyosis, others may develop the disease as a result of the formation of scar tissue after an open surgery like a cesarean section.

There are also several risk factors that indicate a higher likelihood of developing adenomyosis, including a history of childbearing and previous uterine surgery. It is important to understand these causes and risk factors to understand whether you might be at risk.

Causes of Adenomyosis

The causes of adenomyosis are unknown. However, some theories have been formed about its potential origins. Some of these theories include:
  • Invasive tissue growth1 – After an injury to the uterus or a surgery such as a cesarean section, scar tissue may begin to migrate and invade the wall of the uterus.
  • Childbirth-related uterine inflammation – Multiple studies2,3,4 have shown higher rates of adenomyosis in women who have experienced childbirth.
  • Developmental origins – It is possible for adenomyosis to develop at the same time the uterus is developing in a fetus.
  • Stem cell origins5 – Bone marrow stem cells may invade the uterine muscle, causing adenomyosis to form.
Adenomyosis growth depends on the production of estrogen, so it’s possible for symptoms to resolve after menopause. This is not always the case, and if symptoms persist after menopause, it’s important to discuss treatment options with an adenomyosis specialist.

Adenomyosis Risk Factors

There are multiple factors that may place women at a higher risk for adenomyosis. These include:

  • Childbearing
  • Previous uterine surgery including cesarean section, fibroid removal in an open surgical procedure or dilation and curettage
  • Shorter-than-average menstrual cycles
  • Early age of first period

Traditionally, adenomyosis has been most commonly diagnosed in women age 50 and older. But because a confirmed diagnosis can only occur in pathology after a hysterectomy, that age range may be skewed toward women who are finished with childbearing or past their childbearing years and more likely to opt for a hysterectomy3. It’s possible for adenomyosis to develop in women of all ages.

Potential Complications

If left untreated, adenomyosis may lead to the following long-term complications:

  • Chronic anemia and fatigue from more frequent and heavy bleeding during periods
  • Low quality of life from pain and fear of bleeding

The CIGC Difference

Unlike a standard OBGYN, CIGC’s adenomyosis specialists perform laparoscopic surgeries every day. DualPortGYN was developed by the CIGC minimally invasive GYN specialists to improve the outcomes of hysterectomies. DualPortGYN takes advantage of advanced surgical techniques that enhance the safety and lower the complication rates of each procedure. For those interested in maintaining fertility, CIGC has nonsurgical treatment options available.

While hysterectomy is the primary surgical solution for adenomyosis, any course of treatment is discussed thoroughly with you by the specialists and is weighed against each patient’s goals for fertility.

Schedule a Consultation

If you think you have adenomyosis, our specialists are ready to provide an evaluation of your symptoms and conditions and recommend an appropriate solution.


  1. Struble J, Reid S, Bedaiwy M. Adenomyosis: A clinical review of a challenging gynecologic condition. J Minim Invasive Gynecol. 2016 Feb 1;23(2):164-85
  2. Kitawaki J. Adenomyosis: The pathophysiology of an oestrogen-dependent disease. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):493–502.
  3. Taran FA, Weaver AL, Coddington CC. et al. Understanding adenomyosis: a case control study. Fertil Steril. 2010;94:1223–1228.
  4. Templeman C, Marshall S F, Ursin G. et al. Adenomyosis and endometriosis in the California Teachers Study. Fertil Steril. 2008;90:415–424
  5. Sasson IE, Taylor HS. Stem cells and the pathogenesis of endometriosis. Ann N Y Acad Sci. 2008;1127:106-115. doi:10.1196/annals.1434.014