Endometriosis and adenomyosis are two conditions that can have a big impact on women’s lives, yet they’re often misunderstood, misdiagnosed, or confused with one another. Both involve the presence of endometrial-like tissue outside of where it’s meant to be, and both can cause pain, heavy bleeding, and fertility challenges. But they are not the same condition.
In this post, I’ll explain the differences, highlight common symptoms, diagnosis, and explore natural approaches—including acupuncture—that may improve your quality of life.
The Difference Between Endometriosis and Adenomyosis:
- Endometriosis: Endometrial-like tissue grows outside the uterus (such as on the ovaries, fallopian tubes, pelvic lining, and in some cases even the bowel or bladder). Each month, this tissue responds to hormonal changes, which can cause inflammation, scarring, adhesions, and severe pain.
- Adenomyosis: Endometrial tissue grows into the muscular wall of the uterus. This thickens the uterus, leading to heavy, painful periods and often a feeling of pressure in the pelvis.
The key difference is where the tissue grows—outside the uterus in endometriosis versus within the muscle wall in adenomyosis.
Common Symptoms
Both conditions share similarities, which is why they’re sometimes confused:
- Heavy, painful or irregular periods
- Pelvic pain before or during menstruation
- Pain during or after sex
- Lower back pain
- Bloating (“endo belly”)
- Fatigue
- Fertility issues
Adenomyosis-specific clues: very heavy bleeding, clots, and an enlarged, tender uterus.
Endometriosis-specific clues: pain during ovulation, bowel movements or urination, and widespread pelvic pain due to adhesions.
It’s also important to know that the severity of pain doesn’t always match the severity of disease—some women with only mild endometriosis experience extreme pain, while others with advanced disease may have very little pain at all.
Endometriosis vs Adenomyosis: Key Differences at a Glance:
| Feature | Endometriosis | Adenomyosis |
|---|---|---|
| Where tissue grows | Outside the uterus (e.g. ovaries, fallopian tubes, pelvic cavity, bowel, bladder) | Inside the uterine muscle wall |
| Main symptoms | Pelvic pain, painful/irregular periods, pain during sex, pain on bowel/bladder movements, bloating, fatigue, fertility issues | Very heavy bleeding, painful periods, clots, enlarged tender uterus, pelvic pressure, fatigue |
| Impact on fertility | Can reduce egg quality, cause adhesions, block tubes, and make implantation harder | Can make implantation harder, increase miscarriage risk, and disrupt uterine contractions |
| Diagnosis | Symptoms + pelvic exam + imaging; laparoscopy is the gold standard | Imaging (3D colour Doppler ultrasound or MRI), enlarged uterus on exam |
| Treatment options | Pain relief, hormone therapy, surgery, lifestyle changes, acupuncture | Hormone therapy, surgery (in severe cases), lifestyle changes, acupuncture |
Natural Ways to Help Yourself
While medical treatments (such as surgery or hormone therapy) are often suggested, there are also supportive steps you can take:
Reduce exposure to oestrogen-mimicking chemicals (endocrine disruptors):
Choose organic produce where possible
Use natural, non-toxic skincare and cleaning products
Avoid plastics (store food in glass or stainless steel, never heat food in plastic)
Filter your drinking water
Support healthy liver function (your liver helps metabolise oestrogen):
Eat cruciferous vegetables (broccoli, kale, cauliflower, Brussels sprouts)
Limit alcohol and processed foods
Stay hydrated
Balance inflammation and pain naturally:
Omega-3 rich foods (salmon, chia, flax, walnuts)
Turmeric and ginger
Gentle exercise like yoga or walking
Heat therapy (warm baths, hot water bottles, infrared heat lamps)
- Castor oil packs
Track your cycle so you can see patterns and work with them rather than being blindsided each month.
How Acupuncture Can Help
Acupuncture can be an effective natural therapy alongside conventional treatment for endometriosis and adenomyosis. Research and clinical experience show that acupuncture may:
- Reduce pelvic pain and cramps by calming nerve sensitivity
- Improve blood flow to the uterus and pelvic area
- Reduce inflammation
- Support hormone balance
- Help regulate cycles and improve fertility outcomes
- Calm stress and anxiety, which often worsen symptoms
In my clinic, I use specific acupuncture points tailored to endometriosis and adenomyosis, alongside electro acupuncture and a TDP therapeutic infrared heat lamp.
These work together to move blood in the pelvic area, reduce inflammation, and ease pain, while also supporting overall reproductive health.
For many women, acupuncture provides not only physical benefits, but also emotional support through what can be an overwhelming journey.
Many women report noticeable relief after just a few treatments, with ongoing improvement over time.
Final Thoughts
If you suspect endometriosis or adenomyosis, don’t ignore your symptoms—they’re real and valid. Getting the right diagnosis, through tools like a 3D colour ultrasound, can be life-changing. Alongside medical care, natural lifestyle steps and acupuncture can help reduce pain, balance hormones, and improve overall wellbeing.