Adenomyosis Physiotherapy in Clapham

Adenomyosis is a condition where the lining of the womb starts growing into the muscle in the wall of the womb. This can make the womb enlarged, sometimes described on a scan as a “bulky uterus”, and cause heavy, painful periods.

According to the NHS, it’s more commonly diagnosed in women over 30 and those who have given birth, though it can affect anyone who has periods. Some women have no symptoms at all. It’s closely related to endometriosis, and the two often occur together.

• Painful periods, sometimes severe enough to stop you doing your usual activities
• Heavy or prolonged periods
• Pelvic pain, which may be there between periods too
• Bloating, heaviness or fullness in the tummy, sometimes called “adenomyosis belly”
• Pain during sex
• Pain spreading to the lower back or legs
• Tiredness, especially with heavy bleeding

Heavy bleeding can lead to low iron levels, which adds to tiredness, so it’s worth asking your GP to check.

Physiotherapy doesn’t treat adenomyosis itself or the heavy bleeding, which need medical care. What it can help with is the pain and muscle tension that build up around it. Ongoing pelvic pain often makes the pelvic floor and tummy muscles tighten and guard, which adds its own layer of pain. Your plan may include:

• Pelvic floor relaxation: breathing and down-training to release tension
• Manual therapy: gentle myofascial release for the tummy, pelvis and pelvic floor, only with your consent
• Stretching and mobility: for the back, hips and tummy
• Pain education: understanding how persistent pain works, which can reduce flare-ups and fear
• A plan for painful periods: strategies to use at home each cycle

Heat

A hot water bottle or heat pad on the tummy or lower back can ease cramping and muscle spasm.

TENS

A TENS machine, which uses small electrical pulses through pads on the skin, helps some women manage period pain.

Gentle movement

Walking, stretching, yoga or Pilates can ease cramping for some women and help with pain between periods. Build up gradually and adapt around your cycle.

Breathing and positions

Slow belly breathing and positions that let the pelvic floor relax, such as lying on your back with your knees bent and apart, can take the edge off pain.

Pacing

Planning heavier days around your cycle and balancing rest with gentle activity can help with both pain and tiredness.

Back and leg pain

Pain from the womb can be felt in the lower back and down the legs, and muscle tension can add to it. Physiotherapy can help ease the muscular part. For back pain that isn’t linked to your cycle, see our lower back pain page.

Bloating

Many women notice bloating or a swollen tummy, especially around their period. Relaxing the tummy and pelvic floor muscles and keeping your bowels regular can help, as constipation can make it worse.

Painful sex

Deep pain during sex is common with adenomyosis. Read more about painful sex (dyspareunia).

Hysterectomy

A hysterectomy is the most effective treatment for adenomyosis, and is usually considered when other treatments haven’t helped. If you’ve had or are planning one, see our post-hysterectomy physiotherapy page.

Menopause

Adenomyosis is affected by oestrogen, so symptoms may ease after menopause. Find out about menopause physiotherapy.

Your first appointment lasts 60 minutes and takes place in a private, judgement-free room at our Clapham clinic. Olivia will:

• Talk through your symptoms, cycle, diagnosis or scans so far, treatment history and goals
• Assess your posture, breathing, movement and tummy
• With your consent, carry out an internal examination to assess pelvic floor tension. It’s always optional and fully explained beforehand
• Explain what she has found and agree a treatment plan with you

See your GP if your periods become more painful, heavier or irregular, or if you have pelvic pain, bloating or pain during sex. Adenomyosis is usually diagnosed with an ultrasound or MRI scan, and your GP can discuss treatments such as hormonal options, pain relief or referral to a gynaecologist.

Seek urgent medical help if pelvic or period pain is severe or much worse than usual. Olivia is happy to work alongside your GP or gynaecologist.