Uterine Wall Assessment

Adenomyosis Evaluation

A dedicated ultrasound evaluation to diagnose and characterise adenomyosis – a common cause of pelvic pain and heavy menstrual bleeding.

Overview

Understanding adenomyosis – when the endometrium invades the muscle.

Adenomyosis is a condition in which endometrial tissue – the lining that normally grows inside the uterus – grows into the muscular wall of the uterus (myometrium). This causes the uterine wall to thicken and can lead to painful, heavy periods, chronic pelvic pain, and infertility. It affects up to 20‑30% of women, but is often underdiagnosed.

Adenomyosis evaluation is a specialised transvaginal ultrasound that looks for characteristic features: diffuse or focal thickening of the myometrium, tiny cystic spaces (myometrial cysts), echogenic islands, and abnormal vascularity. It helps differentiate adenomyosis from fibroids and guides treatment decisions – from medical management (hormonal therapy, pain relief) to surgical options (endometrial ablation, hysterectomy).

At Amytri, our adenomyosis evaluations are performed by experienced consultant radiologists using state‑of‑the‑art transvaginal ultrasound, often with Doppler assessment. We provide a detailed report that documents the extent and pattern of involvement, helping your gynaecologist tailor your management plan.

What adenomyosis evaluation covers

  • Assessment of uterine size and shape – diffuse or asymmetrical enlargement
  • Myometrial thickness measurement – focal or diffuse thickening
  • Detection of myometrial cysts (tiny anechoic spaces within the muscle)
  • Identification of echogenic islands – hyperechoic spots in the myometrium
  • Evaluation of the junctional zone – irregular or poorly defined
  • Doppler assessment – abnormal vascularity within the myometrium
  • Differentiation from uterine fibroids and other pathology
  • Guidance for medical or surgical management
Why it matters

Accurate diagnosis leads to effective management.

Adenomyosis is treatable – but it is often overlooked. Ultrasound provides the definitive evidence needed to confirm the diagnosis and guide appropriate therapy.

Diagnosis

Confirm or rule out adenomyosis

Ultrasound features – such as myometrial cysts, echogenic islands, and irregular junctional zone – provide a reliable diagnosis of adenomyosis, even in the absence of symptoms.

Differentiation

Distinguish from fibroids

Adenomyosis and fibroids can coexist and share symptoms, but they are treated differently. Ultrasound evaluation helps distinguish between them, avoiding unnecessary procedures.

Planning

Guide treatment decisions

Medical therapy (hormonal contraceptives, GnRH agonists, progestins) is often effective, but severe cases may require surgery – mapping helps determine the extent of disease and the best approach.

What we assess

Comprehensive characterisation of adenomyosis.

We use high‑resolution transvaginal ultrasound with Doppler to detect both diffuse and focal adenomyosis.

Uterine Size and Shape

We assess for diffuse or asymmetrical uterine enlargement – a key indicator of adenomyosis. The uterus may appear globular or bulkier on one side.

Myometrial Thickening

We measure the myometrial thickness, looking for asymmetric thickening (anterior > posterior or vice versa) or diffuse thickening (>40 mm in a nulliparous uterus).

Myometrial Cysts

We detect tiny cystic spaces (1‑5 mm) scattered throughout the myometrium – a classic sign of adenomyosis. These represent islands of endometrial tissue within the muscle.

Echogenic Islands

We look for hyperechoic spots or linear striations within the myometrium – these represent ectopic endometrial tissue and are a hallmark of adenomyosis.

Junctional Zone Assessment

We evaluate the junctional zone – the area between the endometrium and myometrium. A thickened (>12 mm) or poorly defined junctional zone with irregularity is strongly suggestive of adenomyosis.

Doppler Assessment

We use colour and spectral Doppler to assess vascularity – adenomyosis often shows increased flow within the myometrium, which can help differentiate it from fibroids (which typically have peripheral vascularity).

How it works

Your adenomyosis evaluation journey, step by step.

01
Referral

Referral and history

Your gynaecologist refers you for an adenomyosis evaluation – often because of pelvic pain, heavy bleeding, or an inconclusive previous scan.

02
Scan

Ultrasound examination

We perform a transvaginal ultrasound (with transabdominal complement if needed) to evaluate uterine size, myometrial thickness, and characteristic features of adenomyosis – including cysts, echogenic islands, and junctional zone appearance.

03
Interpret

Interpretation and reporting

We document the features and severity of adenomyosis – diffuse vs focal, degree of thickening, and presence of associated pathology (e.g., endometriosis, fibroids). We provide a clear, actionable report.

04
Plan

Guidance and management

We discuss the findings with you and your gynaecologist. Treatment options may include hormonal therapy, pain management, or surgical interventions – depending on the severity and your fertility wishes.

Is it for you?

Adenomyosis evaluation is recommended if any of these apply.

Many women with adenomyosis are misdiagnosed – if you have these symptoms, a targeted evaluation can provide answers.

Severe dysmenorrhoea (painful periods)

Intense, cramping pelvic pain that starts before or during menstruation is the hallmark symptom of adenomyosis.

Heavy menstrual bleeding (menorrhagia)

Adenomyosis is a common cause of heavy, prolonged periods that interfere with daily life.

Chronic pelvic pain

Constant or intermittent pelvic pain not associated with menstruation can also indicate adenomyosis.

Infertility or recurrent miscarriage

Adenomyosis can affect uterine receptivity and implantation – evaluation is often part of the fertility work‑up.

Suspected fibroids but symptoms persist after treatment

If you have been treated for fibroids but symptoms continue, adenomyosis may be the underlying cause.

Incidental finding on routine ultrasound

If a routine scan shows features suggestive of adenomyosis, a dedicated evaluation provides a definitive assessment.

Dr. Abhishek at Amytri Diagnostics & Healthcare
Dr. Abhishek Consultant Radiologist & Fetal Medicine
Meet your specialist

Expert in adenomyosis imaging with precision.

Dr. Abhishek has extensive experience in gynaecological ultrasound, with a special focus on uterine pathology including adenomyosis. He is skilled in transvaginal imaging and Doppler assessment, providing the detailed characterisation needed to guide treatment decisions.

Qualified consultantMBBS · DMRD · DNB (Radiodiagnosis)
Gynaecological expertiseAdenomyosis, fibroid mapping, and uterine imaging
Advanced technologyHigh‑resolution transvaginal and Doppler ultrasound
Patient‑centred careClear explanations and compassionate support
Share the journey

Your partner is welcome to join.

Adenomyosis evaluation is often part of a journey to find answers for chronic pain or fertility issues – having your partner with you provides support and shared understanding.

We welcome partners to attend the ultrasound. We explain the findings, show you the affected areas on screen, and discuss the implications for treatment – helping both of you understand the path ahead.

Be present togetherShare the experience
Ask questions togetherGet clarity as a couple
See the imagesView the uterine wall on screen
Emotional supportNavigate the journey together
Gentle answers

Questions about adenomyosis evaluation.

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Get the answers you need – book your adenomyosis evaluation today.

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