Adenomyosis vs endometriosis — differences

Creator: Dr Berra Önsoy
Published: 2026-01-15

Adenomyosis vs endometriosis: how to tell them apart

Adenomyosis and endometriosis are close cousins but need different treatment plans. Around 30% of women have both.

Medically written & reviewed by

Op. Dr. Berra Önsoy · Consultant Obstetrician & Gynaecologist

Istanbul, Turkey · 29 years of clinical practice · 6 min read · Consults in English & Turkish

Istanbul University Cerrahpaşa (English) MD, 1997. Ob-Gyn residency at Taksim Training & Research Hospital (2001). Private practice in Istanbul focused on endometriosis, myoma surgery, high-risk pregnancy and aesthetic gynaecology.

Clinical focus

Endometriosis surgery
Myoma (fibroid) surgery
High-risk pregnancy
Aesthetic gynaecology
HPV & colposcopy

Last medically reviewed: 15 January 2026View full clinical credentials →·Verify on:drberraonsoy.com instagram.com

Key takeaways

Endometriosis is outside the uterus; adenomyosis is inside the wall.
Around 30% of women have both.
Treatment approaches differ — excision vs medical / hysterectomy.

The core difference

Endometriosis: endometrium-like tissue outside the uterus. Adenomyosis: endometrium-like tissue inside the muscle wall of the uterus. Adenomyosis typically causes heavy, painful periods and a diffusely enlarged tender uterus.

How treatment differs

Endometriosis is best treated with excision surgery. Adenomyosis is more medically managed: Mirena coil, GnRH analogues, or — for women who have completed their family — hysterectomy. Focal adenomyomectomy is possible for isolated lesions.

Frequently asked questions

Can adenomyosis affect fertility?

Yes, particularly for embryo implantation. Treatment before IVF often improves outcomes.

Is Mirena effective?

Yes — around 70% of women see marked improvement in bleeding and pain.

Is hysterectomy the only cure?

It is the only definitive cure, but not required for every woman.

Could a doctor-led plan help you?

A 30-minute video consultation with Dr Berra Önsoy — reviewing your symptoms and imaging and giving you a clear personalised plan for endometriosis surgery.

Request a video consultation