24/03/2026
Endometriosis, adenomyosis, fibroids... what’s the difference? 🎗️🩺🩸
GENTLE REMINDER: I’m a husband learning behind my wife, who lives with stage IV endo and fibro. This is not medical advice but my own research and a wish to understand. Please share your real-life experiences so I can write more accurately for the next woman. Your lived truth matters more than anything. Tell me what I get right or wrong so I can keep learning and spread better awareness. THANK YOU.
I think one of the cruelest things about women’s health is how often three very different problems can produce one very similar sentence:
“I’m bleeding too much, hurting too much, bloated too much, and nobody seems sure what it is.”
Endometriosis?
Adenomyosis?
Fibroids?
How do you know which one do you have?
These are three words that often get thrown around together, three conditions that can absolutely overlap, three conditions that can make a woman feel exhausted, frightened, anaemic, dismissed, and confused.
But they are not the same thing. The simplest way I can explain it is this...
1. Endometriosis is when tissue similar to the womb lining grows outside the womb.
2. Adenomyosis is when tissue from the lining grows into the muscle wall of the womb.
3. Fibroids are benign growths, not cancer, made of muscle and fibrous tissue in or around the womb.
That sounds neat and tidy on paper.
But life with these conditions is not neat and tidy at all.
1). Endometriosis is often the one people think of as “outside the womb” pain. It can affect the pelvis, ovaries, ligaments, bowel, bladder, ureters, diaphragm and more.
It is famous for painful periods, but it can also cause pain when opening the bowels, pain when passing urine, pain during or after s*x, fatigue, fertility struggles, and bloating that leaves women looking months pregnant by the end of the day.
2). Adenomyosis is different, but I think it can feel just as brutal. It lives in the womb muscle itself.
From what I have read, it often causes very painful periods, very heavy bleeding, pelvic pain, s*x pain, and a feeling of heaviness, fullness, or pressure low in the abdomen.
Some women say it feels like their womb itself has become sore, swollen, and angry.
3). Fibroids are different again. They are solid growths in the womb. Some women never know they have them.
Others bleed heavily, pass clots, become iron deficient, feel pressure on the bladder or bowel, need to wee more often, become constipated, feel a fullness in the belly, or have pain and discomfort during s*x. Sometimes the issue is not only pain, but pressure and bulk.
So if I had to put it in everyday language, I would say this:
• Endometriosis often behaves like disease outside the womb.
• Adenomyosis often behaves like pain and bleeding from within the womb muscle.
• Fibroids often behave like lumps in or around the womb causing bleeding, pressure, or both.
Of course, real bodies do not read textbooks.
A woman can have endometriosis and adenomyosis together. A woman can have adenomyosis and fibroids together. A woman can have all three.
And when that happens, the symptoms can blur into each other so badly that she starts doubting her own body.
If your pain is severe, if your bleeding is draining you, if your belly feels swollen and tender, if s*x hurts, if you are running to the toilet, if you are too tired to function, the label matters medically, yes, but your suffering matters immediately.
One thing that seems important is the pattern.
If the main story is very painful periods, pelvic pain, pain with s*x, bowel pain, bladder pain, or fertility worries, endo is often part of the conversation.
If the main story is heavy bleeding, severe cramping, heaviness, fullness, and a womb that seems to feel sore or enlarged, adenoo often needs looking at.
If the main story is heavy or prolonged periods plus pressure, fullness, frequent urination, constipation, or a sense that something bulky is pressing inside, fibroids often fit that picture.
But again, those are clues, not proof.
That is why I think one of the most important things women can hear is this:
• You are not silly for being confused.
• These conditions confuse doctors too.
• They can mimic each other.
• They can exist together.
• They can all deeply affect quality of life.
Another thing I learned is that scans matter, but they are not magic in every situation.
For suspected endometriosis, transvaginal ultrasound can help identify ovarian endometriomas and deep endo, but a normal scan does not rule endometriosis out. Too many women hear “your scan is fine” and then feel they must be fine too, when they absolutely are not.
For adenomyosis and fibroids, ultrasound is often part of the work-up as well. With adenomyosis, doctors are looking at the womb muscle and whether it looks enlarged or changed. With fibroids, ultrasound can show those growths and help work out where they are and how big they are.
Heavy bleeding itself should never be shrugged off.
Not only because it is distressing, messy, limiting and humiliating for many women, but because ongoing heavy bleeding can drain iron and lead to anaemia.
And once tiredness, dizziness, weakness and breathlessness join the picture, life can get smaller very quickly.
So what is the biggest difference?
To me, the biggest difference is location.
• Endometriosis is outside the womb.
• Adenomyosis is in the womb muscle.
• Fibroids are growths of the womb muscle.
But what they can have in common is just as important, sch as: pain, bleeding, bloating, pressure, fatigue, fear, and being dismissed for far too long.
If you are reading this and wondering which one you might have, remember that you deserve proper assessment, not guessing games based on one rushed appointment. You deserve somebody to hear the full pattern of your pain, bleeding, bowel changes, bladder symptoms, pressure, fatigue, and how it affects your life.
And if you already have one diagnosis but still feel something else is being missed, I do not think you are imagining things. Many women are living proof that one label does not always tell the full story.
If this topic felt painfully familiar, my free 130+ pages eBook, "You Did Nothing To Deserve This!" was made for the woman who is tired of feeling brushed aside. You can find it by tapping the link in my profile/bio. And if you prefer a physical copy to underline and hold onto, the Amazon paperback is available too, just type: "endometriosis validation" into Amazon’s search tab.
Please tell me, in your real life...
• Were you ever told it was one thing and later found out it was another?
• Do you live with more than one of these at the same time?
I would genuinely love to learn from your experience, because behind every medical word there is a woman carrying the weight of it.
Lucjan 🎗
