Q Why does adenomyosis cause such heavy periods and severe pain? I'm curious about the mechanism.
A It is because the ectopic endometrium inside the uterine muscle bleeds and inflames every month, making it hard for the whole uterus to contract. When the uterus cannot contract properly, bleeding does not stop, causing heavy bleeding, while inflammation directly stimulates the nerves, causing severe pain.
Detailed Answer
A normal uterus stops bleeding during menstruation by contracting the muscle layer. In adenomyosis, the endometrial tissue lodged within the myometrium bleeds every month and causes inflammation, making the muscle layer itself hard and uneven and reducing its ability to contract. As a result, blood loss increases greatly, causing heavy bleeding, which over time leads to iron-deficiency anemia. At the same time, the inflammation within the muscle layer repeatedly stimulates the nerves, producing severe pain that begins several days before menstruation and continues throughout. The deeper the lesion, the more severe the pain and bleeding.
Korean Medicine Clinic Perspective
At the clinic, we interpret this process as a state in which blood stasis fills the uterine muscle layer so that blood cannot flow properly. The principle of "where there is blockage, there is pain" (bultong-jeuktong) acts strongly within the uterine muscle. When the blocked blood is released and made to circulate, contractile function recovers, and pain and bleeding tend to decrease together.
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