Symptoms most often start late in the childbearing years after having children. Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy periods. Because the symptoms are so similar, adenomyosis is often misdiagnosed as uterine fibroids.
In a study conducted in Brazil, with 256 women who were scheduled for hysterectomy. Adenomyosis was diagnosed in 60 of 256 cases (23.4%), 11 of 55 (20%) with prolapse; four of 35 (11.4%) with ovarian mass; five of 25 (20%) with chronic pelvic pain; three of four (75%) with endometriosis.