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Despite increasing public awareness of endometriosis, with celebrity figureheads including Lena Dunham and Molly Mae, the condition’s ‘evil twin sister’, adenomyosis, remains neglected. While the NHS has an entire webpage which explains what endometriosis is, there is currently no equivalent for its sister condition. Read on for five things you should know. It’s not the same as endometriosis Both endometriosis and adenomyosis occur when the lining of the uterus (known as the endometrium) grows out of place, but there are major differences between the two. In endometriosis, the rogue tissue invades areas outside of the uterus. While the extent of the growth varies from patient to patient, it can affect areas such as the bladder, bowel, ovaries, and even the lungs. Adenomyosis, on the other hand, causes the rogue tissue to bury inside the muscular wall of the uterus. It’s possible to suffer from both conditions at the same time. Symptoms include bloating, heavy periods, and pelvic pain Thanks to the invasive endometrial growth, adenomyosis is characterised by an enlarged uterus. During menstruation, the embedded tissue swells and bleeds, typically causing a variety of symptoms (although some women are asymptomatic). According to a patient leaflet published by University College Hospital, sufferers commonly have painful and irregular periods, with more than half experiencing heavy bleeding. Chronic pre-menstrual pain, and feelings of heaviness and discomfort in the pelvis are among other possible symptoms. Less frequently, adenomyosis can cause bloating, pain during intercourse, and pain related to bowel movements. All symptoms should stop after the menopause. It affects 1 in 10 women The condition is believed to affect 10 per cent of women in the UK. That makes it just as prevalent as endometriosis, although it’s more common in women between the ages of 40-50, and those who have been pregnant before. While the cause of the condition is not known, UCH says that “genetics and some hormones may play a role”. In terms of long-term effects, the North Bristol NHS trust says that adenomyosis does not appear to decrease the chance of pregnancy, however it has been linked to an increased risk of miscarriage and premature birth. Treatment options are limited For women with mild symptoms, trying to get pregnant, or nearing menopause, the North Bristol trust says that treatment may not be necessary, but for those seeking relief from symptoms, it recommends medication to reduce pain and bleeding, and hormonal interventions such as the contraceptive pill. The only “cure” is a surgical procedure involving the removal of the womb (hysterectomy), although this is a last resort intervention. The Bristol-based trust also offers an alternative surgery which involves blocking the blood supply to the endometrial growth, forcing it to shrink, but neither procedure is advisable for women who want to get pregnant in the future. It can take years to diagnose The condition is typically diagnosed using MRI and ultrasound scans, but the NHS says that adenomyosis can take “a long time, even years, to diagnose” because “symptoms and severity can vary between women”. The frequent dismissal of women’s gynaecological symptoms means that signs of adenomyosis may be conflated with ‘normal’ menstruation, or even other conditions such as endometriosis. Anecdotal reports of sufferers suggest that misdiagnosis is common. Gabrielle Union, one of the only celebrities to have publicly identified as having the condition, suspects her condition went undiagnosed for years. Speaking at a conference in 2019, Union explained: “The gag is I had [adenomyosis] in my early twenties, and instead of someone diagnosing me they were like ‘Oh you have periods that last nine or 10 days and you’re bleeding through overnight pads? Not a mere inconvenience... perhaps there’s something more there.’” Earlier this year, the charity Tommy’s reported that the condition might be “underdiagnosed” after a review of existing studies found that “mild” cases could be missed by clinicians using current diagnostic methods. “There should be training for clinicians and sonographers to diagnose adenomyosis using a standardised criteria,” said Dr Ishita Mishra, leader of the review. “Being able to identify this condition using a uniform set of criteria would then help give us a true picture of the numbers affected, and better understanding of the impact of this condition,” Mishra explained. If you have any health concerns, you should always contact your GP in the first instance. 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It’s that time of year again, when we settle down in front of the telly to watch the glorious pop parade that is the Eurovision Song Contest. Liverpool will be the setting for the grand final on May 13, taking on hosting duties as last year’s winner, Ukraine, isn’t able to. Of course, the music is what matters when it comes to picking a winner, but let’s be honest, who doesn’t love checking out the performers’ weird and wonderful fashion choices? These are just some of the most epic on-stage outfits in Eurovision history… 1. ABBA ABBA was victorious at the 1974 contest with Waterloo, taking to the stage in glitzy satin and suede ensembles. Agnetha Fältskog and Björn Ulvaeus completed their look with knee-high silver platform boots. 2. Co-Co Representing Britain in 1978, six-piece pop group Co-Co chose super shimmery clown-inspired, rainbow coloured costumes. 3. Buck’s Fizz Previously a member of Co-Co, Cheryl Baker returned to Eurovision in 1981 with Buck’s Fizz, taking home the winner’s trophy for Making Your Mind Up. The memorable performance saw singers Bobby G and Mike Nolan whipping off the knee-length skirts of Baker and Jay Aston to reveal mini skirts underneath. 4. Youddiph We’re not sure if she was a bit chilly on stage, but Russian contestant Youddiph pulled her flowing red dress over her head like a shawl while performing in the 1994 final in Dublin. 5. Dana International Opting for the bird of paradise look, 1998’s winner Dana International teamed a plain black gown with a fabulous feathered jacket. 6. Lordi Long-time fans of Eurovision have learned to expect the unexpected. Finnish heavy metal band won in 2006 with Hard Rock Hallelujah, while kitted out in what looked like Halloween monster costumes. 7. Scooch Pop quartet Scooch was ‘Flying The Flag’ for the UK in 2007 with these Britney-esque cabin crew costumes. Sadly, they crash landed at the final in Helsinki, coming joint 22nd out of 24 finalists. 8. Verka Serduchka Also in 2007, Ukrainian drag singer Verka Serduchka fared significantly better than Scooch, coming in second place with a bonkers but brilliant military-themed performance. The singer donned a silver snakeskin trench coat with a matching star-topped hat and glitterball tie. 9. Conchita Wurst Austrian winner Conchita Wurst continued Eurovision’s drag tradition in 2014, accessorising her glittering golden gown with glossy hair and a perfectly groomed beard. 10. Kate Miller-Heidke Australia has, somewhat confusingly been allowed to participate in Eurovision since 2015. The nation may not technically be part of Europe, but it sure knows what’s required of a contestant on the fashion front. In 2019, Kate Miller-Heidke was dolled up in a voluminous fairy princess dress and crown, the singer performing Zero Gravity while being flung from side to side on a long, bendy pole. 11. Sheldon Riley Also representing Australia, Sheldon Riley gave us one of 2022’s most dramatic outfits. Dressed in all white, Riley wore a gown with a long feathered train, paired with a tuxedo-style cropped jacket and a crystal mask covering his face. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Can I go to work if my child has chickenpox? What is mitochondrial donation treatment and who can get it? Pensioner, 85, shares the simple switch that’s helped him to do 650,000 press-ups

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