As a nurse, Chisom had helped patients through painful procedures — but her own monthly pain was severe enough to make her vomit. Five years of "just period pain" ended when an ultrasound revealed adenomyosis — a condition hiding in plain sight.
Nurse, Surulere. Presented with progressively worsening dysmenorrhoea (severe cramping, vomiting, inability to work during periods), heavy flow with clots, and pelvic pressure for 5 years.
AdenomyosisChisom knew pain. She worked night shifts in a Lagos hospital and had seen patients in genuine distress. But every December she found herself lying on the floor of her bathroom for the first two days of her period, unable to keep any food down, texting her ward to say she could not come in.
Multiple doctors over five years had told her variations of the same thing: "Some women just have painful periods." She had been prescribed mefenamic acid, buscopan, oral contraceptives, and at one point was told her pain was "possibly anxiety." The oral contraceptive pills reduced the pain to "merely terrible" — from "unbearable." She accepted this as victory.
It was a colleague who asked if anyone had ever scanned her uterus specifically for adenomyosis. Chisom had heard the word but never had it investigated. She booked at Mascot Healthcare and asked directly for a transvaginal ultrasound.
Adenomyosis is the presence of endometrial tissue within the uterine muscle wall. It causes dysmenorrhoea that worsens over time, heavy periods, and a characteristic bulky tender uterus.
Period pain so intense it caused vomiting in the first two days — Chisom described it as "contractions that don't end."
Soaking 5–7 pads per day, passing clots — associated with the heavy menstrual bleeding typical of adenomyosis.
A constant dragging sensation in the pelvis between periods, worsening premenstrually.
Deep dyspareunia — pain with deep penetration — affecting intimacy for two years.
Symptoms noticeably worse each year — a hallmark of adenomyosis progression.
Mefenamic acid 500 mg TDS — moderate pain reduction in milder months; insufficient during severe cycles.
Combined oral contraceptive pill — reduced but did not eliminate dysmenorrhoea; reduced flow somewhat.
Buscopan (antispasmodic) — minimal effect on adenomyosis pain, which is not primarily spasmodic.
Heat pad — helpful for comfort; not addressing the underlying pathology.
Transvaginal ultrasound at Mascot Healthcare revealed a bulky uterus (11 × 8 × 6 cm; normal < 8 × 5 × 4 cm) with heterogeneous myometrium, myometrial cysts, and ill-defined endometrial borders — classic adenomyosis features. No fibroids were identified.
The doctor explained the diagnosis clearly: the endometrial lining had grown into the muscular wall of the uterus, causing it to bleed into itself each cycle — producing the cramping, the heavy flow, and the pelvic pressure. It was not in her head. It was in her uterine wall.
Management options discussed: a hormonal IUD as first-line for symptom control and menstrual suppression; or hormone-suppressing medication for short-term symptom relief in those seeking fertility. Chisom opted for the hormonal IUD insertion.
Adenomyosis (transvaginal ultrasound: bulky heterogeneous uterus with myometrial cysts and widened junctional zone)
Hormonal IUD insertion; medication to reduce heavy bleeding on heavy days; follow-up ultrasound at 6 months
By month 3 after the hormonal IUD, periods lighter and dysmenorrhoea reduced by approximately 65%. Month 6: minimal period pain, light spotting only.
Six months after the hormonal IUD insertion, Chisom's period pain is described as "a mild ache" — from floor-level vomiting to manageable. She no longer takes sick leave for menstrual pain.
Adenomyosis affects an estimated 20% of women and is a leading cause of severe dysmenorrhoea that worsens over years. It is routinely missed in Nigerian primary care because the standard advice is still "some women just have painful periods."
A well-performed transvaginal ultrasound can identify adenomyosis features in most cases. No woman should accept monthly floor-level pain as her baseline.
Period pain that makes you vomit or miss work is not normal. Adenomyosis is diagnosable and manageable — but only if someone looks.
Walk in to Mascot Healthcare, Akoka — same-day consultation, transparent pricing, 4.9★ rated.