Difference between fibroid polyp and adenomyosis Detailed pdf

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Quick answer

“Fibroid polyp” is not a precise medical term. It commonly means either:

A submucosal fibroid that projects into the uterine cavity, sometimes on a stalk, called a pedunculated submucosal fibroid, or
An endometrial polyp, which is a different benign growth arising from the uterine lining.

Fibroid polyp versus adenomyosis

Feature	Fibroid polyp, usually submucosal fibroid	Adenomyosis
What it is	A benign smooth-muscle tumor, usually a discrete lump.	Endometrial-type glands and stroma growing within the uterine muscle wall.
Where it occurs	Usually just beneath the uterine lining and bulges into the uterine cavity. It may be pedunculated, meaning attached by a stalk.	Diffusely or focally within the myometrium, the muscle layer of the uterus.
Appearance of uterus	May be normal-sized or irregularly enlarged, depending on number and size of fibroids.	Often diffusely enlarged, rounded, and tender.
Typical bleeding pattern	Heavy menstrual bleeding; bleeding between periods can occur, especially when it protrudes into the cavity.	Heavy and often prolonged periods, sometimes irregular bleeding.
Pain pattern	May cause cramps and pressure, but pain is often less prominent unless the fibroid is degenerating or prolapsing.	Classically causes progressively painful periods, chronic pelvic pain, and pain during intercourse.
Effect on fertility	A fibroid that distorts the uterine cavity can reduce implantation and contribute to infertility or miscarriage.	May be associated with subfertility and adverse pregnancy outcomes, though the degree of effect varies.
Ultrasound/MRI	A well-defined, round or oval mass. A submucosal fibroid distorts the endometrial cavity.	Heterogeneous myometrium, asymmetric wall thickening, myometrial cysts, and an indistinct junction between lining and muscle. MRI can clarify uncertain cases.
Hysteroscopy	Often directly visible within the uterine cavity and may be removed during hysteroscopy.	Usually not visible as a cavity lesion because it lies within the uterine wall.
Biopsy	If it is a cavity lesion, tissue can be sampled or removed for histopathology.	An endometrial biopsy does not reliably diagnose adenomyosis because the abnormal tissue is in the muscle wall.
Common treatment if symptoms need treatment	Medicines for bleeding, hysteroscopic removal for cavity-distorting lesions, myomectomy, uterine artery embolization in selected patients, or hysterectomy if definitive treatment is needed.	NSAIDs for pain, hormonal treatment especially a levonorgestrel-releasing IUD or other progestin-based options, and hysterectomy as definitive treatment when symptoms are severe and fertility is no longer desired.

If you meant an endometrial polyp instead

An endometrial polyp is not a fibroid. It is an overgrowth of the uterine lining rather than muscle.

Feature	Endometrial polyp	Adenomyosis
Tissue of origin	Endometrium, the uterine lining	Myometrium, the uterine muscle
Structure	Localized soft growth, often with a stalk	Diffuse or focal change in muscle wall
Main symptoms	Spotting, bleeding between periods, bleeding after sex, heavy or irregular bleeding	Heavy, prolonged, and painful periods; pelvic pain
Best confirmation	Saline sonography or hysteroscopy, with tissue examination after removal	Transvaginal ultrasound or MRI; histology after hysterectomy is the definite diagnosis
Usual procedure	Hysteroscopic polypectomy	Medical management first; hysterectomy is definitive if symptoms remain severe
Cancer concern	Most are benign, but removal and pathology are commonly advised in postmenopausal bleeding or if risk factors are present	Adenomyosis itself is benign and is not usually treated as a precancerous lesion

Key practical distinction

A fibroid polyp or endometrial polyp is a localized growth.
Adenomyosis is disease spread within the uterine muscle.
A cavity lesion is often treatable with hysteroscopic removal.
Adenomyosis is generally managed with pain and bleeding control, especially hormonal therapy, because it cannot usually be simply “picked out” like a polyp.

These conditions can coexist. Fibroids can make ultrasound assessment of adenomyosis more difficult, and a person may have more than one cause of heavy bleeding or pelvic pain.

When to seek prompt gynecologic review

Arrange evaluation promptly for:

Heavy bleeding causing dizziness, fainting, breathlessness, or suspected anemia
Bleeding after menopause
Rapidly worsening pelvic pain or a protruding vaginal mass
Difficulty conceiving
Persistent bleeding between periods

A transvaginal ultrasound is usually the first investigation. If a lesion is inside the uterine cavity, saline-infusion ultrasound or hysteroscopy may be recommended. For suspected adenomyosis with unclear ultrasound findings, MRI can be useful.

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Fibroid polyp versus adenomyosis: detailed comparison

Important terminology: “Fibroid polyp” is not a formal diagnosis. It may mean:

A submucosal fibroid that bulges into the uterine cavity, sometimes attached by a stalk
An endometrial polyp, a separate benign growth arising from the uterine lining

1. Basic difference

Feature	Fibroid polyp, usually a submucosal fibroid	Adenomyosis
Nature	A localized benign tumor of uterine smooth muscle	Endometrial glands and supporting tissue located within the uterine muscle
Main site	Beneath the uterine lining, projecting into the cavity	Within the uterine wall, called the myometrium
Pattern	Usually a discrete, defined lump	Often diffuse, though it can be focal
Uterine cavity	May be distorted by the mass	Usually no discrete cavity mass
Uterus	Can be irregularly enlarged	Often uniformly enlarged, soft, and tender

2. Symptoms

Fibroid polyp or submucosal fibroid

Common features include:

Heavy periods
Prolonged bleeding
Bleeding between periods
Passage of clots
Pelvic pressure or fullness
Cramping
Infertility or miscarriage risk if the uterine cavity is distorted

A submucosal fibroid can cause substantial bleeding even when it is relatively small, because it affects the uterine lining and cavity.

Adenomyosis

Typical features include:

Heavy and prolonged periods
Progressively painful periods
Chronic pelvic pain
Pain during intercourse
Irregular bleeding
A tender, enlarged uterus

Some people with adenomyosis have no symptoms. It commonly coexists with fibroids or endometriosis.

3. Imaging and diagnosis

Test	Fibroid polyp / submucosal fibroid	Adenomyosis
Transvaginal ultrasound	Often shows a well-defined mass and cavity distortion	May show a heterogeneous muscle wall, asymmetric thickening, small myometrial cysts, and poor definition of the junctional zone
Saline-infusion sonography	Especially useful to show whether a lesion projects into the cavity	Less useful for confirming diffuse disease in the muscle wall
Hysteroscopy	Can directly show and treat a cavity fibroid or an endometrial polyp	Often appears normal if adenomyosis does not involve the cavity
MRI	Clarifies size, position, and type of fibroid	Useful when ultrasound is uncertain; can show junctional-zone thickening and myometrial cystic or hemorrhagic foci
Biopsy	A lesion removed from the cavity can be examined in the laboratory	A routine endometrial biopsy does not reliably diagnose adenomyosis because the abnormal tissue is in the muscle wall

Transvaginal ultrasound is generally the first investigation. Textbook sources note that ultrasound can diagnose adenomyosis with moderate accuracy, but accuracy falls when fibroids coexist or when adenomyosis is focal. MRI can help in unclear cases.

4. Treatment differences

Fibroid polyp / submucosal fibroid

Management depends on bleeding, size, location, anemia, fertility plans, and symptoms.

Options may include:

NSAIDs for cramps
Tranexamic acid for heavy bleeding, if appropriate
Hormonal therapy, including hormonal contraceptives or a levonorgestrel-releasing IUD in suitable cases
Hysteroscopic myomectomy, which removes a fibroid projecting into the uterine cavity while preserving the uterus
Myomectomy by other surgical routes for larger or differently positioned fibroids
Uterine artery embolization for selected patients
Hysterectomy when definitive treatment is needed and future pregnancy is not desired

A submucosal fibroid causing bleeding or pain is commonly treated with hysteroscopic removal.

Adenomyosis

Treatment focuses mainly on reducing pain and bleeding while considering fertility wishes.

Options include:

NSAIDs for menstrual pain
Combined hormonal contraceptives
Progestin-based treatment, including a levonorgestrel-releasing IUD, oral progestins, or injectable progestins
GnRH-based therapies in selected situations
Uterine artery embolization or uterine-preserving surgery in carefully selected cases
Hysterectomy, which is the definitive treatment when symptoms remain severe and pregnancy is no longer desired

Unlike a cavity fibroid, adenomyosis usually cannot simply be removed through hysteroscopy because it lies within the uterine muscle.

5. Fertility implications

Issue	Submucosal fibroid	Adenomyosis
Effect on conception	More likely to interfere if it distorts the cavity	May be associated with subfertility, but the effect varies
Effect on miscarriage	Can increase risk when cavity distortion is significant	May be associated with miscarriage and obstetric complications, though individual risk varies
Fertility-preserving procedure	Hysteroscopic myomectomy is often possible for a cavity lesion	Medical symptom control or selected uterine-preserving approaches may be considered

A gynecologist or fertility specialist should individualize decisions, especially if pregnancy is desired.

6. If the report says “polyp”

An endometrial polyp differs from both a fibroid and adenomyosis:

It originates from the endometrial lining, not the muscle.
It is usually a localized soft growth, sometimes on a stalk.
It commonly causes spotting, bleeding between periods, heavy bleeding, or postmenopausal bleeding.
It is usually diagnosed with ultrasound, saline-infusion sonography, or hysteroscopy.
It is often removed by hysteroscopic polypectomy, and the removed tissue is examined under the microscope.

Most endometrial polyps are benign, but bleeding after menopause or other risk factors should prompt timely assessment and tissue evaluation.

7. When urgent medical assessment is needed

Seek urgent care for:

Soaking one or more pads or tampons per hour for several hours
Dizziness, fainting, chest discomfort, breathlessness, or marked weakness during bleeding
Severe new pelvic pain, fever, or vomiting
Bleeding after menopause
A protruding vaginal mass
Possible pregnancy with bleeding or pain

Heavy menstrual bleeding can cause iron-deficiency anemia. A clinician may check a blood count and iron studies alongside pelvic imaging.

Clinical note: This comparison is educational and cannot determine what a specific ultrasound finding represents. The exact wording of the scan report, symptoms, age, bleeding pattern, and pregnancy plans all affect management.

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mkdir -p "/tmp/workspace/fibroid-polyp-adenomyosis-pdf/src" "/tmp/workspace/fibroid-polyp-adenomyosis-pdf/output" && python - <<'PY' from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_LEFT from reportlab.lib.units import cm from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, PageBreak, KeepTogether from reportlab.pdfbase.pdfmetrics import stringWidth from reportlab.graphics.shapes import Drawing, Path, Circle, Ellipse, String, Rect, Line from reportlab.graphics import renderPDF from reportlab.lib.colors import HexColor from reportlab.pdfbase.ttfonts import TTFont from reportlab.pdfbase import pdfmetrics from reportlab.pdfgen import canvas from reportlab.platypus.flowables import Flowable from pathlib import Path out=Path('/tmp/workspace/fibroid-polyp-adenomyosis-pdf/output/Fibroid_Polyp_vs_Adenomyosis.pdf') NAVY=HexColor('#173F5F'); TEAL=HexColor('#167D8D'); ROSE=HexColor('#C85A71'); GOLD=HexColor('#E5A53B'); PALE=HexColor('#EAF4F5'); LAV=HexColor('#F7EFF2'); TEXT=HexColor('#263238'); GREY=HexColor('#5B6870') styles=getSampleStyleSheet() styles.add(ParagraphStyle(name='TitleX', parent=styles['Title'], fontName='Helvetica-Bold', fontSize=25, leading=30, textColor=NAVY, alignment=TA_CENTER, spaceAfter=10)) styles.add(ParagraphStyle(name='SubX', parent=styles['Normal'], fontName='Helvetica', fontSize=11, leading=15, textColor=GREY, alignment=TA_CENTER)) styles.add(ParagraphStyle(name='H1X', parent=styles['Heading1'], fontName='Helvetica-Bold', fontSize=17, leading=21, textColor=NAVY, spaceBefore=8, spaceAfter=8)) styles.add(ParagraphStyle(name='H2X', parent=styles['Heading2'], fontName='Helvetica-Bold', fontSize=12.5, leading=16, textColor=TEAL, spaceBefore=7, spaceAfter=4)) styles.add(ParagraphStyle(name='BodyX', parent=styles['BodyText'], fontName='Helvetica', fontSize=9.4, leading=13, textColor=TEXT, spaceAfter=5)) styles.add(ParagraphStyle(name='SmallX', parent=styles['BodyText'], fontName='Helvetica', fontSize=7.7, leading=10, textColor=GREY)) styles.add(ParagraphStyle(name='CalloutX', parent=styles['BodyText'], fontName='Helvetica-Bold', fontSize=10, leading=14, textColor=NAVY, leftIndent=8, rightIndent=8)) def P(t, style='BodyX'): return Paragraph(t, styles[style]) def uterus_diagram(kind): d=Drawing(470,255) # title inside drawing d.add(String(235,238, {'normal':'Normal uterus','fibroid':'Submucosal fibroid','adenomyosis':'Adenomyosis'}[kind], textAnchor='middle', fontName='Helvetica-Bold', fontSize=14, fillColor=NAVY)) # uterus silhouette: outer pear / approximate p=Path(); p.moveTo(155,185); p.curveTo(124,166,112,129,128,89); p.curveTo(143,51,177,26,235,23); p.curveTo(293,26,327,51,342,89); p.curveTo(358,129,346,166,315,185); p.curveTo(287,202,263,210,235,212); p.curveTo(207,210,183,202,155,185); p.close() d.add(p); d._code.append('') # Fill overlay via duplicate shape p2=Path(); p2.moveTo(155,185); p2.curveTo(124,166,112,129,128,89); p2.curveTo(143,51,177,26,235,23); p2.curveTo(293,26,327,51,342,89); p2.curveTo(358,129,346,166,315,185); p2.curveTo(287,202,263,210,235,212); p2.curveTo(207,210,183,202,155,185); p2.close(); p2.fillColor=HexColor('#F7D9DF'); p2.strokeColor=ROSE; p2.strokeWidth=2 d.add(p2) # cavity c=Path(); c.moveTo(235,174); c.curveTo(211,152,196,125,203,94); c.curveTo(211,74,224,63,235,54); c.curveTo(246,63,259,74,267,94); c.curveTo(274,125,259,152,235,174); c.close(); c.fillColor=HexColor('#FFFDF8'); c.strokeColor=HexColor('#8D5F69'); c.strokeWidth=1.4; d.add(c) # tubes for side in [-1,1]: d.add(Line(150 if side==-1 else 320,170,100 if side==-1 else 370,198,strokeColor=ROSE,strokeWidth=3)) d.add(Circle(92 if side==-1 else 378,202,9,fillColor=HexColor('#F7D9DF'),strokeColor=ROSE)) if kind=='fibroid': d.add(Circle(235,104,31,fillColor=GOLD,strokeColor=HexColor('#A66F13'),strokeWidth=1.5)) d.add(Line(266,109,390,122,strokeColor=GOLD,strokeWidth=1.5)); d.add(String(396,118,'Defined muscle mass',fontName='Helvetica',fontSize=9,fillColor=TEXT)) d.add(Line(235,73,235,55,strokeColor=GOLD,strokeWidth=1.5)); d.add(String(240,67,'Bulges into cavity',fontName='Helvetica',fontSize=9,fillColor=TEXT)) elif kind=='adenomyosis': # dots scattered through posterior muscle wall for x,y in [(279,151),(298,137),(305,114),(287,96),(309,83),(271,72),(316,155),(276,127),(294,62)]: d.add(Circle(x,y,4,fillColor=TEAL,strokeColor=TEAL)) d.add(Line(305,119,405,125,strokeColor=TEAL,strokeWidth=1.5)); d.add(String(410,121,'Tissue within muscle',fontName='Helvetica',fontSize=9,fillColor=TEXT)) d.add(Line(273,72,392,63,strokeColor=TEAL,strokeWidth=1.5)); d.add(String(397,59,'Diffuse / ill-defined',fontName='Helvetica',fontSize=9,fillColor=TEXT)) else: d.add(String(235,5,'Simplified educational cross-section, not an imaging diagnosis',textAnchor='middle',fontName='Helvetica-Oblique',fontSize=7.5,fillColor=GREY)) return d def panel(title, text, color=PALE): t=Table([[P(''+title+' '+text,'BodyX')]], colWidths=[16.8*cm]) t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),color),('BOX',(0,0),(-1,-1),0.5,HexColor('#C8D9DC')),('LEFTPADDING',(0,0),(-1,-1),9),('RIGHTPADDING',(0,0),(-1,-1),9),('TOPPADDING',(0,0),(-1,-1),7),('BOTTOMPADDING',(0,0),(-1,-1),7)])) return t def footer(canv,doc): canv.saveState(); canv.setStrokeColor(HexColor('#C6D9DD')); canv.line(1.6*cm,1.35*cm,19.4*cm,1.35*cm) canv.setFont('Helvetica',7.5);canv.setFillColor(GREY);canv.drawString(1.6*cm,0.9*cm,'Educational guide - not a substitute for a clinical consultation') canv.drawRightString(19.4*cm,0.9*cm,f'Page {doc.page}') canv.restoreState() doc=SimpleDocTemplate(str(out),pagesize=A4,rightMargin=1.6*cm,leftMargin=1.6*cm,topMargin=1.45*cm,bottomMargin=1.7*cm) story=[] # cover story += [Spacer(1,1.1*cm), P('Fibroid Polyp vs Adenomyosis','TitleX'), P('A visual guide to what they are, how symptoms differ, diagnosis, and treatment choices','SubX'), Spacer(1,0.55*cm)] cover=Table([[uterus_diagram('fibroid'),uterus_diagram('adenomyosis')]],colWidths=[8.4*cm,8.4*cm]) cover.setStyle(TableStyle([('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),0),('RIGHTPADDING',(0,0),(-1,-1),0)])); story += [cover,Spacer(1,.25*cm)] story += [panel('First, clarify the phrase “fibroid polyp”','This is not a formal medical diagnosis. It commonly refers to a submucosal fibroid that projects into the uterine cavity, sometimes on a stalk. It may also be used loosely for an endometrial polyp, which is a separate lining-based growth. This guide focuses on submucosal fibroid versus adenomyosis, with a short polyp note on page 4.',LAV),Spacer(1,.4*cm)] story += [P('At a glance','H2X'), P('Submucosal fibroid: a defined benign smooth-muscle lump that can distort the cavity. Adenomyosis: endometrial-type tissue embedded within the uterine muscle, often producing diffuse enlargement and painful periods.','BodyX'), Spacer(1,.5*cm), P('Contents','H2X'), P('1. Anatomy and terminology 2. Symptoms and clinical clues 3. Tests and imaging 4. Treatment and fertility considerations 5. Red flags and questions for your clinician 6. Sources','BodyX'), PageBreak()] # p2 story += [P('1. Anatomy and terminology','H1X'),P('The key difference is location and pattern. Both are benign uterine conditions and both can cause abnormal uterine bleeding. They can also coexist.','BodyX'),Spacer(1,.1*cm)] compdata=[[P('Feature','BodyX'),P('Submucosal fibroid','BodyX'),P('Adenomyosis','BodyX')], [P('Origin','BodyX'),P('Smooth muscle of the uterus, also called a leiomyoma.','BodyX'),P('Endometrial glands and stroma within the myometrium.','BodyX')], [P('Pattern','BodyX'),P('Usually a localized, well-defined mass.','BodyX'),P('Usually diffuse or ill-defined. A focal adenomyoma can occur.','BodyX')], [P('Where it grows','BodyX'),P('Under the lining and toward the uterine cavity.','BodyX'),P('Inside the uterine muscle wall.','BodyX')], [P('Effect on cavity','BodyX'),P('May protrude into or distort the cavity.','BodyX'),P('Usually does not create a discrete cavity mass.','BodyX')], [P('Uterine feel','BodyX'),P('May be normal or irregularly enlarged.','BodyX'),P('Often diffusely enlarged, soft, and tender around menses.','BodyX')]] t=Table(compdata,colWidths=[3.0*cm,6.85*cm,6.85*cm],repeatRows=1);t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,0),NAVY),('TEXTCOLOR',(0,0),(-1,0),colors.white),('BACKGROUND',(0,1),(0,-1),PALE),('GRID',(0,0),(-1,-1),0.35,HexColor('#B7C9CD')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5)]));story += [t,Spacer(1,.35*cm),P('Visual comparison','H2X'),Table([[uterus_diagram('fibroid'),uterus_diagram('adenomyosis')]],colWidths=[8.4*cm,8.4*cm]),panel('Why the distinction matters','A cavity-distorting fibroid can often be removed hysteroscopically. Adenomyosis is within the muscle wall, so treatment usually focuses first on controlling bleeding and pain with medication or hormonal options.',PALE),PageBreak()] #p3 story += [P('2. Symptoms and clinical clues','H1X'),P('Symptoms overlap. The bleeding pattern, pain pattern, pelvic examination, ultrasound findings, age, and pregnancy plans help a gynecologist decide what is most likely.','BodyX')] sym=[[P('Finding','BodyX'),P('More suggestive of submucosal fibroid','BodyX'),P('More suggestive of adenomyosis','BodyX')], [P('Bleeding','BodyX'),P('Heavy or prolonged periods; sometimes bleeding between periods. Small cavity lesions may cause substantial bleeding.','BodyX'),P('Heavy, prolonged periods or irregular bleeding.','BodyX')], [P('Pain','BodyX'),P('Cramping and pelvic pressure may occur; pain is variable.','BodyX'),P('Painful periods that may worsen over time, chronic pelvic pain, or pain during intercourse.','BodyX')], [P('Fertility','BodyX'),P('A lesion that distorts the cavity can interfere with implantation and may be relevant in infertility or recurrent miscarriage.','BodyX'),P('May be associated with subfertility and pregnancy complications, but the individual effect varies.','BodyX')], [P('Examination','BodyX'),P('May show an enlarged or irregular uterus.','BodyX'),P('Often a uniformly enlarged and tender uterus.','BodyX')]] t=Table(sym,colWidths=[2.6*cm,7.1*cm,7.0*cm],repeatRows=1);t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,0),TEAL),('TEXTCOLOR',(0,0),(-1,0),colors.white),('BACKGROUND',(0,1),(0,-1),PALE),('GRID',(0,0),(-1,-1),0.35,HexColor('#B7C9CD')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5)]));story += [t,Spacer(1,.35*cm),P('3. How clinicians investigate','H1X')] diag=[['1','History and examination','Bleeding pattern, pain, anemia symptoms, medications, pregnancy possibility, and reproductive goals.'],['2','Pregnancy test and blood tests when indicated','A complete blood count and iron assessment may be used when bleeding is heavy or anemia is suspected.'],['3','Transvaginal ultrasound','Usually first-line. It can identify fibroids, assess the cavity, and look for features of adenomyosis.'],['4','Saline-infusion ultrasound or hysteroscopy','Helps define a focal lesion inside the uterine cavity. Hysteroscopy can also remove some cavity fibroids or polyps.'],['5','MRI in selected cases','Can help when ultrasound is unclear, especially if adenomyosis is suspected or multiple conditions coexist.']] rows=[] for n,h,b in diag: rows.append([P(''+n+'','BodyX'),P(''+h+' '+b,'BodyX')]) t=Table(rows,colWidths=[1.1*cm,15.6*cm]);t.setStyle(TableStyle([('BACKGROUND',(0,0),(0,-1),GOLD),('GRID',(0,0),(-1,-1),0.35,HexColor('#D3C6AE')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),7),('RIGHTPADDING',(0,0),(-1,-1),7),('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6)]));story += [t,Spacer(1,.28*cm),panel('A biopsy does not usually confirm adenomyosis','An endometrial biopsy samples the lining, while adenomyosis is located in the uterine muscle. Biopsy may still be used to investigate abnormal bleeding or exclude other conditions when appropriate.',LAV),PageBreak()] #p4 story += [P('4. Treatment and fertility considerations','H1X'),P('Treatment is individualized. It depends on bleeding severity, pain, anemia, lesion size and location, age, other health conditions, and whether pregnancy is desired now or later.','BodyX')] tr=[[P('Goal','BodyX'),P('Submucosal fibroid','BodyX'),P('Adenomyosis','BodyX')], [P('Ease pain / reduce bleeding','BodyX'),P('NSAIDs, tranexamic acid when appropriate, and hormonal options may reduce symptoms.','BodyX'),P('NSAIDs and hormonal menstrual suppression are commonly used. Progestin-based methods, including a levonorgestrel IUD, may help selected patients.','BodyX')], [P('Preserve uterus / fertility','BodyX'),P('Hysteroscopic myomectomy can remove a suitable cavity lesion while preserving the uterus.','BodyX'),P('Options require specialist discussion because disease lies in the muscle. Medical therapy may control symptoms but does not remove it.','BodyX')], [P('Procedures','BodyX'),P('Myomectomy; other approaches depend on size and position. Uterine artery embolization is an option for some people but needs fertility counseling.','BodyX'),P('Selected uterine-preserving procedures or uterine artery embolization may be considered in individual cases.','BodyX')], [P('Definitive treatment','BodyX'),P('Hysterectomy if symptoms are severe and childbearing is complete.','BodyX'),P('Hysterectomy is definitive when medical or conservative treatment fails and future pregnancy is not desired.','BodyX')]] t=Table(tr,colWidths=[2.8*cm,6.9*cm,7.0*cm],repeatRows=1);t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,0),NAVY),('TEXTCOLOR',(0,0),(-1,0),colors.white),('BACKGROUND',(0,1),(0,-1),PALE),('GRID',(0,0),(-1,-1),0.35,HexColor('#B7C9CD')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5)]));story += [t,Spacer(1,.28*cm),P('If the ultrasound says “endometrial polyp”','H2X'),P('An endometrial polyp is different from a fibroid and adenomyosis. It is a localized growth from the uterine lining. It can cause spotting, irregular bleeding, heavy periods, or postmenopausal bleeding. Hysteroscopic polypectomy removes the lesion and allows laboratory examination of the tissue.','BodyX'),panel('Important','Postmenopausal bleeding should always be assessed promptly. Most polyps are benign, but tissue assessment may be needed depending on symptoms and risk factors.',LAV),PageBreak()] #p5 story += [P('5. When to seek care and what to ask','H1X'),P('Seek urgent care if bleeding soaks at least one pad or tampon per hour for several hours, or if there is fainting, severe dizziness, shortness of breath, chest pain, severe new pelvic pain, fever, or possible pregnancy with pain or bleeding. Heavy menstrual bleeding can cause iron-deficiency anemia.','BodyX')] questions=['Is the finding definitely a submucosal fibroid, an endometrial polyp, adenomyosis, or more than one condition?','Does it distort the uterine cavity?','Could this explain my bleeding, pain, anemia, or fertility concerns?','Do I need saline-infusion ultrasound, MRI, hysteroscopy, or an endometrial biopsy?','Which treatment best fits my symptom severity and pregnancy plans?','What are the risks, recovery time, and chance of needing further treatment?'] story += [P('Useful questions for your clinician','H2X')] for q in questions: story.append(P('• '+q,'BodyX')) story += [Spacer(1,.15*cm),P('Key takeaways','H2X'),panel('Localized mass versus muscle-wall disease','A submucosal fibroid is a defined muscle mass that can project into the uterine cavity. Adenomyosis is tissue within the muscle wall and commonly causes painful, heavy periods. Both can occur together, so an imaging report and a gynecologic assessment should be interpreted in context.',PALE),Spacer(1,.35*cm),P('Sources and further reading','H2X'),P('Berek & Novak’s Gynecology: Diagnosis and management of adenomyosis, pp. 580-581. Sabiston Textbook of Surgery: Adenomyosis, p. 2796. Grainger & Allison’s Diagnostic Radiology: Endometrial polyp imaging, pp. 896-897. American College of Obstetricians and Gynecologists: Abnormal uterine bleeding and heavy menstrual bleeding patient guidance. Mayo Clinic: Adenomyosis diagnosis and treatment.','SmallX'),Spacer(1,.35*cm),P('This guide is for education. It does not diagnose a specific scan finding or replace care from a qualified clinician.','SmallX')] doc.build(story,onFirstPage=footer,onLaterPages=footer) print(out) PY python - <<'PY' from pypdf import PdfReader p='/tmp/workspace/fibroid-polyp-adenomyosis-pdf/output/Fibroid_Polyp_vs_Adenomyosis.pdf' r=PdfReader(p) print('pages',len(r.pages),'size',__import__('os').path.getsize(p)) for i,pge in enumerate(r.pages): text=pge.extract_text() or '' print(i+1,len(text),text[:50].replace('\n',' | ')) PY

Writing File

~/fibroid-polyp-adenomyosis-pdf/src/create_pdf.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.colors import HexColor
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER
from reportlab.lib.units import cm
from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, PageBreak
from reportlab.graphics.shapes import Drawing, Path as GPath, Circle, String, Line
from pathlib import Path

ROOT=Path('/tmp/workspace/fibroid-polyp-adenomyosis-pdf')
OUT=ROOT/'output'/'Fibroid_Polyp_vs_Adenomyosis.pdf'
NAVY=HexColor('#173F5F'); TEAL=HexColor('#167D8D'); ROSE=HexColor('#C85A71'); GOLD=HexColor('#E5A53B'); PALE=HexColor('#EAF4F5'); LAV=HexColor('#F7EFF2'); TEXT=HexColor('#263238'); GREY=HexColor('#5B6870')
S=getSampleStyleSheet()
S.add(ParagraphStyle(name='TitleX', parent=S['Title'], fontName='Helvetica-Bold',fontSize=25,leading=30,textColor=NAVY,alignment=TA_CENTER,spaceAfter=10))
S.add(ParagraphStyle(name='SubX', parent=S['Normal'],fontName='Helvetica',fontSize=11,leading=15,textColor=GREY,alignment=TA_CENTER))
S.add(ParagraphStyle(name='H1X',parent=S['Heading1'],fontName='Helvetica-Bold',fontSize=17,leading=21,textColor=NAVY,spaceBefore=8,spaceAfter=8))
S.add(ParagraphStyle(name='H2X',parent=S['Heading2'],fontName='Helvetica-Bold',fontSize=12.5,leading=16,textColor=TEAL,spaceBefore=7,spaceAfter=4))
S.add(ParagraphStyle(name='BodyX',parent=S['BodyText'],fontName='Helvetica',fontSize=9.3,leading=12.8,textColor=TEXT,spaceAfter=5))
S.add(ParagraphStyle(name='SmallX',parent=S['BodyText'],fontName='Helvetica',fontSize=7.7,leading=10,textColor=GREY))
def P(x,style='BodyX'): return Paragraph(x,S[style])

def uterus(kind):
 d=Drawing(400,235); title={'normal':'Normal uterus','fibroid':'Submucosal fibroid','adenomyosis':'Adenomyosis'}[kind]
 d.add(String(200,218,title,textAnchor='middle',fontName='Helvetica-Bold',fontSize=13,fillColor=NAVY))
 p=GPath(); p.moveTo(126,170);p.curveTo(100,148,98,112,117,76);p.curveTo(137,38,167,22,200,20);p.curveTo(233,22,263,38,283,76);p.curveTo(302,112,300,148,274,170);p.curveTo(247,194,153,194,126,170);p.close();p.fillColor=HexColor('#F7D9DF');p.strokeColor=ROSE;p.strokeWidth=2;d.add(p)
 c=GPath();c.moveTo(200,164);c.curveTo(180,143,170,116,177,91);c.curveTo(183,70,192,60,200,52);c.curveTo(208,60,217,70,223,91);c.curveTo(230,116,220,143,200,164);c.close();c.fillColor=HexColor('#FFFDF8');c.strokeColor=HexColor('#8D5F69');c.strokeWidth=1.2;d.add(c)
 for a,b,cx in [(126,87,73),(274,313,327)]: d.add(Line(a,166,b,190,strokeColor=ROSE,strokeWidth=2.5));d.add(Circle(cx,193,8,fillColor=HexColor('#F7D9DF'),strokeColor=ROSE))
 if kind=='fibroid':
  d.add(Circle(200,104,27,fillColor=GOLD,strokeColor=HexColor('#A66F13'),strokeWidth=1.3));d.add(Line(226,106,335,120,strokeColor=GOLD,strokeWidth=1.4));d.add(String(339,116,'Defined mass',fontName='Helvetica',fontSize=8.2,fillColor=TEXT));d.add(String(200,8,'Projects toward the cavity',textAnchor='middle',fontName='Helvetica-Oblique',fontSize=7.6,fillColor=GREY))
 elif kind=='adenomyosis':
  for x,y in [(246,142),(261,127),(265,108),(252,91),(272,82),(242,73),(274,150),(247,118),(263,61)]: d.add(Circle(x,y,3.5,fillColor=TEAL,strokeColor=TEAL))
  d.add(Line(265,109,350,120,strokeColor=TEAL,strokeWidth=1.4));d.add(String(354,116,'Within muscle',fontName='Helvetica',fontSize=8.2,fillColor=TEXT));d.add(String(200,8,'Diffuse / ill-defined changes',textAnchor='middle',fontName='Helvetica-Oblique',fontSize=7.6,fillColor=GREY))
 return d

def panel(title,text,bg=PALE):
 t=Table([[P('<b>'+title+'</b><br/>'+text)]],colWidths=[16.8*cm]);t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),bg),('BOX',(0,0),(-1,-1),.5,HexColor('#C8D9DC')),('LEFTPADDING',(0,0),(-1,-1),9),('RIGHTPADDING',(0,0),(-1,-1),9),('TOPPADDING',(0,0),(-1,-1),7),('BOTTOMPADDING',(0,0),(-1,-1),7)]));return t
def table(rows,widths,head=NAVY):
 t=Table(rows,colWidths=widths,repeatRows=1);t.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,0),head),('TEXTCOLOR',(0,0),(-1,0),colors.white),('BACKGROUND',(0,1),(0,-1),PALE),('GRID',(0,0),(-1,-1),.35,HexColor('#B7C9CD')),('VALIGN',(0,0),(-1,-1),'TOP'),('LEFTPADDING',(0,0),(-1,-1),6),('RIGHTPADDING',(0,0),(-1,-1),6),('TOPPADDING',(0,0),(-1,-1),5),('BOTTOMPADDING',(0,0),(-1,-1),5)]));return t
def foot(canv,doc):
 canv.saveState();canv.setStrokeColor(HexColor('#C6D9DD'));canv.line(1.6*cm,1.35*cm,19.4*cm,1.35*cm);canv.setFont('Helvetica',7.5);canv.setFillColor(GREY);canv.drawString(1.6*cm,.9*cm,'Educational guide - not a substitute for a clinical consultation');canv.drawRightString(19.4*cm,.9*cm,'Page %s'%doc.page);canv.restoreState()

story=[Spacer(1,1*cm),P('Fibroid Polyp<br/>vs Adenomyosis','TitleX'),P('A visual guide to what they are, how symptoms differ, diagnosis, and treatment choices','SubX'),Spacer(1,.45*cm),Table([[uterus('fibroid'),uterus('adenomyosis')]],colWidths=[8.4*cm,8.4*cm]),Spacer(1,.15*cm),panel('First, clarify the term “fibroid polyp”','This is not a formal diagnosis. It commonly describes a <b>submucosal fibroid</b> projecting into the uterine cavity, sometimes on a stalk. It may also be used loosely for an <b>endometrial polyp</b>, which is a different lining-based growth.',LAV),Spacer(1,.25*cm),P('<b>At a glance:</b> A submucosal fibroid is a defined benign smooth-muscle lump that can distort the cavity. Adenomyosis is endometrial-type tissue embedded within the uterine muscle, often causing painful and heavy periods.'),PageBreak()]
story += [P('1. Anatomy and terminology','H1X'),P('The central difference is <b>location and pattern</b>. Both are benign uterine conditions and both may cause abnormal uterine bleeding. They may coexist.'),table([[P('<b>Feature</b>'),P('<b>Submucosal fibroid</b>'),P('<b>Adenomyosis</b>')],[P('<b>Origin</b>'),P('Smooth muscle of the uterus, also called a leiomyoma.'),P('Endometrial glands and stroma within the myometrium.')],[P('<b>Pattern</b>'),P('Usually localized and well-defined.'),P('Usually diffuse or ill-defined; a focal adenomyoma can occur.')],[P('<b>Where it grows</b>'),P('Under the lining and toward the uterine cavity.'),P('Inside the uterine muscle wall.')],[P('<b>Effect on cavity</b>'),P('May protrude into or distort the cavity.'),P('Usually no discrete cavity mass.')],[P('<b>Uterine feel</b>'),P('May be normal or irregularly enlarged.'),P('Often diffusely enlarged, soft, and tender around menses.')]],[3*cm,6.85*cm,6.85*cm]),Spacer(1,.25*cm),P('Visual comparison','H2X'),Table([[uterus('fibroid'),uterus('adenomyosis')]],colWidths=[8.4*cm,8.4*cm]),panel('Why the distinction matters','A cavity-distorting fibroid can often be removed hysteroscopically. Adenomyosis lies within the muscle wall, so treatment commonly begins with symptom control using medication or hormonal options.'),PageBreak()]
story += [P('2. Symptoms and clinical clues','H1X'),P('Symptoms overlap. The bleeding and pain pattern, examination, ultrasound findings, age, and reproductive goals help guide assessment.'),table([[P('<b>Finding</b>'),P('<b>More suggestive of submucosal fibroid</b>'),P('<b>More suggestive of adenomyosis</b>')],[P('<b>Bleeding</b>'),P('Heavy or prolonged periods; sometimes bleeding between periods. Small cavity lesions can cause substantial bleeding.'),P('Heavy, prolonged periods or irregular bleeding.')],[P('<b>Pain</b>'),P('Cramping and pressure may occur, but pain is variable.'),P('Painful periods that may worsen over time, chronic pelvic pain, or pain during intercourse.')],[P('<b>Fertility</b>'),P('Cavity distortion can interfere with implantation and may matter in infertility or recurrent miscarriage.'),P('May be associated with subfertility and pregnancy complications, though individual effect varies.')],[P('<b>Examination</b>'),P('May show enlarged or irregular uterus.'),P('Often uniformly enlarged and tender uterus.')]],[2.6*cm,7.1*cm,7*cm],TEAL),Spacer(1,.2*cm),P('3. Tests and imaging','H1X'),P('<b>Transvaginal ultrasound</b> is usually first-line. It can identify fibroids, assess cavity distortion, and detect features that support adenomyosis. A saline-infusion ultrasound or hysteroscopy can better define a lesion inside the cavity. MRI is useful in selected unclear cases.'),panel('Biopsy note','An endometrial biopsy samples the lining. It does not reliably diagnose adenomyosis because adenomyosis is located in the uterine muscle. Biopsy may still be needed to investigate abnormal bleeding or rule out other disease.',LAV),PageBreak()]
story += [P('4. Treatment and fertility considerations','H1X'),P('Treatment is individualized according to symptom severity, anemia, lesion size and location, age, other medical conditions, and whether pregnancy is desired.'),table([[P('<b>Goal</b>'),P('<b>Submucosal fibroid</b>'),P('<b>Adenomyosis</b>')],[P('<b>Ease pain / bleeding</b>'),P('NSAIDs, tranexamic acid when appropriate, and hormonal options can reduce symptoms.'),P('NSAIDs and hormonal menstrual suppression are commonly used. Progestin-based options, including a levonorgestrel IUD, may help selected patients.')],[P('<b>Preserve uterus</b>'),P('Hysteroscopic myomectomy can remove a suitable cavity lesion while preserving the uterus.'),P('Options need specialist discussion because disease lies in the muscle. Medical therapy can control symptoms but does not remove it.')],[P('<b>Procedures</b>'),P('Myomectomy and selected other approaches. Uterine artery embolization may be considered with fertility counseling.'),P('Selected uterine-preserving procedures or uterine artery embolization may be considered individually.')],[P('<b>Definitive treatment</b>'),P('Hysterectomy if symptoms are severe and childbearing is complete.'),P('Hysterectomy is definitive if conservative management fails and future pregnancy is not desired.')]],[2.8*cm,6.9*cm,7*cm]),Spacer(1,.18*cm),P('If the report says “endometrial polyp”','H2X'),P('An <b>endometrial polyp</b> is different from both a fibroid and adenomyosis. It is a localized growth from the uterine lining and may cause spotting, irregular bleeding, heavy periods, or postmenopausal bleeding. Hysteroscopic polypectomy removes it and enables tissue examination.'),panel('Important','Postmenopausal bleeding needs prompt assessment. Most polyps are benign, but tissue assessment may be needed depending on symptoms and risk factors.',LAV),PageBreak()]
story += [P('5. When to seek care and what to ask','H1X'),P('Seek urgent care for bleeding that soaks one or more pads or tampons per hour for several hours, fainting, severe dizziness, breathlessness, chest pain, severe new pelvic pain, fever, or possible pregnancy with pain or bleeding. Heavy menstrual bleeding can lead to iron-deficiency anemia.'),P('Useful questions for your clinician','H2X')]
for q in ['Is this a submucosal fibroid, an endometrial polyp, adenomyosis, or more than one condition?','Does the lesion distort my uterine cavity?','Could this explain my bleeding, pain, anemia, or fertility concerns?','Do I need saline-infusion ultrasound, MRI, hysteroscopy, or an endometrial biopsy?','Which treatment fits my current symptoms and future pregnancy plans?','What are the recovery time and chance of needing further treatment?']: story.append(P('• '+q))
story += [P('Key takeaways','H2X'),panel('Localized mass versus muscle-wall disease','A submucosal fibroid is a defined muscle mass that can project into the cavity. Adenomyosis is tissue within the muscle wall and commonly causes painful, heavy periods. Both can occur together, so scan results need to be interpreted alongside symptoms and an examination.'),Spacer(1,.2*cm),P('Sources','H2X'),P('Berek & Novak’s Gynecology, Diagnosis and Management of Adenomyosis, pp. 580-581. Sabiston Textbook of Surgery, Adenomyosis, p. 2796. Grainger & Allison’s Diagnostic Radiology, Endometrial Polyp Imaging, pp. 896-897. American College of Obstetricians and Gynecologists, Abnormal Uterine Bleeding and Heavy Menstrual Bleeding patient guidance. Mayo Clinic, Adenomyosis Diagnosis and Treatment.','SmallX'),P('This guide is educational and cannot diagnose a specific scan finding. Discuss personal symptoms and management options with a qualified gynecologist.','SmallX')]
SimpleDocTemplate(str(OUT),pagesize=A4,rightMargin=1.6*cm,leftMargin=1.6*cm,topMargin=1.45*cm,bottomMargin=1.7*cm).build(story,onFirstPage=foot,onLaterPages=foot)
print(OUT)

Running Command

python "/tmp/workspace/fibroid-polyp-adenomyosis-pdf/src/create_pdf.py" && python - <<'PY' from pypdf import PdfReader from pathlib import Path p=Path('/tmp/workspace/fibroid-polyp-adenomyosis-pdf/output/Fibroid_Polyp_vs_Adenomyosis.pdf') r=PdfReader(str(p)) print(f'EXISTS={p.exists()} SIZE={p.stat().st_size} PAGES={len(r.pages)}') for n,page in enumerate(r.pages,1): text=page.extract_text() or '' print(n, len(text), text[:70].replace('\n',' | ')) PY

Editing File

~/fibroid-polyp-adenomyosis-pdf/src/create_pdf.py

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/fibroid-polyp-adenomyosis-pdf/src/create_pdf.py'

Running Command

Editing File

~/fibroid-polyp-adenomyosis-pdf/src/create_pdf.py

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/fibroid-polyp-adenomyosis-pdf/src/create_pdf.py'

Running Command

Created a 5-page illustrated PDF with simplified anatomical diagrams, comparison tables, symptoms, diagnosis, treatment options, fertility considerations, red flags, and sources.

Fibroid Polyp vs Adenomyosis

PDF Document · PDF

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