It is common and badly missed. For decades it was found only in uteruses removed for other reasons, so it looked like a rare condition of older women. Better ultrasound changed that: scanning unselected clinic patients turns it up in about one in five ¹. Roughly a third have no symptoms; the rest range from heavier periods to barely functional one week a month ².

The bleeding drains you slowly. Cycle after cycle of heavy loss strips iron faster than food replaces it, and iron-deficiency anaemia is markedly more common here than in matched controls — it pulls down energy and exercise tolerance with it ².

A scan is the way in. A transvaginal ultrasound from someone who knows the features catches about three in four cases, with few false alarms ³. A generic pelvic scan hunting for fibroids often misses it.

The move is to get it named, then treated — not to endure it. Most clinicians won't look unless you make them, so walk in with the ask ready.

What treatment buys back. A levonorgestrel IUD cuts menstrual bleeding by 70 to 90 percent and eases cramping within a few cycles ⁴²; if it doesn't suit, daily dienogest brings pain scores down about six points on a ten-point scale ⁵.

• First month: the overnight-pad drawer stops being daily-use, and the painkiller bottle stays on the shelf.
• Months three to six: iron recovers, the 3 pm crash fades, and you get through a workday in the heavy week.
• Year one: you stop scheduling your life around your period, because you no longer need to.