When Andrea Murray decided to undergo a hysterectomy after debilitating menstrual pain that began when she was around 15 years old, her life drastically changed for the better.
“I would have abnormally extreme pain to the point where something was wrong and go to the emergency room,” she said. “It was horrible. … The pain is just something so indescribable.”
Murray, now 40, of Harmony in Beaver County, underwent a laparoscopic surgery when she was 19 to diagnose what her doctors suspected: endometriosis and a second, lesser-known condition, adenomyosis.
When endometrial cells that would be shed during menstrual cycles instead start to plant and grow into the muscular wall, or lining, of the uterus, that’s when adenomyosis occurs, according to Dr. Nicole Donnellan, an associate professor in the OB-GYN department at the University of Pittsburgh and director of the endometriosis and chronic pelvic pain center at UPMC Magee-Womens Hospital.
Comparatively, endometriosis occurs when those cells plant outside the uterus, she said.
“My doctor at the time suggested a hysterectomy, (but) at that point, I wanted children, so I opted not to have it,” she said.
Instead, Murray was put on continuous birth control, which stopped her menstrual cycle and muted her pain. But she endured multiple surgeries, ovarian cyst rupture and different growths on the outside of her ovaries.
“I would just call them flare-ups, and I would deal with them as I got older,” she said. “They kept kind of getting progressively worse, where I would just be completely immobile for a couple of days.”
“I got to a point where it was almost so frequent and continuous that my quality of life was just absolutely horrible.”
In 2019, at age 32, Murray decided she needed the hysterectomy.
“The position of my uterus had actually fallen backwards. They were going to have to do (a) whole pelvic sling if I wanted children. … I would’ve even struggled to get pregnant,” she said. “After hearing all of that, I called my doctor [and said], ‘It’s time. I can’t live like this.’”
What is adenomyosis?
Dr. Lisa Hildenbrand, an obstetrician and gynecologist at Independence Health System, said adenomyosis often causes heavy menstrual bleeding, severe cramping, pelvic pain and painful intercourse.
“While more women are being diagnosed today, it’s likely due to greater awareness and improved imaging that help identify the condition earlier,” she said.
Donnellan compared the pain and pressure during adenomyosis to “sitting on a fence post,” and it manifests as what she calls “an angry uterus” that’s inflamed.
In addition to severe pain around the site of her uterus, Murray experienced back pain and exhaustion.
“Physically, I didn’t do a lot,” she said. “It just puts a really big damper on your life.”
Adenomyosis can be medically managed through hormone therapy such as birth control pills or an intrauterine device, but the major surgical treatment is a hysterectomy to eliminate the condition altogether, Donnellan said. That’s also the way to formally confirm the condition, as it’s harder to diagnose than endometriosis, which can be confirmed laparoscopically, she said.
“If you are a younger person that hasn’t had a child (and) still desires children, they’re all tricky to diagnose and treat,” she said.
Donnellan said at UPMC, she and other doctors use a predictive threshold system when looking for adenomyosis. If a patient scores seven or more out of 10 typical issues, adenomyosis is diagnosed.
A main difference that points toward adenomyosis instead of endometriosis can be if doctors notice the uterus is largely tender upon examination, Donnellan said.
As for the “million-dollar question” of why adenomyosis occurs? Doctors don’t know, Donnellan said.
“We still don’t know why people get this, and we still don’t know how to treat it better. I’ve been doing this for 17 years and still no changes,” she said. “It is appalling that we don’t know more about this.”
Donnellan said research dollars often don’t go toward women’s health.
“We do tend to see (adenomyosis) more in subsequent pregnancies and sometimes with C-sections,” she said of risk factors.
Often, Donnellan said, adenomyosis is seen in a slightly older demographic, with people in their 30s and 40s. Endometriosis, which she said has gotten more recognition, shows up in younger women.
Heather Abraham, host of KDKA’s “Talk Pittsburgh” and co-host of “Pittsburgh Today Live,” told TribLive that she received a “suspected” diagnosis of adenomyosis about a year before undergoing a hysterectomy in January 2025.
“For me, there was a little bit of shock, a little bit of surprise, that this thing even existed,” she said of adenomyosis, explaining that she hadn’t heard the term previously. “Honestly, the thing I felt the most was relief.”
Abraham, 42, of Bridgeville, said after her third C-section in 2019 and after she stopped breastfeeding, she suffered heavier, painful periods that were “out of control,” as well as symptoms like leg pain, fatigue, migraines, weight gain and cyst ruptures.
“I’ve always had heavier periods, a little bit longer … it was normal for me,” she said. “I don’t think it was as noticeable until I was done having children. For some women, they aren’t diagnosed until having babies.”
Since her hysterectomy, Abraham said she has been doing “amazing.”
“It was the best and easiest decision that I’ve ever made,” she said. “Am I still tired? Yes, but I feel like I’m what normal tired is now and not that physical exhaustion.”
Heavy emotional toll
Murray said having a hysterectomy to address her adenomyosis and endometriosis was probably the hardest decision she has made, emotionally.
“The older I got, the worse things had gotten on my body and the bigger the toll it had taken and the more it was impacting my personal life, my sex life, my work, my happiness, my health,” she said. “My chances of getting pregnant and carrying a child were getting harder.”
Murray said women often feel that their purpose in life is to be a mother.
“It’s very personal as a woman. I almost felt it was my purpose here to reproduce. To come to the realization that I would never do that — it was a hard pill to swallow,” she said. “There are still some days that it hits me.”
One of the hardest parts for Murray was losing what she felt was her purpose.
“I struggled — ‘What am I going to do with my life now? What’s my purpose? What am I going to give to the world? I have no child to leave; what mark am I going to make?’” she said.
Now, Murray finds her purpose as a firefighter with the Harmony Township Volunteer Fire Department.
After her procedure, Murray found herself in what she called a scary situation where a woman was “screaming for help.” She didn’t elaborate on the instance but said it affected her deeply.
“It was really bad. I found myself running over to her and didn’t even think twice,” Murray said about her decision to help. “The fire department showed up. It stayed with me — the more I thought about it, ‘I could do that, that’s something I could do.’”
Murray joined in 2020 and then attended the Washington County Fire Academy.
“I walked in there one night, the fire department down the road where I live, and asked for an application,” she said. “I’m only 5 feet tall. I’m pretty sure they thought I was crazy.”
Having a hysterectomy ended up being what was best for her in the long run.
“I just decided to take my life in a different direction,” Murray said. “If I couldn’t contribute to the world with kids, I decided to contribute to it in other ways.”
She was recently promoted to president of the fire department.
“If it weren’t for the hysterectomy, I don’t know if that ever would’ve happened,” she said. “I feel like that has totally given my life purpose now. That’s where I met my husband.”
She has a stepson now. And the procedure itself was life-changing for her body, Murray said.
“I lost a ton of weight. I got active. Going through the actual hysterectomy and recovery was pretty brutal, (but) a year later, my life took a whole 180,” Murray said. “I do still have flare-ups maybe once every four months, three months. They’re just tiny. They might last a few hours.
“It’s a lot different than it used to be.”
More research necessary
Though Murray didn’t experience what she called the “misogynistic side” of healthcare that she knows other women have experienced through firsthand conversations, Murray believes more awareness of adenomyosis is needed.
The exact prevalence of adenomyosis is unknown, according to the Cleveland Clinic in 2023, but researchers know it’s more common in those older than 40 and/or have had a procedure on their uterus.
About one in three people with adenomyosis don’t show symptoms, however, the Cleveland Clinic said.
“It seems like my doctor was actually a rarity because my doctor did offer the hysterectomy when I was so young, and he basically told me, ‘Whenever you’re ready,’ to give him a call,” she said. “Other women, they say they go into their doctor, and they ask for one and (the doctor says), ‘Oh no, you’re too young,’ or ‘You might want more kids.’ They’re constantly told no by their doctors.
“Maybe if there’s more research done on these, maybe there are more options than just surgeries or just hysterectomies … a lot of women suffer, and a lot of women are told to suck it up and just deal with it.”
Abraham said even 10 years ago, people wouldn’t be talking about gynecological conditions openly, but when she experienced hers, she posted on social media to spread awareness.
“I think it’s just as a mom with two young girls, now that I have this knowledge, I want to make sure they’re aware of what a normal period looks like,” she said. “I hope that other women can do the same.
“Shared experiences are how we connect with each other, better our own lives, build community.”
Women are taught that having a period is meant to be an uncomfortable experience, so they are less likely to speak up or “complain” if something seems awry, Abraham said.
“We learn to live in our discomfort,” she said. “What you think is normal may not be. It’s important to ask the questions.”
Murray said someone saying they’re in severe pain should be addressed and not dismissed.
“A lot of women are embarrassed or confused. You question your own sanity because of it,” she said. “I just feel like if the word gets out there, if more people talk about it and it’s something that is researched more and considered more as an option for teenage girls and pain is not just brushed off, maybe women could have a better quality of life if they’re diagnosed sooner.”
Donnellan agreed.
“You shouldn’t have to fail 28 (tests) in order to earn your surgery,” she said.
She hopes awareness continues to grow.
“If you can’t go to school or if you can’t go to work because of your period, that’s not normal,” she said. “If that individual cannot participate in basic society and job and living — if it’s knocking them out of their day-to-day activities — then that’s not normal.”