The first step in diagnosing adenomyosis is a physical examination by a specialist. Following this examination by a gynecologist or obstetrician-gynecologist, the patient's medical history and symptoms are reviewed. In addition, the following methods are used for diagnosis:

Ultrasound is used to visualize thickened uterine muscle layers or cysts.
Magnetic resonance imaging (MRI) is used to diagnose adenomyosis and differentiate it from other possible pelvic conditions.
Rarely, a specialist may perform a biopsy for definitive diagnosis of adenomyosis.
Through pelvic examination, the specialist determines if the uterus is enlarged, softened, or tender to the touch.
The specialist determines appropriate treatment methods considering the symptoms and findings.