Best Adenomyosis Treatment

When it comes to treating adenomyosis, there isn’t really a single “best adenomyosis treatment” option that fits everyone. What works best truly depends on a few key things: how severe your symptoms are, your overall health, and whether or not you wish to preserve your fertility.

Here are some of the common treatment approaches doctors consider:

• Pain Management: Sometimes, simple Nonsteroidal Anti-inflammatory Drugs (NSAIDs) can be a good starting point. They help to ease the pain and reduce some of the inflammation that comes with adenomyosis.
• Hormonal Therapy: This is a big one for many. Options like birth control pills, intrauterine devices (IUDs) with hormones, or other forms of hormone therapy can be quite effective in controlling bleeding and helping to regulate your periods.
• Ablation: Endometrial ablation, which involves destroying the lining of the uterus, can really help reduce bleeding symptoms for some. However, it’s generally not suitable if you’re hoping to have children in the future.
• Hysterectomy: For severe cases, especially if other treatments just haven’t brought relief, a hysterectomy (which is the removal of the uterus) might be recommended.
• Uterine Artery Embolization (UAE): This procedure works by blocking the blood flow to the affected areas of the uterus, which can lead to a reduction in symptoms.

Is hysterectomy a definitive cure for adenomyosis?

Many doctors commonly advocate hysterectomy, or the surgical removal of the uterus, as a treatment option for adenomyosis.

Since adenomyosis lesions usually are inside the uterine muscles, removing the uterus will completely treat the disease. However, hysterectomy results in surgical infertility.

Moreover, if adenomyosis co-exists alongside endometriosis, which it does in about 27% to 70% of the cases, removing the uterus alone will not offer complete symptom alleviation. Endometriosis lesions grow outside the uterus and can occur in various pelvic organs as well as in extra-pelvic regions. Thus, hysterectomy is not a cure for these lesions.

At the Seckin Endometriosis Center, we perform a hysterectomy if the patient desires this option and we have received full consented to the decision. We recognize that the idea of hysterectomy can be a difficult and emotional decision, so our treatment approaches always aim to preserve our patients’ fertility whenever possible.

What can be done to avoid hysterectomy?

There are no standard drugs that can treat adenomyosis. Most endometriosis medications can also be helpful for adenomyosis. If adenomyosis is the only disease present, the symptoms often go away after menopause.

Suppose you are nearing menopause and the symptoms are not severe. In that case, adenomyosis can be managed with over-the-counter pain medications and hormonal birth control such as progestin-only mini pills or intrauterine hormonal devices. It is important to note that these medications do not treat the lesions themselves but only help in managing the symptoms of the disease. Also, not all patients may respond well to these medications.

Are there better surgical options available?

When adenomyosis is diffuse, there are few good surgical options. When there is a focal area of adenomyosis or an adenomyoma, we can carefully excise these. Excision of these areas can lead to improved pain, bleeding, and possibly fertility. However, exceptional skill is necessary to reconstruct the uterus layer by layer so as to facilitate a safe future pregnancy.

What is the gold standard treatment for adenomyosis?

The gold standard treatment for adenomyosis, particularly in severe pain, is hysterectomy, which involves the removal of the uterus.

However, hysterectomy is not suitable for women who wish to preserve their fertility. For those seeking to retain fertility, other treatments like hormonal therapy (e.g., birth control pills or IUDs) or endometrial ablation may be considered, but they may not offer permanent relief. The choice of treatment depends on the severity of symptoms and the patient’s reproductive goals.

Do you have adenomyosis and are thinking about your treatment options? Please do not hesitate to share your story by leaving a comment on our post on Facebook or Instagram