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  • Q&A with Australian Health Practitioners

    What treatments are available for adenomyosis

    Related Topic
    Women's Health
    I am 44 years old, U/S diagnosis of adenomyosis with a thickened uterus especially on 1 side. Experience pain all month in addition to the 5 days during menstruation.
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    Thanks

    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    Adenomyosis refers to a disorder where the lining of the uterus (endometrium) is present within the muscle layer of the uterus (myometrium). This is a benign disease that is oestrogen dependent. Women with adenomysosis are more likely to have endometriosis as well as fibroids. The symptoms vary and can be heavy periods, painful periods and chronic pelvic pain.

    There are several options for the treatment of adenomyosis:

    1- Hysterectomy:This is the most effective surgical treatment as it is a guarranteed treatment. Depending on the patient's suitability, we can perform the procedure in a minimally invasive technique such as Laparoscopic. The benefit of performing it laparoscopically (key-hole) is the opportunity to excise any deposits of endometriosis and check for any disease on the ovaries. Adenomyosis is a histologic diagnosis therefore the condition can only be confirmed after a hysterectomy.

    2- Mirena IUD: This has been shown to improve the symptoms of bleeding and pain. This is an option that is not invasive and takes a few minutes to insert. It lasts for 5 years as well and provides contraception. 

    3- Combined Oral Contraceptive Pill: this is frequently used as a first line treatment. The efficacy of it varies. 

    4- Other medications such as danazol and GNRH analogs can be used but the side effect profile is not well tolerated by women.

    5- Uterine Artery Embolization: This is a radiologic treament where the arteries supplying the blood to the uterus are occluded. The success rate of this treatment varies according to which study you look at. It is quoted mostly as two thirds of patients reporting improvements in their symptoms.

    If you have completed your family, a total laparoscopic hysterectomy remains the most efficacious treatment option for this condition. If you have not completed your family, the recommedation is to try other medical options such as the COCP or the Mirena. 

    Good luck.

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