What is adenomyosis?
Adenomyosis is a condition in which tissue similar to the lining of the uterus grows within its muscular wall. It can cause heavy, painful periods, a feeling of pressure and, in some cases, an enlarged uterus. It sometimes coexists with fibroids or endometriosis.
Treatment with medication
When symptoms are manageable, the first line is usually medical management: hormonal contraceptives, progestins or a levonorgestrel IUD, which reduce bleeding and pain. They control symptoms while used, without removing the affected tissue.
When is surgery considered?
- Bleeding or pain that does not respond to medical treatment.
- Anemia from heavy, repeated bleeding.
- Symptoms that significantly affect your quality of life.
- You no longer wish to become pregnant and want a definitive solution.
The surgical option that resolves adenomyosis definitively is hysterectomy (removing the uterus), which I usually perform by minimally invasive surgery. In selected cases where the uterus is to be preserved, there are alternatives we evaluate individually. Because adenomyosis is often diffuse, uterus preservation is not always possible.
Frequently asked questions
Does adenomyosis always require surgery?
No. Many cases are controlled with medical treatment; surgery is considered when symptoms do not respond or affect your quality of life.
What is the surgery for adenomyosis?
The one that resolves it definitively is hysterectomy, usually minimally invasive. In selected cases there are conservative techniques.
Can the uterus be preserved?
In some selected cases yes, especially if pregnancy is desired. Since it is often diffuse, it is not always possible; it is defined per case.
Is adenomyosis the same as fibroids?
No. Fibroids are well-defined benign tumors; adenomyosis is diffuse tissue within the muscle of the uterus. They can coexist.