Adenomyosis may require surgery, either adenomyomectomy or hysterectomy, if you experience severe pelvic pain with heavy bleeding.

Adenomyosis Treatment: When Do You Need Surgery?

Heavy and prolonged bleeding accompanied by severe cramps and pelvic pain that makes your everyday activities challenging can be the signs of adenomyosis. It’s a gynecological condition where endometrial tissue, which is found in the uterus, develops within the thick muscular wall, called the myometrium.

This can enlarge the uterus, sometimes doubling its original size. Adenomyosis treatment in Thane may include medication, hormonal therapy, and, if nothing works, surgical treatment. Let’s discuss adenomyosis treatment and when surgery is generally considered.

When Adenomyosis Needs Treatment

Not everyone with adenomyosis needs treatment. Many don’t even know they have it until it’s incidentally found on routine pelvic exams. If it’s asymptomatic, you may be advised to wait. For others, less-invasive treatments are tried first.

Adenomyosis growth is fueled by estrogen, so the symptoms often automatically disappear once you hit menopause. Until then, a gynecologist in Thanemight prescribe symptomatic treatments, such as NSAIDs to relieve menstrual cramps. Hormonal medication, such as birth control pills, and non-hormonal treatments, such as tranexamic acid tablets, can control heavy bleeding.

If pregnancy isn’t in your plan right now, a hormonal IUD is another symptom management option for adenomyosis. The device releases progestin, which thins out the uterine lining, controlling heavy bleeding during menstruation.

Surgery for Adenomyosis: When It’s Necessary

Surgery is usually unnecessary unless the above treatments do not provide adequate relief or your symptoms are interfering with your daily life. For example, if severe bleeding has led to anemia, switching medications may not be a wise decision.

At this point, your surgeon may consider a more effective treatment option, such as surgery that removes adenomyosis tissue or hysterectomy (uterus removal). Let’s understand each option.

Adenomyomectomy

It’s a uterus-preserving surgery that involves careful removal of the diseased adenomyosis tissue from the muscular wall, while preserving uterine function. The procedure is complex and often requires skilled surgeons. The tissue growth can be classified into two types:

• Diffuse Adenomyosis: A condition where the adenomyosis tissue is spread throughout the uterine muscle, blending with the healthy tissues. This makes removal difficult without affecting healthy uterine tissue.
• Focal Adenomyosis: This one is relatively less complex because the tissue is concentrated in one place, forming a lump called an adenomyoma. It looks like a fibroid. Fibroids can be detached from the muscular wall easily because they grow with a capsule, but adenomyomas don’t have distinct edges or a defined shape, making removal still challenging.

Note that adenomyomectomy may elevate your risk of needing a C-section birth if you plan pregnancy in the future. Although vaginal birth may be possible in some cases, doctors usually advise a cesarean birth to prevent uterine rupture during labor. That’s particularly true if they have made a deep cut into the uterine wall.

Hysterectomy

A more definitive treatment for adenomyosis is hysterectomy — a procedure that removes the uterus containing the diseased tissue. Since the root cause of the problem is removed, you will no longer experience pelvic pain, bleeding, or other symptoms. However, you will also no longer be able to get pregnant. So, it’s only a practical option for those who have completed childbearing.