Adenomyosis – Diagnosis and Treatment

Diagnosis

Adenomyosis is not always easy to identify because its symptoms are similar to other conditions, like uterine fibroids or endometriosis. Healthcare providers use several steps to figure out if a person has adenomyosis.

Doctors start by listening to symptoms such as heavy menstrual bleeding, pelvic pain, or painful periods (dysmenorrhea). During a pelvic exam, they may notice that the uterus feels larger or more tender than usual.

Common diagnostic tools:

• Transvaginal Ultrasound: This test helps doctors detect changes in the uterine muscle (myometrium) and signs of adenomyosis.
• Magnetic Resonance Imaging (MRI): MRI provides detailed images of the uterus, which can reveal focal or diffuse adenomyosis and other issues in the uterine wall.
• Endometrial Biopsy: Sometimes doctors take a sample of the uterine lining to rule out other causes, but this test does not confirm adenomyosis.

Doctors usually make a definite diagnosis after performing a hysterectomy and examining the uterus in a lab.

Treatment

Treatment for adenomyosis usually depends on a person’s age, how severe their symptoms are, if they still want to have children, and how close they are to menopause. Several approaches may help reduce pain and heavy bleeding.

Common treatment options include:

Treatment Type	Fertility Impact	Main Purpose
Anti-inflammatories	No effect	Pain relief
Hormone therapies	May reduce fertility	Control symptoms
IUD/hormonal devices	May reduce fertility	Lessen periods
Hysterectomy	Ends fertility	Permanent solution
Uterine artery embolization	Possible effect on fertility	Reduce symptoms

• Anti-Inflammatory Medicines: Drugs like ibuprofen can ease pain and may lower menstrual blood loss when taken before and during periods.
• Hormonal Therapies: Doctors sometimes recommend birth control pills with both estrogen and progestin, hormonal patches, and vaginal rings to help control bleeding and discomfort. The levonorgestrel-releasing intrauterine system is another choice that can make periods lighter or stop them altogether.
• Surgical Options: If other treatments do not work, doctors may perform a laparoscopic hysterectomy (removal of the uterus). Unlike some surgeries for fibroids (leiomyomas), doctors do not usually remove the ovaries for adenomyosis.
• Other Methods: Doctors may consider conservative surgery or uterine artery embolization for some people who wish to keep their fertility.

Ways to Care for Yourself

Simple actions at home can help with symptoms like painful periods, blood clots, and pelvic discomfort. People often use a heating pad or soak in a warm bath to ease cramping.

Getting Ready for Your Visit

Steps You Can Take

Before going to the appointment, gather important information to help the doctor understand your situation. Bring a list of your symptoms and when they started. Write down any medications, vitamins, or supplements you use, including how much you take.

Note important medical facts, such as your menstrual cycle details, past pregnancies, menopause status, or if you have ever experienced uterine rupture.

Consider what you want to ask the doctor. Possible questions might include:

• Are there medicines to help my symptoms?
• When would surgery be recommended?
• Could this condition affect my ability to have children?

Write any questions down so you do not forget them.

Things Your Doctor Might Ask

The doctor will likely want details about your health. They may ask:

Question Type	Examples
About Symptoms	When symptoms started, how severe they were
About Menstrual Cycle	When your last period was, if symptoms match cycle.
About Reproductive Health	If you could be pregnant, if you use birth control.
About Triggers	What helps or worsens symptoms.
About Menopause and Past Problems	If menopause has begun, if you experienced uterine rupture.