Adenomyosis

Our healthcare providers are experts in identifying uterine adenomyosis symptoms. We regularly look for any possible signs of the condition during every gynecologic ultrasound.

If our experts suspect adenomyosis, gynecologic imaging helps us determine as early as possible the best treatment for you. Depending on your symptoms, your provider may use:

Hysteroscopy

Hysteroscopy is a procedure that helps our providers see inside your uterus. Our specialists, who are recognized for excellence in hysteroscopy, perform this exam in the office. We insert a hysteroscope (thin tube with a camera and light) into the vagina to send images to a monitor.

During hysteroscopy, our provider inspects the lining of your uterus to see if you have adenomyosis. This in-depth look helps us understand not only if you have the condition, but if so, how far along it is and what type of treatment you need.

3D ultrasound

We use 3D pelvic ultrasound to get a detailed picture of your uterus. Your provider inserts a slender probe (called an inducer) covered with a plastic sleeve and lubricating gel into your vagina.

The probe sends sound waves throughout your pelvis. The ultrasound machine uses these sound waves to create images of your uterus, allowing specialists to see any adenomyoma. These are growths of abnormal tissues (called nodules) that are caused by adenomyosis.

MRI

Your provider may do an MRI if they suspect you have adenomyosis. A pelvic MRI is an imaging test that uses magnets and radio waves to create an image of your pelvis and uterus. We use these images to diagnose adenomyosis.

Before we begin treatment, we talk with you about your symptoms and any plans for future pregnancies. If you do hope to get pregnant in the future, preserving your fertility is always our first priority.

If you have adenomyosis, but aren’t experiencing any bothersome symptoms, we may not need to treat the condition at all. But if your adenomyosis needs treatment, we use the latest techniques that help preserve your uterus whenever possible.

Adenomyosis medications

To relieve pain and stop heavy bleeding, we use a variety of medications. Your provider may recommend:

• Anti-inflammatory drugs: Ibuprofen (Advil^®, Motrin^®) or naproxen sodium (Aleve^®) help relieve pain and decrease blood flow.
• Birth control: Combined estrogen and progestin, or progesterone-only types of birth control help prevent ovulation and control heavy bleeding.
• Progestin-releasing intrauterine device (IUD): A device inserted into the uterus releases levonorgestrel, a hormone that helps reduce bleeding.

Endometrial ablation

When adenomyosis is in one area or isn’t too deep in the uterine wall, we may use endometrial ablation. Surgeons insert a probe that uses energy to destroy the uterine lining. If you plan to have children, talk with your provider about how this procedure might affect your fertility.

Hysterectomy

If your adenomyosis symptoms are severe and you don’t wish to become pregnant, we may recommend a hysterectomy. Our surgeons perform minimally invasive hysterectomies, including:

• Laparoscopic hysterectomy: We make a small incision in the abdomen to insert an instrument with a lighted camera (called a laparoscope) to see your uterus. We insert small surgical instruments through additional small incisions to remove the uterus.
• Vaginal hysterectomy: We insert surgical instruments into your vagina to remove your uterus without needing to make any incisions in your uterus.

Fertility Preservation

In most cases, we can perform uterine-sparing treatments that help make it possible for you to have a child in the future. If you plan to become pregnant, you’ll meet with our fertility specialists to determine the best adenomyosis treatment for you.

Taking the Next Step

From heavy periods and cramps that keep you from doing the things you enjoy to worries around future pregnancies, adenomyosis can interrupt your life. Our providers will talk to you about your experiences, feelings, concerns and goals when you come in for an appointment. We’ll create a treatment plan for you that fits your life and works for you.