Endometrial cells line the uterus and slough off during menstruation. In the case of adenomyosis, endometrial cells spontaneously arise deep within the muscle tissue of the uterus, instead of just along the inner lining, and cause heavy, painful periods. In the past, the most common adenomyosis treatment was a hysterectomy procedure to surgically remove the uterus. Today, most cases of adenomyosis can be managed with nonsurgical measures, including a course of anti-inflammatory medications, hormone supplements, and home remedies to relieve pain.
Adenomyosis treatment depends on a number of factors, especially a patient's age and the severity of her symptoms. During an exam at the gynecologist's office, the doctor usually conducts a thorough pelvic exam and an ultrasound to determine the seriousness of the condition. A tissue biopsy helps the doctor rule out other causes of severe menstrual pain and heavy bleeding. After confirming that adenomyosis is responsible for symptoms, he or she can explain different treatment options.
Adenomyosis usually stops after menopause, so a woman who is nearing menopausal age may not need to receive extensive adenomyosis treatment. Younger women may be able to benefit from over-the-counter anti-inflammatory drugs that reduce swelling and tenderness in the uterus. During a period, cramps and pain can often be somewhat relieved by using a heating pad on the lower abdomen, avoiding physical activity, and taking warm baths.
Many doctors prescribe birth control pills or vaginal contraceptive rings as a form of adenomyosis treatment. Contraceptives that contain progesterone- and estrogen-regulating chemicals are usually very effective at relieving adenomyosis, as they reduce the frequency and severity of periods. In addition, patients may also benefit from injections or daily contraceptives that contain gonadotropin-releasing hormone agonist solutions that prevent menstruation altogether.
When symptoms persist or recur despite nonsurgical remedies, surgical adenomyosis treatment may be needed. A surgeon can perform a hysterectomy to remove the entire uterus, thus ensuring that adenomyosis never returns. Most hysterectomies for adenomyosis complications can be performed laparoscopically, which involves making several small cuts in the abdomen and removing the uterus in pieces. The surgeon uses a small camera to direct precision surgical instruments around the uterus, cutting out and removing sections until the entire uterus is excised. Following the procedure, the surgeon repairs surrounding tissue and sutures the surgical wounds.
A patient usually needs to stay in the hospital for several days following a hysterectomy so doctors can monitor her recovery. The risk of complications is low, but blood clotting and infection could occur and cause additional health problems. Most patients are able to fully recover after about one month.