Our Summary

Adenomyosis is a condition where the tissue that normally lines the uterus starts growing within the muscular wall of the uterus, causing it to enlarge. This can lead to heavy menstrual bleeding and painful periods, though some women may not have any symptoms. Despite many ways to detect adenomyosis, there’s no standard diagnostic method for doctors to follow, which can make it harder to identify and treat. This is especially true when the patient has other gynaecological conditions as well.

This study aims to summarize recent and relevant information on adenomyosis, including its prevalence, symptoms, diagnosis, and treatment. The researchers examined data from four databases: PubMed, Web of Science, Elsevier, and Google Scholar.

Through their review, they found that the most reliable way to diagnose adenomyosis is through a tissue biopsy taken during a procedure like a hysteroscopy or laparoscopy. However, imaging methods, such as transvaginal sonography and magnetic resonance imaging (MRI), are often used to distinguish adenomyosis from other conditions. An MRI can be particularly useful for differentiating between adenomyosis and myomatosis (a condition involving benign tumors in the uterus), and it can help detect adenomyosis early.

Regarding treatment, there’s no specific therapy or treatment plan for adenomyosis due to the lack of precise diagnostic criteria. However, the most effective treatments currently are medications that inhibit the production of certain hormones (aromatase inhibitors and gonadotropin-releasing hormone antagonists). Additionally, minimally invasive surgical techniques, like endometrial ablation (removal of the lining of the uterus) and uterine artery embolisation (blocking the blood supply to the uterus), are becoming increasingly popular.

FAQs

  1. What is adenomyosis and what are its symptoms?
  2. What are the most reliable methods for diagnosing adenomyosis?
  3. What are the current treatment options for adenomyosis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about endometrial ablation is to ensure they follow post-procedure care instructions carefully. This may include avoiding strenuous activities, taking prescribed pain medication as needed, and attending follow-up appointments to monitor recovery progress. It’s also important to be aware of any potential complications or side effects, such as infection or changes in menstrual patterns, and to contact their doctor immediately if they experience any concerning symptoms. By following these guidelines, patients can maximize the effectiveness of the procedure and ensure a smooth recovery process.

Suitable For

Patients with adenomyosis who experience heavy menstrual bleeding and painful periods are typically recommended endometrial ablation as a treatment option. This minimally invasive surgical procedure can help alleviate symptoms and improve quality of life for these patients. Additionally, patients who are not candidates for hormonal therapies or who do not wish to undergo a hysterectomy may also be recommended endometrial ablation as a treatment option. It is important for patients to discuss their symptoms and treatment preferences with their healthcare provider to determine the best course of action for their individual situation.

Timeline

Before endometrial ablation, a patient with adenomyosis may experience heavy menstrual bleeding, painful periods, and possible other gynaecological symptoms. They may undergo various diagnostic tests, such as transvaginal sonography, MRI, and tissue biopsies, to confirm the presence of adenomyosis. Treatment options may include medications to manage symptoms or minimally invasive surgical procedures.

After undergoing endometrial ablation, the patient may experience reduced or eliminated menstrual bleeding and relief from painful periods. Recovery time is typically short, with most patients able to resume normal activities within a few days. Follow-up appointments with the healthcare provider may be necessary to monitor the effectiveness of the procedure and ensure the patient’s overall health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about endometrial ablation in relation to adenomyosis may include:

  1. Is endometrial ablation a suitable treatment option for my adenomyosis?
  2. What are the potential risks and benefits of undergoing endometrial ablation for adenomyosis?
  3. How likely is it that endometrial ablation will effectively reduce my heavy menstrual bleeding and painful periods associated with adenomyosis?
  4. Are there any alternative treatments or therapies for adenomyosis that I should consider before choosing endometrial ablation?
  5. What is the success rate of endometrial ablation in treating adenomyosis, and how long-lasting are the results?
  6. Will I still be able to have children after undergoing endometrial ablation for adenomyosis?
  7. What is the recovery process like after undergoing endometrial ablation for adenomyosis, and what kind of follow-up care will I need?
  8. Are there any specific lifestyle changes or precautions I should take after undergoing endometrial ablation for adenomyosis?
  9. How will endometrial ablation affect my overall gynaecological health and well-being in the long term?
  10. Are there any potential complications or side effects associated with endometrial ablation for adenomyosis that I should be aware of?

Reference

Authors: Moldassarina RS. Journal: Arch Gynecol Obstet. 2023 Jul;308(1):171-181. doi: 10.1007/s00404-023-06982-1. Epub 2023 Apr 15. PMID: 37060397