Adenomyosis Treatment by Expert Gynaecologist

Diagnosis and Treatment of Adenomyosis

Diagnosis of Adenomyosis-

During diagnosis, doctors first evaluate your medical history and recommend a few diagnostic tests to determine if your uterus is enlarged or infected. On the basis of the severity of the condition, age, and your desire for future pregnancy, doctors plan out the suitable treatment procedure for adenomyosis. Some of the common diagnostic tests for adenomyosis are –

• Pelvic exam- Before performing a pelvic exam, doctors first physically examine your vagina and vulva to check out any swelling and soreness. After that, they insert a speculum into the vagina to collect the cell sample. Later on, this cell sample helps doctors identify the conditions like cancer or any sexually transmitted diseases.
• Transvaginal ultrasound- It is an imaging test that involves high-frequency sound waves to get an image of your internal body organs. These images provide valuable information about the thickening of the uterine in the adenomyosis suspect. 
• MRI scan- In an MRI scan, magnetic and radio waves are produced to get high-resolution images of internal organs. It is performed to identify radiological features of the uterus, like the thickening of the area between the endometrium and myometrium. Doctors suggest removing all the medical and electrical devices inside your body, like- pacemakers and piercings, as these metals can interfere with magnetic resonance.

Treatment for Adenomyosis

Doctors plan suitable treatment for adenomyosis by considering the severity of the condition, the age of the women, and their desire for future pregnancy. Usually, women with mild symptoms may not require any specific treatment, but in severe cases, surgery is a must.

Non-surgical treatment-

This treatment  involves medications like- painkillers, hormonal therapy, and anti-inflammatory drugs to manage the symptoms temporarily.

• Painkillers– It is prescribed to relieve adenomyosis-associated pain.
• Hormonal therapy- Hormonal contraceptives are the first-line therapy for managing symptoms of adenomyosis. It involves birth control pills or progesterone-releasing intrauterine devices.

Non-surgical treatment is a temporary measure as it only focuses on managing the pain and other symptoms, but surgery is required for severe conditions and for a complete cure of adenomyosis.

Surgical treatment- Doctors suggest surgery when the condition is severe, and women experience symptoms like abnormal vaginal bleeding, heavy or prolonged menstrual bleeding, and painful intercourse. Hysterectomy (uterus removal) is the only surgical treatment procedure for adenomyosis. During a hysterectomy, the gynaecologist removes the uterus and other female reproductive organs, including- ovaries, cervix, and fallopian tube. Hysterectomy can be performed in two ways-

Open-cut hysterectomy- It is a traditional method of removing the uterus that involves cuts and stitches. Doctors make 6-8 inch long incisions through which the doctor removes the uterus and other reproductive organs, if necessary. Once done, the doctor stitches the surgical site. This surgical procedure requires a 2-3 days hospital stay.

Laparoscopic hysterectomy- In this procedure, doctors make keyhole incisions and insert a laparoscope into the lower abdomen. The doctor inserts the surgical tools through the incisions and removes the uterus. This procedure requires one day of hospitalization.

How do I prepare my body before surgical treatment for adenomyosis?

Your gynaecologist is likely to suggest a few tips before undergoing surgery to minimize the risks associated with it-

• Diet modification- It is extremely important to enrich your diet with adequate nutrition and proteins. You should avoid skipping meals. Increase your water intake by including vegetable broth, soups, or infused water. You must avoid oily and fleshy foods. 
• Avoid smoking and alcohol- Smoking and alcohol consumption before the surgery can possibly increase the risk of anaesthesia-related complications. 
• Physical and mental well-being- It is very important to stay physically and mentally fit before undergoing surgery. Practice some meditation and yoga to calm down your nerves. 
• Discuss your medical history with your doctor- If you are taking any medication before surgery, discuss it with your doctor. Any underlying health condition can increase the chances of risks and complications associated with surgery.

However, apart from these tips, it is extremely important to eat light, relax and have a good sleep before the surgery.

Risks and complications associated with adenomyosis treatment

As like any other treatment procedure, adenomyosis is also associated with certain risks and complications-

• During the surgical treatment, there are higher chances of blood loss and the risk of blood transfusion.
• Damage to the surrounding areas, like the bladder, blood vessels, and nerves.
• Risk of blood clots in the legs or the lungs.
• Hormonal therapy may increase the risk of- fatigue, weight gain, hot flashes, and memory loss.
• Side effects related to anaesthesia.

Apart from these, women also experience some emotional side effects after the treatment, like-  depression, anxiety, and mood swings.