Treating Adenomyosis: From Hormones to Surgery
The treatment of adenomyosis depends on the woman’s age, her symptoms, her desire for future fertility, and whether she wishes to preserve her uterus. Because adenomyosis is driven by oestrogen, menopause is the natural cure — symptoms reliably resolve when ovarian function ceases. For women who are years away from menopause, a structured treatment plan is needed.
Hormonal Medical Therapies
The goal of medical treatment is to suppress the menstrual cycle and reduce oestrogenic stimulation of the adenomyotic tissue:
- Combined oral contraceptive pill (COCP) taken continuously suppresses menstruation and provides reliable pain relief for most women with mild-moderate adenomyosis
- Levonorgestrel IUS (Mirena) delivers progestogen directly to the uterine cavity; reduces heavy bleeding by 80–90% in most women; effective for pain as well as bleeding
- GnRH agonists induce medical menopause and significantly reduce uterine size and symptom burden; limited to 6 months unless add-back HRT is used; useful bridge to surgery or natural menopause
- Dienogest (progestogen) is widely used in Europe and increasingly in India for adenomyosis; taken daily; effective for pain and bleeding reduction
Surgical Options
Endometrial ablation — destroys the uterine lining under hysteroscopic guidance; reduces heavy bleeding significantly but is not suitable if adenomyosis involves deep myometrium; not appropriate for women wishing to conceive.
Adenomyomectomy — surgical excision of the adenomyotic tissue while preserving the uterus; technically challenging due to the diffuse nature of the disease; performed laparoscopically in selected women who strongly wish to retain fertility.
Hysterectomy — the only definitive surgical cure; appropriate for women who have completed their family and whose quality of life is significantly impaired despite medical treatment. Laparoscopic or robotic hysterectomy allows minimally invasive removal with fast recovery.
For adenomyosis treatment in Ahmedabad, contact Dr. Nishtha Tripathi Patel at +91 76988 00333.