How it's diagnosed
Adenomyosis can be challenging to diagnose because there's no simple blood test for it, and symptoms overlap with other conditions like fibroids and endometriosis. Diagnosis usually starts with your symptoms and an examination, then imaging — a transvaginal ultrasound or MRI can show characteristic changes in the uterine muscle. Historically it was only confirmed after a hysterectomy, but modern imaging now allows a diagnosis in many cases without surgery.
Because it's under-recognised, it can help to specifically ask about adenomyosis if you have heavy, painful periods.
Treatment options
Treatment depends on your symptoms, age and whether you want to become pregnant. Options include pain relief (anti-inflammatories), hormonal treatments to reduce bleeding and pain — such as the hormonal IUD, the combined pill, or other hormonal medicines — and, for heavy bleeding, procedures. For women who have completed their family and have severe symptoms, hysterectomy (removing the uterus) is the definitive cure.
Many women manage adenomyosis well for years with hormonal treatment, without needing surgery.
Choosing what's right
The best approach is individual. If you want to preserve fertility, treatment focuses on managing symptoms with medication. If bleeding and pain are severe and your family is complete, more definitive options may be considered. Treating associated iron deficiency is important too.
There's usually more than one reasonable path. A telehealth consult can help you understand your options and arrange referral to a gynaecologist where appropriate.
References & sources
This content is general information and not a substitute for individual medical advice. Please consult a GP for your personal situation.
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