How is adenomyosis treated?

The uterus is an important organ for every woman. It can satisfy women's dream of becoming a mother, but it can also bring troubles to women. Among them, adenomyosis is a disease in which the uterus is prone to attack, and adenomyosis is a difficult gynecological disease. Fortunately, current medical technology provides a wide range of treatments for adenomyosis, and clinical decisions are individualized based on the patient's age, symptoms, and fertility requirements. Surgery and drug treatment options can be chosen at the same time. The treatment methods include:

1. Medication

(1) Symptomatic treatment: For patients with mild symptoms who only require relief of dysmenorrhea, non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin or naproxen can be used for symptomatic treatment during dysmenorrhea.

(2) For patients with mild symptoms, no desire to have children, or near menopause, oral contraceptives or progestins can cause the ectopic endometrium to decidualize and atrophy, thereby controlling the development of adenomyosis.

(3) For women with heavy menstrual flow, dysmenorrhea, and no desire to have children, an intrauterine device containing highly effective progestin can be chosen. It continuously releases progestin locally in the uterus to control the development of ectopic lesions and needs to be removed or replaced after five years.

2. Surgery

Surgical treatment includes radical surgery and conservative surgery. Radical surgery is hysterectomy, and conservative surgery includes adenomyosis lesion (adenomyoma) resection, endometrial and myometrial resection, myometrial electrocoagulation, uterine artery occlusion, presacral neurectomy and sacral neurectomy.

(1) Hysterectomy

It is suitable for patients who have no fertility requirements, have extensive lesions, severe symptoms, and are ineffective with conservative treatment. Moreover, in order to avoid residual lesions, total hysterectomy is the first choice, and partial hysterectomy is generally not advocated.

(2) Lesion resection for adenomyosis

Suitable for patients who want to have children or young patients. Because adenomyosis often has diffuse lesions and unclear boundaries with the normal uterine muscle tissue, how to choose the method of resection to reduce bleeding, residual tissue and facilitate postoperative pregnancy is a rather difficult problem.