Medications For Adenomyosis Do Not Help Long Term

The female reproductive system is a complex and intricate system that all fits together and works in harmony until it doesn’t. It seems that women have a disproportionate number of health concerns that are gynecological in nature.

One fairly well-known gynecological medical condition that affects 1 in 10 women in the United States is endometriosis. Adenomyosis is often called the sister of endometriosis and is a lesser-known condition which is surprising because it affects approximately 1 out of every 5 women in the U.S.

Today we are going to talk about adenomyosis and whether there is an adenomyosis medication on the market that can treat it. We will also touch on the surgical options that are often used to eliminate adenomyosis.

Endometriosis And Adenomyosis Are Similar But Different

Both of these conditions occur due to abnormal cell growth, and they are both caused by the same type of cell. For unknown reasons, cells that belong inside the uterus, making up its lining, go off the grid and begin to grow in other locations.

With endometriosis, these rogue uterine lining cells migrate into areas outside of the uterus and begin to grow, affecting other organs such as the ovaries, bowels, fallopian tubes, and more. Adenomyosis occurs when these misguided cells begin to form within the uterine wall, often enlarging its size.

Commonly Shared Symptoms

Some women with adenomyosis do not exhibit any severe symptoms and may not realize they have the condition. Some of the most prominent symptoms of these conditions also resemble those of uterine myomas (fibroids), so they are often diagnosed incorrectly. Pelvic pain and abnormally heavy and prolonged bleeding are some shared symptoms, as are pain during sex, a bloated belly, super painful menstrual cramps, fertility issues, and complications during pregnancy.

Diagnosis Of Adenomyosis

Adenomyosis is tricky to diagnose and is often mistaken for endometriosis or uterine fibroids. Your doctor may notice changes in the size or feel of your uterus during a pelvic exam and decide to do some image scans.

Many use transvaginal ultrasound, which is a technology that harnesses sound waves to create images of the organs within the pelvic region. Sometimes, an ultrasound technician with specialized training can recognize signs of adenomyosis, such as a thickening of the uterine wall.

MRI scans create higher-quality images and can provide more detail. In fact, some patients have been misdiagnosed with uterine fibroids and discovered they do not have fibroids but adenomyosis after undergoing an MRI scan.

Treatment Options

Women are normally offered medication for adenomyosis as a first line of treatment, depending on their symptoms. Unfortunately, these are usually only short-term solutions and can only help alleviate symptoms but do nothing to eliminate adenomyosis.

Medications

Currently, there is no designated adenomyosis medication available, so doctors may offer one or more of the following:

  • Over-the-counter medications such as ibuprofen, motrin, or other NSAID medications. These do not contain steroids but work by blocking the enzymes that contribute to inflammation, fever, and pain;
  • Contraceptives with hormones, such as birth control pills or an IUD with a combination of hormones, can often lighten heavy bleeding and alleviate some of the cramping associated with adenomyosis;
  • Gonadotropin-Releasing Hormone Agonists (GnRH) are a group of drugs that inhibit certain hormones from being produced and released by the ovaries. These can sometimes help reduce symptoms such as heavy bleeding, but they can also cause severe side effects;
  • Non-hormonal medications such as tranexamic acid may be used to help reduce the volume of bleeding.

Unfortunately, there is no one medication for adenomyosis that cures the condition or that can alleviate all of the symptoms women have to deal with when they suffer from the condition. Currently, the best that can be hoped for using a mixture of medications, is to treat the symptoms so the woman is as comfortable as possible.

Surgical Treatment

Invasive treatments and surgery are often suggested as treatments for adenomyosis. Some of these treatments include the following:

  • Endometrial ablation: This procedure obliterates the lining of the uterus using extreme heat or cold or through radiofrequency. This can alleviate heavy bleeding but does not eliminate adenomyosis, but it does remove the possibility of becoming pregnant in the future.
  • Adenomyomectomy: This is similar to a myomectomy and is done to remove the adenomyosis tissue and lesions. This is a tricky surgery and can be done open or sometimes laparoscopically, depending on the extent of the tissue growth. The uterus is often compromised and is subject to rupture during a pregnancy after this procedure.
  • Hysterectomy: This surgery is done to remove the entire uterus and will eliminate the adenomyosis. Once the uterus is removed, pregnancy is no longer possible, and the woman is subject to elevated risks of long-term complications such as heart disease, stroke, and memory conditions such as dementia.

Eliminating Adenomyosis Without Surgery

If you are suffering from adenomyosis and looking for a treatment that will not only alleviate your symptoms but also remove their root cause, you will want to learn about uterine artery embolization (UAE). This is a non-surgical procedure that is performed by an especially trained interventional radiologist as an outpatient procedure.

Much like uterine fibroids, adenomyosis needs a blood supply to stay alive and continue to grow, so it latches on to certain blood vessels contained within the uterine artery. The doctor zeros in on these specific vessels and, using a tiny catheter, injects small particles into the vessel to block the blood flow to these sections of rogue tissue. The adenomyosis can no longer sustain itself, so it shrinks away, eliminating the symptoms. The results are permanent, and your uncompromised uterus stays where it is.

Myth Busters About Adenomyosis Treatments

Here are some statements and responses that clear up a few inaccuracies that you may find in your search for a treatment for adenomyosis.

  1. There is no medication available currently that cures adenomyosis.
    TRUE, currently there is no adenomyosis medication that can eliminate this condition.
  2. A hysterectomy is the only cure for adenomyosis.
    FALSE, Uterine artery embolization can help around 80% of the women who suffer from the condition. Depending on the nature of the symptoms, UAE may be able to completely eliminate your adenomyosis and restore your quality of life.
  3. If you want to have a baby, you should not choose uterine artery embolization as a treatment.
    FALSE, Dr. Lipman from the Atlanta Fibroid Center has a wall full of baby pictures from happy mothers who have undergone this procedure.

How Do The Adenomyosis Medications And Other Treatments Compare?

The chart below shows a comparison of treatment options and their effectiveness in eliminating adenomyosis.

Adenomyosis Treatment Comparison Chart
Treatment Eliminates Adenomyosis Treats Symptoms Only Future Pregnancy Is NO LONGER Possible
NSAID medications x
Hormonal Contraceptives x
Gonadotropin-Releasing Hormone Agonists x
Tranexamic acid x
Endometrial ablation x Destroys the uterine lining, so there is no chance of getting pregnant in the future.
Adenomyomectomy Most often, it is not possible to remove all the abnormal tissue. It may continue growing. Compromises the uterus, and rupture is possible during a future pregnancy
Hysterectomy x Removes the uterus
UAE x

The available treatment choices (hysterectomy, ablation, adenomyomectomy) are less than optimal as two remove the possibility of pregnancy completely and the other can damage your uterus to the point it may rupture if you become pregnant.

UAE is a safe, non-surgical option that can be done without hospitalization or a long recovery period. It is definitely worth checking to see if you are a good candidate. The experts at the Atlanta Fibroid Center would love to talk with you more about the procedure and if it may be right for you. Set up your appointment today.

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