Adenomyosis Treatment

How is Adenomyosis Diagnosed?

Adenomyosis is usually assessed by a gynaecologist through a review of symptoms, menstrual history and a pelvic examination, followed by specialised imaging. The process of adenomyosis diagnosis includes:

• Pelvic Examination: A gynaecologist may check whether the uterus feels enlarged, soft or tender.

• Transvaginal Ultrasound: This scan uses sound waves to examine the uterus and can show features associated with adenomyosis.

• MRI: Magnetic resonance imaging gives more detailed images of the uterus and may help distinguish adenomyosis from other conditions.

• Endometrial Biopsy: A biopsy may be used to investigate abnormal bleeding or to rule out other conditions. It does not, by itself, confirm adenomyosis.

• Assessment for Other Conditions: Fibroids and endometriosis can cause similar symptoms, so doctors may investigate these conditions as well.

How is Adenomyosis Treated Based on Severity?

Adenomyosis treatment is recommended according to the severity of pain or bleeding, fertility plans and how well earlier treatments have worked. The table below shows the different treatment options for adenomyosis based on severity levels:

Types of Adenomyosis and Their Treatment

Adenomyosis does not have treatment categories as clear-cut as some other diseases. However, imaging may describe the condition as diffuse or focal, and the location and extent can influence treatment planning.

The following table outlines the treatment approaches based on the pattern of adenomyosis:

The exact treatment depends more on symptoms, fertility goals and response to treatment than on the imaging label alone.

Stages of Adenomyosis and Its Treatment

Adenomyosis is divided into four stages. The table below describes the treatment options suitable for each stage:

Oral Medicines for Adenomyosis

Adenomyosis treatment commonly starts with medicines that reduce pain, control bleeding, or suppress the hormonal stimulation of the uterine lining.

Note: Adenomyosis medicines should be taken only on a doctor's advice. Specific medicines may not be suitable for everyone, particularly when pregnancy is being planned.

Other Treatments for Adenomyosis

Adenomyosis may require advanced procedures or specialised devices when oral medicines do not adequately control symptoms or when the patient wants a uterus-preserving option. Some of the additional treatments for adenomyosis that doctors might recommend include:

• Levonorgestrel-Releasing Intrauterine System: The levonorgestrel-releasing intrauterine system (LNG-IUS) releases a progestogen inside the uterus. It can make periods lighter and less painful and is recommended as an important first-line treatment option for heavy menstrual bleeding associated with adenomyosis.

• Uterine Artery Embolisation (UAE): This minimally invasive procedure reduces blood flow and vaginal bleeding and pain. Research suggests that UAE can improve heavy bleeding and pain in selected patients with symptomatic adenomyosis.

• Endometrial Ablation: This procedure removes or destroys the uterine lining, also known as the endometrium, and may be considered for selected patients with heavy bleeding. It is not suitable for everyone with adenomyosis and is not an option for those who want to become pregnant.

• Focused Ultrasound or Radiofrequency Ablation: These non-surgical uterine-sparing procedures use heat or sound waves to target and shrink areas of adenomyosis while leaving the rest of the uterus intact.

Note: Interventional procedures and uterus-preserving surgery require specialist assessment. Their suitability depends on the location and extent of adenomyosis, symptoms and fertility plans.

Surgical Treatments for Adenomyosis

Surgery is considered when adenomyosis causes severe symptoms and medicines or less invasive treatments have not provided enough relief. Some surgical treatments that doctors might recommend to treat adenomyosis include:

Ayurvedic and Alternative Treatments for Adenomyosis

Although there is not enough evidence to recommend Ayurvedic or other alternative therapies as replacements for established medical treatments for adenomyosis, here are a few ways Ayurveda can help:

• Abhyanga: A therapeutic massage that involves the application of warm herbal oils to the body and helps reduce inflammation, promote relaxation, and reduce pain.

• Uttar Basti: A medicated enema that has been effective in balancing hormones and reducing inflammation.

• Uterine Pichu: A localised treatment using an oil-soaked tampon that targets the affected area directly.

• Herbal Formulations: Herbal preparations include ingredients like Ashoka (reduces heavy bleeding), Shatavari (improves hormonal balance and reduces inflammation), Lodhra and Guggul (both herbs contain anti-inflammatory and uterine-toning properties).

• Yoga and Relaxation: Gentle yoga, breathing exercises and relaxation may help some people manage pelvic discomfort or stress.

• Dietary Changes: A balanced diet can support overall health, but no diet has been proven to eliminate adenomyosis.

Note: Complementary therapies should support, not replace, prescribed medical care. Speak with your gynaecologist and a qualified Ayurveda or AYUSH practitioner before using herbal medicines.

Home Care for Managing Adenomyosis

Adenomyosis symptoms can often be more easily managed with simple home practices alongside medical treatment:

• A heating pad or hot-water bottle may help ease menstrual cramps and pelvic discomfort.

• Note bleeding, pain and other symptoms so your doctor can assess whether treatment is helping.

• Allow yourself enough rest during particularly painful or heavy periods.

• Eat balanced meals and discuss iron testing with your doctor if your periods are very heavy.

• Regular gynaecological reviews help assess treatment response and ongoing bleeding or pain.

Latest Treatment for Adenomyosis in India

High-intensity focused ultrasound (HIFU) is one of the newer uterus-preserving approaches being studied. It uses focused ultrasound energy to ablate adenomyosis tissue without conventional surgery. Recent research has reported encouraging results, including studies examining fertility outcomes, but better prospective trials are still needed.

HIFU should therefore be viewed as an emerging treatment rather than a universal replacement for established adenomyosis treatment. Availability and suitability in India can vary between specialist centres.

How Long Does Adenomyosis Treatment Take?

Adenomyosis treatment duration varies because medicines may be used for long-term symptom control, while procedures have a defined treatment and recovery period:

The exact duration depends on the treatment chosen, symptom response, fertility plans and whether further treatment is needed.

Adenomyosis Treatment Side Effects

Adenomyosis treatment can cause side effects that vary according to the medicine or procedure used:

• NSAIDs: May cause stomach irritation and other digestive problems.

• Hormonal Treatments: May cause irregular bleeding, breast tenderness, headaches or mood changes in some people.

• LNG-IUS: Irregular bleeding is common initially and usually changes over time.

• Tranexamic Acid: Some people may experience digestive symptoms or headaches.

• Surgery: Pain, bleeding, infection and other surgical complications are possible.

• Hysterectomy: Recovery takes time, and pregnancy is no longer possible after the uterus is removed.

Lifestyle Changes for Managing Adenomyosis

Adenomyosis symptoms may be easier to manage when treatment is combined with practical lifestyle changes. Some of the lifestyle changes that you can make to manage adenomyosis include:

• Stay physically active according to your comfort level.

• Limit alcohol and caffeine as they can affect hormonal balance.

• Use relaxation techniques if stress makes pain harder to manage.

• Avoid smoking as it can cause numerous health issues, including adenomyosis.

Lifestyle measures can support symptom management, but they do not remove adenomyosis itself.

Triggers That Can Worsen Adenomyosis Symptoms

Adenomyosis symptoms can be triggered for various reasons, particularly around menstruation and pregnancy. These triggers include:

• Natural estrogen spikes during your menstrual cycle.

• Severe emotional stress increases pelvic pain sensitivity.

• Diets high in processed sugars and trans fats.

• Heavy lifting or deep sexual penetration.

• Coexisting conditions like fibroids or endometriosis can cause inflammation.

If pain or bleeding suddenly becomes much worse, seek medical assessment rather than assuming it is simply adenomyosis.

Adenomyosis Treatment Cost

The cost of adenomyosis treatment in India varies depending on symptom severity, the recommended treatment, the hospital, and whether surgery is required. Initial evaluation may include a gynaecologist consultation and pelvic or transvaginal ultrasound, which can cost approximately ₹800-₹2,500 on average in India.

If symptoms are managed with medicines or hormonal treatment, the overall cost is generally lower than that of surgical treatment. It depends on the medicines prescribed and how long they are needed. When surgery is required, a hysterectomy costs around ₹60,000 to ₹2.2 lakh.

The final cost may also include pre-operative investigations, anaesthesia, hospital stay, medicines, pathology and follow-up appointments. Patients should therefore ask the hospital for a complete treatment estimate rather than relying only on the quoted surgical fee.

Does Health Insurance Cover Adenomyosis Treatment in India?

Yes. Health insurance can cover adenomyosis treatment, if deemed medically necessary. As this is covered as a gynaecological disorder, coverage may also include hospitalisation, surgical treatments such as hysterectomy and adenomyomectomy, diagnostic tests like MRIs and pelvic ultrasounds and day care expenses.

If adenomyosis was already diagnosed before buying the policy, it may be considered a pre-existing disease and the related waiting period of up to 3 years might apply.

Health insurance coverage of at least ₹10 lakh to ₹15 lakh can be of great help in your healthcare expenses, but you may consider opting for higher coverage to ensure all surgical and medical costs are covered. The appropriate amount depends on personal health needs and expected medicare expenses.

Note: It is essential that you read your policy documents carefully for a clear understanding of terms and conditions.