Adenomyosis

Who it may help

Uterine artery embolisation (UAE) may be considered, in selected cases, for women with adenomyosis who want to avoid major surgery. It reduces blood flow to the affected tissue and may relieve heavy bleeding and pelvic pain.

Whether it suits you depends on your MRI findings, your main symptoms, how severe the condition is, the size of your uterus and any plans for pregnancy.

Understanding adenomyosis

Adenomyosis happens when tissue similar to the lining of the uterus grows into the muscular wall of the uterus. As this tissue responds to hormonal changes, it can cause inflammation, swelling and pain, which may affect periods, pelvic comfort and daily routines.

It can be difficult to recognise at first because its symptoms overlap with other conditions of the uterus. Some women have heavy bleeding or strong cramps for years before finding out what is causing the problem.

Adenomyosis does not affect everyone in the same way. Some people have mild symptoms, while others live with ongoing pain, heavy periods and tiredness from blood loss. This is why a proper diagnosis is an important first step before deciding on treatment.

Causes and symptoms

The exact cause of adenomyosis is not always clear. Hormonal changes may play a role, and previous surgery on the uterus, childbirth or inflammation of the uterine lining may be linked to a higher risk.

Symptoms vary, but common signs include:

• heavy or prolonged periods
• pelvic pain or pressure
• strong period cramps
• bloating or a feeling of heaviness
• pain that gets worse around your period

Some women also have pain during sex or an ongoing pelvic ache outside their period. Symptoms may start mildly and become more noticeable over time.

People sometimes talk about stages of adenomyosis, but it is usually assessed by severity, symptoms and imaging rather than a simple staging system. In practical terms, symptoms can become more disruptive if the condition progresses or is left untreated.

Because adenomyosis can look similar to fibroids, endometriosis or other pelvic conditions, imaging is often needed to confirm the diagnosis.

Diagnosis and treatment options

Diagnosis may involve a review of your symptoms, a pelvic examination and imaging. An ultrasound can sometimes show changes in the uterus, while an MRI gives more detail about the uterine wall and how far the condition extends.

Once the diagnosis is clearer, treatment depends on how severe your symptoms are and what you want from treatment. Medication may help control heavy bleeding or pain, and hormonal options may also be discussed.

If you want to avoid major surgery, minimally invasive options may be considered in selected cases. Endometrial ablation may help heavy bleeding by treating the lining of the uterus, while uterine artery embolisation (UAE) reduces blood flow to the affected tissue and may relieve bleeding and pelvic pain.

Your history and imaging are reviewed carefully to decide whether UAE or another treatment may suit you.

Treatment may focus on reducing symptoms, improving daily comfort and avoiding more invasive procedures where possible. Follow-up matters too, as improvement can take time and may need monitoring.