Uterine Artery Embolisation for Adenomyosis

Minimally invasive and effective treatment for a debilitating condition.

Adenomyosis is a condition where the lining of the womb extends abnormally deep into the uterus. This is more common than previously thought (affecting up to 70% of women). Symptoms are similar to those from uterine fibroids including:

  • Heavy periods and prolonged bleeding
  • Severe period pain

Adenomyosis causes heavy and prolonged bleeding. The heavy bleeding caused by fibroids can lead to tiredness, fatigue and low energy due to iron deficiency anaemia. Severe pain from adenomyosis also can severely affect quality of life and sexual function.

What causes adenomyosis?

We don’t know for sure. We know there is some link to endometriosis, a condition where cells from the lining of the womb are found outside the uterus. Adenomyosis often co-exists with fibroids, adenomyosis is routinely misdiagnosed as fibroids.

How is adenomyosis diagnosed?

Adenomyosis can be identified on transvaginal US but is often missed. MRI pelvis is far more sensitive for detection of adenomyosis as well as allowing identification of all fibroids and other potential causes of symptoms such as endometriosis. Accurate diagnosis is important as this affects treatment options.

Do I need treatment?

Only patients who are symptomatic need treatment. The majority of women with adenomyosis will not be symptomatic. When they occur however symptoms can be debilitating. If you are concerned by any of the following then you may wish to consider treatment:

  • Heavy bleeding with frequent changes of pads
  • Having to wear double pads
  • Passing large clots
  • Tiredness due to anaemia
  • Concerns over periods limit your work, social life or normal activities

How is adenomyosis managed?

Adenomyosis can be managed in the following ways:

  • Medically – for example using contraceptive medication to control bleeding symptoms. Anti-inflammatory medications can also be used for pain.
  • Surgically – options include endometrial ablation or hysterectomy. For more focal collections of adenomyosis (known as adenomyoma) there may also be other surgical options. Hysterectomy, removal of the entire uterus is a definitive treatment for symptoms but comes with the risks of anaesthesia and surgery as well as of course preventing further pregnancy.
  • Uterine Artery Embolisation – this minimally invasive approach is almost identical UFE performed for uterine fibroids. This allows significant symptom control in a majority of patients and can prevent the need for hysterectomy.

The first line treatment option is medical management. Undoubtedly symptoms are best managed by an individual patient-centred approach and some women would be best served by surgery and others by embolisation. When you are seen in rooms by the IR specialist you can trust that you will be offered treatment only if it is thought to be the best option for you as an individual.

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