Adenomyosis is the invasion of endometrial glands and stroma into the uterine muscle layer, forming diffuse or localized lesions. Symptoms typically include severe dysmenorrhea, heavy menstrual bleeding, and chronic pelvic pain.

Adenomyosis, a term that may seem unfamiliar, is increasingly affecting the health of many women. According to statistics, the incidence of adenomyosis among women of childbearing age is rising yearly, placing great physical and psychological stress on patients.

Mary is one such patient severely affected by adenomyosis. For many years, she has suffered from debilitating menstrual pain. During those few days each month, Mary feels like she is facing a formidable enemy, with pain preventing her from functioning normally in her work and life. She sought medical advice from various doctors, but one suggestion plunged her into deep fear and conflict: a hysterectomy.

"Does adenomyosis always end in a hysterectomy?" This is not only Mary's question but also a common concern among many adenomyosis patients.

Is a hysterectomy always necessary?

A hysterectomy is an effective method for treating adenomyosis, but this does not mean that all patients must undergo this extreme measure. Doctors will consider the treatment plan based on the patient's age, symptoms, fertility needs, and other factors.

Applicable situations for a hysterectomy:

If the patient's symptoms are very severe and cannot be relieved through medication and other conservative treatments, and if the patient has no fertility needs or the adenomyosis lesions are extensive and challenging to remove locally, the doctor may recommend a hysterectomy. This surgery can thoroughly remove the lesions, effectively alleviating symptoms such as severe dysmenorrhea and heavy menstrual bleeding.

However, a hysterectomy is a major surgery that can significantly impact the patient's body and mind. Therefore, before making this decision, the patient needs to communicate thoroughly with the doctor, understand the risks and benefits of the surgery, and make an informed decision after weighing the pros and cons.

Other Treatments:

1. Medication

For patients with mild symptoms, fertility needs, or those approaching menopause, doctors usually consider medication first. By using non-steroidal anti-inflammatory drugs, contraceptives, progestogens, and Traditional Chinese Medicine such as Fuyan Pill, menstrual pain can be alleviated and menstrual flow reduced, thus controlling the progression of the disease.

2. Intrauterine Devices

Intrauterine devices (IUDs) like the Mirena coil can slowly release progestogens and have a therapeutic effect on adenomyosis. This method is minimally invasive and suitable for patients who do not want surgery.

3. Uterus-Preserving Surgery

For younger patients with fertility needs, lesion removal surgery can be considered. This surgery can remove the adenomyosis lesions within the uterus while preserving its integrity, thereby maintaining fertility. However, it should be noted that this surgery is complex and carries a high risk of recurrence postoperatively.

4. Uterine Artery Embolization

Uterine artery embolization reduces blood supply to the uterus by embolizing the uterine arteries, causing the lesions to shrink and alleviating symptoms. This method is minimally invasive and has a quick recovery time, but it may also result in complications such as pain and fever.

In conclusion, adenomyosis does not necessarily always require a hysterectomy. The treatment choice should be individualized based on the patient's age, symptoms, and fertility needs. Patients should not panic or become overly anxious when facing adenomyosis. Still, they should actively cooperate with the doctor's treatment, weighing the pros and cons of various treatment options according to their actual situation and needs.

Additionally, it is essential to adopt good lifestyle habits in daily life, maintain regular routines, avoid prolonged late nights, and keep a positive mindset. A light diet, avoiding overeating, and a healthy lifestyle combined with scientific treatment can effectively control adenomyosis and improve the quality of life.

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