Tuesday, July 27

What is Adenomyosis (Uterine Chocolate Cyst Disease)? How Is It Treated?

Adenomyosis is a disease caused by the inner lining of the uterus settling into the deeper muscle wall of the uterus. While this problem can cause severe groin pain, abnormal vaginal bleeding and swelling, especially during menstrual periods, it also negatively affects the quality of life of the person. Pelvic Pain may last only during the menstrual period and then throughout the month. Pain may accompany complaints during sexual intercourse. Adenomyosis can occur throughout the uterus or only in a part of the uterus. Adenomyosis is considered a benign condition, but its consequences can negatively affect the quality of life of women and therefore patients with complaints should be treated.

How is Adenomyosis Treated?

The history of the patient is very important for the diagnosis of adenomyosis. The patient complains that both the duration and the amount of painful menstruation and bleeding are too high. Pain can also be seen during sexual intercourse. Complaints have been around for a long time in general. It doesn’t come out of nowhere. The complaints tend to increase gradually, but gradually. In the gynecological examination, it is soft, painful, and it is important to increase the pain when the uterus is moved. Not being able to conceive despite wanting to have a child is one of the most common situations. It is easily diagnosed by ultrasonography. It is important that the physician is experienced in this field only to make a diagnosis. If there is a break in the diagnosis, Magnetic Resonance (MR) imaging can also be used.

Treatment of adenomyosis may vary depending on the symptoms experienced by the person and the severity of the symptoms. In addition, the determining factor in treatment is whether the person wants to have a child or not.

Mild symptomatic adenomyosis can be controlled with simple painkillers, magnesium and hot water bags or heaters used to relieve the resulting cramps. In addition, drug use, hormone therapy, drug-releasing spirals, uterine artery embolization, endometrial ablation and hysterectomy in individuals who have had children are among the treatment methods used in the treatment of adenomyosis.

Anti-inflammatory Drug Therapy

Steroid-free anti-inflammatory drugs can be used to relieve the pain caused by adenomyosis. The use of these drugs is usually started 1-2 days before the beginning of menstruation and continues to use the drug during the first few days of menstruation.

Hormone Therapy

Severe painful periods and Abnormal Vaginal Bleeding can be controlled with spirals (IUD) secreting levonorgestel and placed in the uterus.

Uterine Arter Embolization

In fact, this procedure, which is used to shrink fibroids in the treatment of fibroids, can be used to occlude blood flow vessels in the presence of adenomyosis. The particles used for this procedure are guided through a tube placed in the person’s femoral artery. With the cessation of blood flow, adenomyosis shrinks.

Endometrial Ablation

It is a minimally invasive procedure and basically means the destruction or removal of the lining of the uterus. It is used to relieve symptoms in cases where adenomyosis does not penetrate deep into the muscular wall of the uterus. It is preferred to preserve fertility before hysterectomy.


All the treatments mentioned above are aimed at alleviating the symptoms of adenomyosis. The only definitive treatment for adenomyosis is removal of the uterus by hysterectomy. This is the preferred treatment method in cases where the symptoms are at very severe levels. However, since the chance of pregnancy will disappear with the removal of the uterus completely, women with this problem should have completed their fertility or decided not to conceive again.

Does Adenomyosis Cause Infertility?

There are no definitive findings regarding the relation of adenomyosis with infertility. Most women with this problem also have a chocolate cyst, or endometriosis. Therefore, although it is difficult to directly associate Adenomyosis with infertility, it is accepted to be an important factor for infertility. Studies have suggested that this problem may have a role to contribute to infertility.

Article: Gynecology and Obstetrics Specialist Prof. Dr. Master Taner

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