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Ultrasound shows bulky uterus with early changes of adenomyosis. Treatment?

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Posted on Sat, 25 Aug 2012
Question: what treatment if lower usg report saying that your uterus is bulky with early changes of adenomyosis. the level of 25-hydroxy vitamin d - total is sky low . result 9.6ng/ml . utreus size 8.9cm /3.7 c.m./5.4 c.m.uterus is anteverted bulky in size. the myometrial echotexture is coarse and the endometrial myometrial intrface is unsharp.endometrial thickness is 0,9c.m. no focal S.O.L. is seen. cervix looks normal.
doctor
Answered by Dr. Sree Gouri SR (2 hours later)
hi,

Thanks for the query.

your ultrasound features are suggesting adenomyosis,
Adenomyosis occurs due to in-growth of endometrial layer into myometrium, the growth of it is usually estrogen dependent.
the treatment mainly depends on presence of symptoms,
you didn't mention whether you are having any symptoms of adenomyosis like excessive menstrual bleeding, dysmenorrhoea etc,

the treatment options are,
medical treatment like using progesterone pills or cyclical estrogen and progesterone or intrauterine devices like levonorgestrel-releasing-IUD,
these will help in decreasing the symptoms, but after stopping the drugs problem may recur.

the permanent solution for adenomyosis is surgery either hysterectomy or conservative surgery like partial resection of adenomyomata.

as vitamin-D deficiency is said to have some role in estrogen receptor modulation that can be one cause for adenomyosis, so supplementation can improve the symptoms.
after consulting your doctor you can take vitamin-D injections and depending on your symptoms choose treatment for adenomyosis according to your wish and her advice.


Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR (7 hours later)
thanks doctor . you want to know the symtoms of adenomyosis , they have sufferig excessive menstrual bleeding . i want to know , pl. reply me simpley that this disease take how many time to cure & in this disease any major problem . your valuable reply support us to releaise tenssion.
doctor
Answered by Dr. Sree Gouri SR (14 hours later)
hi,

the symptoms of adenomyosis are,
-heavy bleeding during periods,
-dysmenorrhea and pain during periods,
-sometimes the pain may be continuous,
-pressure on bladder causing urinary problems like urgency or frequency etc,
-bearing down feeling etc.

the treatment depends on symptoms, some women with no symptoms may not need treatment other than observation,
in symptomatic women the treatment can be medical treatment to surgical as I told previously.

the problems with this are excessive loss of blood can cause anemia and related problems,
pain abdomen may cause difficulty in doing routine work,
distortion of uterine cavity can affect fertility.

if you are having only symptom of excessive menstrual bleeding, as you are in 30's only you can go for medical treatment after discussing with your doctor.
the period of treatment depends on the extent of the adenomyosis, in case of early stage it may take few months.
as this is common problem in many women with treatment available, you don't get tensed about it.

Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sree Gouri SR

OBGYN

Practicing since :2006

Answered : 5609 Questions

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Ultrasound shows bulky uterus with early changes of adenomyosis. Treatment?

hi,

Thanks for the query.

your ultrasound features are suggesting adenomyosis,
Adenomyosis occurs due to in-growth of endometrial layer into myometrium, the growth of it is usually estrogen dependent.
the treatment mainly depends on presence of symptoms,
you didn't mention whether you are having any symptoms of adenomyosis like excessive menstrual bleeding, dysmenorrhoea etc,

the treatment options are,
medical treatment like using progesterone pills or cyclical estrogen and progesterone or intrauterine devices like levonorgestrel-releasing-IUD,
these will help in decreasing the symptoms, but after stopping the drugs problem may recur.

the permanent solution for adenomyosis is surgery either hysterectomy or conservative surgery like partial resection of adenomyomata.

as vitamin-D deficiency is said to have some role in estrogen receptor modulation that can be one cause for adenomyosis, so supplementation can improve the symptoms.
after consulting your doctor you can take vitamin-D injections and depending on your symptoms choose treatment for adenomyosis according to your wish and her advice.


Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.