What treatments can help avoid hysterectomy for adenomyosis?

Many people with adenomyosis can reduce pain and heavy bleeding without surgery by using anti-inflammatory medications and hormone-based therapies. Common options include a levonorgestrel-releasing IUD, oral progestins, or combined birth control pills, chosen based on your symptoms, goals, and response to previous treatment. In some cases, short-term use of GnRH agonists or antagonists may help ease symptoms as a bridge to a longer-term plan.

If medications aren’t enough, uterus-sparing surgery called adenomyomectomy may be an option for select patients, particularly when adenomyosis is focal and symptoms persist. Other uterus-preserving procedures include uterine artery embolization and high-intensity focused ultrasound, which may be appropriate depending on your anatomy and goals. These treatments aim to control bleeding and pain or reduce the adenomyosis burden rather than reliably cure it, and results vary, with symptoms sometimes returning over time.

Choosing among alternatives to hysterectomy depends on whether bleeding or pain is your main issue, your fertility plans, imaging findings, and other possible contributors, such as endometriosis or fibroids. If you’d like, you can schedule a consultation with our team to review your imaging, symptoms, and history, help confirm whether adenomyosis is the main source of pain, and discuss realistic uterus-preserving options.