Why Treat Adenomyosis?
Adenomyosis is essentially thickening of the lining of the uterus, the endometrium. The endometrium thickens and grows into the muscle of the uterus.1 During the menstrual cycle the normal lining and the overgrowth causes excessive bleeding. Furthermore, the bleeding of the abnormal growth occurs directly into the muscle, which causes pain. This blood accumulated in the muscle causing swelling, irritation and cyst formation over time. This can affect your entire uterus or it can be localized to one area. If you are suffering from adenomyosis, a hysterectomy is not your only option, there is a non-surgical treatment available.
Adenomyosis is often misdiagnosed as fibroids, because it can have similar symptoms. While not every woman may have symptoms, for those that do these can vary and range in severity.
Patients with adenomyosis can have pain that is usually worse than the bleeding, while patients with fibroids it is typically the opposite (bleeding is worse than the pain). Our specialist has years of experience treating patients with uterine fibroids and adenomyosis. Did you know the non-surgical UAE procedure treats both fibroids and adenomyosis in one session? Read more below.
Advantages of Non-Surgical Uterine Artery Embolization Treatment over Surgery:
- No stitches or surgical incision (only a small nick in the skin)
- No general anesthesia required
- Outpatient procedure
- No hospital stay
- Can treat both adenomyosis and fibroids
- Saves your uterus (unlike hysterectomy)
- Little to no downtime for recovery, few days (versus few weeks for surgery)
- Less risks and complications
- Significant improvement in quality of life
- Virtually no blood loss
- No burning or scraping the lining of the uterus
- No internal cutting, bleeding or scarring
What Causes Adenomyosis?
Some studies also suggest that women who have had prior uterine surgery may be at risk for adenomyosis. Though the cause of adenomyosis isn’t known, studies have suggested that various hormones — including estrogen, progesterone, prolactin, and follicle-stimulating hormone — may trigger the condition.
Some potential causes include:
- Inflammation during childbirth – Post-partum uterus may become inflamed causing a break of the inner lining of the uterus.
- Invasive tissue growth – Invasion of endometrial cells into the uterus from incisions during surgery, such as a C-section.
- Developmental – Deposited inadvertently while the uterus and other reproductive organs were forming in utero.
- Hormone use – Estrogen and progesterone use may be a factor.
Diagnosing Adenomyosis
Previously the only definitive way to diagnose adenomyosis was to perform a hysterectomy and examine the uterine tissue under a microscope. However, imaging technology has made it possible for diagnosing adenomyosis without surgery.
Transvaginal ultrasound (TVUS) and MRI are often utilized for the noninvasive diagnosis of adenomyosis.2 An ultrasound is good as an initial first study as it can help to rule out other conditions with similar symptoms; diagnosing adenomyosis can have limitation on this type of study. The best study is an MRI as it can best delineate the characteristics of adenomyosis from other conditions. If you are suffering from heavy pain menstrual cycles and have been left without a diagnosis, seek out our specialist to obtain the appropriate work up for your condition.
82% after Non-Surgical UAE do not need a hysterectomy3
What is the Right Treatment for Adenomyosis?
For patients with adenomyosis there are several factors that will determine which course of treatment is the best, including age, medical history, risk factors and symptoms. Our specialist has treated many patients with adenomyosis, and this experience is important in making sure you have the best outcome. Conventional treatment with hysterectomy allows for definitive treatment however, medications and UAE are less invasive treatments that preserve the uterus and fertility.3
Symptom control: NSAIDs like Ibuprofen or Naproxen may help manage painful symptoms however this does not treat the underlying cause. Birth control pills or a hormone-releasing IUD can help control heavy periods. However, as with anti-inflammatory medications, this does not treat the underlying cause. Many of these options do not provide cotinued improvement and are limited by their menopausal-like side effects as well as inability to conceive.1
Non-Surgical Uterine Artery Embolization (UAE): This is an effective non-surgical treatment that can reduce or eliminate your symptoms by addressing the core root of the problem. Uterine artery embolization is a non-surgical procedure that is outpatient with minimal downtime. In fact, most of our patients are back to normal activity after only one week.
Adenomyomectomy: Focal resection is a surgical option for those with focal adenomyosis limited to a region of the uterus. 75% of women experienced symptom relief with this limited surgical treatment.4
Hysterectomy: This is the gold standard and permanent solution for adenomyosis for some patients.1 But surgery comes with drawbacks when there are non-surgical options available. Major surgery involves a number of risks such as excessive bleeding, blood clots, infection, and an adverse reaction to general anesthesia. Removing the uterus also results in infertility, which is not an option for those wanting to maintain fertility. Hysterectomy requires a one- to two-day hospital stay, followed by a lengthy recovery of six to eight weeks. During this time, your overall activity, along with your ability to drive safely while on pain medications, will be limited. Interestingly, pelvic pain is not necessarily eliminated in patients who undergo hysterectomy for adenomyosis, in one study nearly one-quarter of patients continued to have pelvic pain after hysterectomy.5
The key to choosing the right treatment for adenomyosis is obtaining the correct diagnosis and understanding your treatment options. Asking questions and being informed will help ensure that you obtain the best care for you.
Our specialist at CVI has years of experience in the treatment of both uterine fibroids and adenomyosis. He will partner with you to determine the best course of treatment.
What is Non-Surgical Uterine Artery Embolization (UAE)?
Uterine artery embolization, or UAE, is a non-surgical image-guided procedure that effectively treats adenomyosis (and fibroids) in one treatment. This is done by placing a tiny catheter into the uterine artery and blocking the blood flow to the abnormal lining using tiny particles (see video below).
Uterine embolization can be performed as an outpatient procedure through a tiny pinhole in the skin, resulting in faster return to work and minimal risk (after 30 days) when compared to having a hysterectomy.6 UFE is also done with local and moderate IV sedation, avoiding the risks of general anesthesia. What kind of facility can the UAE procedure be performed at? Read here.
Our outpatient center sees patients throughout Southern California including Los Angeles, Orange County and San Diego. The UAE treatment is performed by our Endovascular Physician (an Interventional Radiologist) who is board certified in image-guided procedures using X-rays, tiny catheters and other micro-tools, and has performed hundreds of complex embolizations with special interest in fibroid treatments.
What is Interventional Radiology? This is the only specialty in medicine specifically trained to perform embolization procedures, such as for symptomatic fibroids. Read more here.
Request an Appointment
Please note that although we strive to protect and secure our online communications, and use the security measures detailed in our Privacy Policy to protect your information, no data transmitted over the Internet can be guaranteed to be completely secure and no security measures are perfect or impenetrable. If you would like to transmit sensitive information to us, please contact us, without including the sensitive information, to arrange a more secure means of communication. By submitting this form you consent to receive text messages from CVI at the number provided. Msg & data rates may apply. Msg frequency varies. Unsubscribe at any time by replying STOP.
Am I a Candidate for Uterine Artery Embolization?
If you have adenomyosis with the following symptoms you may be a candidate for uterine embolization:
- Painful periods
- Heavy bleeding during or in between your periods
- Abdominal pressure and bloating
- Pain during intercourse
- Blood clots during menstruation
- Anemia
- Enlarged Uterus
What do you need to do next? Request a consultation to meet with our embolization doctor who will review your imaging, labs and history to determine if you are candidate for the procedure, and the outcomes you can expect. Each woman is an individual and should discuss the potential risks and benefits of fibroid embolization and other treatments with our doctor to decide which option is best for her.
Consultations are available via an online video telehealth platform or in person at one of the offices in Los Angeles, Orange County or San Diego. Why should you choose us? Read here.
What to Expect From Non-Surgical UAE
Uterine artery embolization is an outpatient non-surgical procedure with minimal downtime. The procedure is done in an outpatient state of the art center where our interventional radiologist performs the adenomyosis treatment through a tiny tube called a catheter. This procedure can be performed by either placing the catheter in an artery at the top of the leg (called a femoral approach) or by placing it into an artery in the lower arm (called a radial approach). The two methods are illustrated below:
The patient is given a local and topical anesthetic to numb the skin and a mild sedative, so that the procedure is not painful. A sophisticated X-ray machine that creates moving pictures in “real” time enables the doctor to see the catheter as it is guided through the blood vessels and into the uterine artery.
The final step in fibroid embolization is the injection of tiny particles the size of sand particles through the catheter. The particles lodge in the blood vessels feeding the uterine lining and cut off their blood supply, but the uterus is largely spared.
UAE Results
UAE presents a useful option for those who wish to avoid hysterectomy and prefer a minimally invasive technique without a hospital stay. 83.1% of patients who underwent UAE for adenomyosis demonstrated overall symptom improvement and 82% in a 7 year follow-up study were able to avoid a hysterectomy.3,7 Previous studies have also shown favorable outcomes with symptom relief after UAE for adenomyosis, however recurrence rates are higher than for the treatment of fibroids but offers symptom relief in over two-thirds of patients and is uterine sparing.8
Why California Fibroid Center?
At CVI, we provide devoted and specialized care for embolization. All clinical decisions are centered on the patient because CVI is owned and controlled by our physician, who is an embolization expert. The doctor has the freedom to spend as much time as needed for patient consultations and medical procedures. Clinical decisions are made based on what is best for you and your treatment, and not influenced by the interests of a profit-driven hedge fund company. The staff are highly trained and dedicated to the patient experience. This allows us to provide the best care and experience for our patients.
Women continue to be thrilled with the totality of their care experience facilitated by our patient-centered approach. Read more about our practice here.
Patient Centered. Dedicated. Comprehensive.
We are Here to Help
Request an appointment to meet with our fibroid specialist who will review your imaging, labs and history to determine if you are candidate for the procedure, and the outcomes you can expect. Each woman is an individual and should discuss the potential risks and benefits of fibroid embolization and other Treatments with our doctor to decide which option is best for her.
Appointments are available via an online video telehealth platform or in person at one of the offices in Los Angeles, Orange County or San Diego. Why should you choose us? Read here.
1.) Struble J, Reid S, Bedaiwy MA. Adenomyosis: a clinical review of a challenging gynecologic condition. J Minim Invasive Gynecol. 2016;23:164-185.
2.) Agostinho L, Cruz R, Osório F, et al. MRI for adenomyosis: a pictorial review [published online October 4, 2017]. Insights Imaging.
3.) de Bruijn AM, Smink M, Hehenkamp WJK, Nijenhuis RJ, Smeets AJ, Boekkooi F, Reuwer PJHM, Van Rooij WJ, Lohle PNM. Uterine Artery Embolization for Symptomatic Adenomyosis: 7-Year Clinical Follow-up Using UFS-Qol Questionnaire. Cardiovasc Intervent Radiol. 2017 Sep;40(9):1344-1350. doi: 10.1007/s00270-017-1686-1. Epub 2017 May 17.
4.) Younes G, Tulandi T. Conservative surgery for adenomyosis and results: a systematic review [published online July 21, 2017]. J Minim Invasive Gynecol.
5.) Stovall TG, Ling FW, Crawford DA. Hysterectomy for chronic pelvic pain of presumed uterine etiology. Obstet Gynecol. 1990;75:676-679.
6.) Spies J et al. Outcome of uterine embolization and hysterectomy for leiomyomas: results of a multicenter study. American Journal of Obstetrics & Gynecology 2004;191: 22-31.
7.) de Bruijn AM, Smink M, Lohle, PNM, et al. Uterine artery embolization for the treatment of adenomyosis: a systematic review and meta-analysis [published online October 9, 2017]. J Vasc Interv Radiol.
8.) Popovic M, Puchner S, Berzaczy D, et al. Uterine artery embolization for the treatment of adenomyosis: a review. J Vasc Interv Radiol 2011;22:901-909.
Told it was fibroids for years? It may be adenomyosis.
When the pain is worse than the bleeding, adenomyosis is often the missed diagnosis — and a hysterectomy is not your only option. Non-surgical UAE treats adenomyosis and fibroids in one session and saves your uterus: 83.1% of patients improved, and 82% avoided hysterectomy at 7-year follow-up.3,7
Adenomyosis UAE at a glance
Everything a hysterectomy isn't
- No stitches or surgical incision — only a small nick in the skin
- No hospital stay
- Little to no downtime — a few days versus a few weeks for surgery
- Virtually no blood loss
- No general anesthesia required
- Treats both adenomyosis and fibroids
- Less risks and complications
- No burning or scraping of the uterine lining
- Outpatient procedure
- Saves your uterus (unlike hysterectomy)
- Significant improvement in quality of life
- No internal cutting, bleeding or scarring
Adenomyosis is a thickening of the uterine lining (endometrium) that grows into the muscle of the uterus, bleeding directly into the muscle and causing swelling, irritation and pain.1 It’s often misdiagnosed as fibroids — a useful clue is that with adenomyosis the pain is usually worse than the bleeding, while with fibroids it’s the reverse. MRI is the best study for telling them apart.2 And a hysterectomy is not the only answer: non-surgical uterine artery embolization (UAE) blocks the blood supply feeding the abnormal lining through a pinhole, treating adenomyosis and fibroids in one session while preserving the uterus — 83.1% of patients improved and 82% avoided hysterectomy at 7 years.3,7
Request an Appointment
Please note that although we strive to protect and secure our online communications, and use the security measures detailed in our Privacy Policy to protect your information, no data transmitted over the Internet can be guaranteed to be completely secure and no security measures are perfect or impenetrable. If you would like to transmit sensitive information to us, please contact us, without including the sensitive information, to arrange a more secure means of communication. By submitting this form you consent to receive text messages from CVI at the number provided. Msg & data rates may apply. Msg frequency varies. Unsubscribe at any time by replying STOP.
Why treat adenomyosis?
The endometrium grows into the muscle of the uterus and bleeds there — causing swelling, irritation and cyst formation over time.1 A hysterectomy is not your only option.
Adenomyosis is essentially thickening of the lining of the uterus, the endometrium. The endometrium thickens and grows into the muscle of the uterus.1 During the menstrual cycle the normal lining and the overgrowth causes excessive bleeding. Furthermore, the bleeding of the abnormal growth occurs directly into the muscle, which causes pain. This blood accumulated in the muscle causing swelling, irritation and cyst formation over time. This can affect your entire uterus or it can be localized to one area. If you are suffering from adenomyosis, a hysterectomy is not your only option — there is a non-surgical treatment available.
Adenomyosis vs. fibroids: why it's so often missed
Adenomyosis is often misdiagnosed as fibroids, because it can have similar symptoms. While not every woman may have symptoms, for those that do these can vary and range in severity.
Patients with adenomyosis can have pain that is usually worse than the bleeding, while for patients with fibroids it is typically the opposite (bleeding is worse than the pain). Our specialist has years of experience treating patients with uterine fibroids and adenomyosis. Did you know the non-surgical UAE procedure treats both fibroids and adenomyosis in one session? Read more below.
What causes adenomyosis?
The cause isn't known — but hormones (estrogen, progesterone, prolactin, FSH) may trigger it, and women with prior uterine surgery may be at risk.
Some studies also suggest that women who have had prior uterine surgery may be at risk for adenomyosis. Though the cause of adenomyosis isn’t known, studies have suggested that various hormones — including estrogen, progesterone, prolactin, and follicle-stimulating hormone — may trigger the condition.
Some potential causes include:
- Inflammation during childbirth — a post-partum uterus may become inflamed, causing a break of the inner lining of the uterus.
- Invasive tissue growth — invasion of endometrial cells into the uterus from incisions during surgery, such as a C-section.
- Developmental — deposited inadvertently while the uterus and other reproductive organs were forming in utero.
- Hormone use — estrogen and progesterone use may be a factor.
How is adenomyosis diagnosed?
It no longer takes surgery. Ultrasound rules out look-alikes; MRI best delineates adenomyosis from other conditions.2
Previously the only definitive way to diagnose adenomyosis was to perform a hysterectomy and examine the uterine tissue under a microscope. However, imaging technology has made it possible for diagnosing adenomyosis without surgery.
Transvaginal ultrasound (TVUS) and MRI are often utilized for the noninvasive diagnosis of adenomyosis.2 An ultrasound is good as an initial first study as it can help to rule out other conditions with similar symptoms; diagnosing adenomyosis can have limitations on this type of study. The best study is an MRI as it can best delineate the characteristics of adenomyosis from other conditions. If you are suffering from heavy, painful menstrual cycles and have been left without a diagnosis, seek out our specialist to obtain the appropriate work up for your condition.
82% after non-surgical UAE do not need a hysterectomy.
What is the right treatment for adenomyosis?
Age, medical history, risk factors and symptoms all matter. Hysterectomy is definitive — but medications and UAE are less invasive and preserve the uterus and fertility.3
For patients with adenomyosis there are several factors that will determine which course of treatment is the best, including age, medical history, risk factors and symptoms. Our specialist has treated many patients with adenomyosis, and this experience is important in making sure you have the best outcome. Conventional treatment with hysterectomy allows for definitive treatment; however, medications and UAE are less invasive treatments that preserve the uterus and fertility.3
Symptom control
NSAIDs like ibuprofen or naproxen may help manage painful symptoms, however this does not treat the underlying cause. Birth control pills or a hormone-releasing IUD can help control heavy periods. However, as with anti-inflammatory medications, this does not treat the underlying cause. Many of these options do not provide continued improvement and are limited by their menopausal-like side effects as well as inability to conceive.1
Non-surgical uterine artery embolization (UAE)
This is an effective non-surgical treatment that can reduce or eliminate your symptoms by addressing the core root of the problem. Uterine artery embolization is a non-surgical procedure that is outpatient with minimal downtime. In fact, most of our patients are back to normal activity after only one week.
Adenomyomectomy
Focal resection is a surgical option for those with focal adenomyosis limited to a region of the uterus. 75% of women experienced symptom relief with this limited surgical treatment.4
Hysterectomy
Uterine Artery Embolization
- Addresses the core root of the problem — the abnormal blood supply
- Treats adenomyosis and fibroids in one session
- Preserves the uterus and fertility3
- Outpatient through a tiny pinhole; no general anesthesia
- Most patients back to normal activity in about one week
- 82% avoided hysterectomy at 7-year follow-up3,7
Hysterectomy
- Major surgery: risks of excessive bleeding, blood clots, infection
- Adverse reaction to general anesthesia is possible
- Results in infertility — the uterus is removed
- One- to two-day hospital stay
- Six to eight weeks of recovery with limited activity and driving
- Nearly one-quarter still had pelvic pain afterward in one study5p>
What is non-surgical uterine artery embolization (UAE)?
A non-surgical image-guided procedure that treats all uterine fibroids in one treatment — by blocking the blood supply they need to grow.2,3
Uterine artery embolization, or UAE, is a non-surgical image-guided procedure that effectively treats adenomyosis (and fibroids) in one treatment. This is done by placing a tiny catheter into the uterine artery and blocking the blood flow to the abnormal lining using tiny particles.
Uterine embolization can be performed as an outpatient procedure through a tiny pinhole in the skin, resulting in faster return to work and minimal risk (after 30 days) when compared to having a hysterectomy.6 UAE is also done with local and moderate IV sedation, avoiding the risks of general anesthesia. What kind of facility can the UAE procedure be performed at? Read here.
Our outpatient center sees patients throughout Southern California including Los Angeles, Orange County and San Diego. The UAE treatment is performed by our Endovascular Physician (an Interventional Radiologist) who is board certified in image-guided procedures using X-rays, tiny catheters and other micro-tools, and has performed over 2,000 complex embolizations across more than 10,000 image-guided procedures, with special interest in fibroid and adenomyosis treatments.
What is Interventional Radiology? This is the only specialty in medicine specifically trained to perform embolization procedures, such as for symptomatic fibroids and adenomyosis. Read more here.
Check if we're in your network. Find out in under a minute — no phone call needed. Check My Insurance →
Am I a candidate for uterine artery embolization?
If you have adenomyosis with any of these symptoms, you may be a candidate for uterine embolization.
- Painful periods
- Heavy bleeding during or in between your periods
- Abdominal pressure and bloating
- Pain during intercourse
- Blood clots during menstruation
- Anemia
- Enlarged uterus
What do you need to do next? Request a consultation to meet with our embolization doctor who will review your imaging, labs and history to determine if you are a candidate for the procedure, and the outcomes you can expect. Each woman is an individual and should discuss the potential risks and benefits of embolization and other treatments with our doctor to decide which option is best for her.
What to expect from non-surgical UAE
An outpatient procedure with minimal downtime, performed through a tiny catheter — from either the leg (femoral) or the wrist (radial).
Numbing & mild sedation
Tiny catheter — femoral or radial
The treatment is performed through a tiny tube called a catheter, placed either in an artery at the top of the leg or in an artery in the lower arm.
Real-time X-ray to the uterine artery
A sophisticated X-ray machine creating moving pictures in “real” time guides the catheter through the blood vessels and into the uterine artery.
Tiny particles cut off the abnormal supply
What are the results of UAE for adenomyosis?
83.1% of patients demonstrated overall symptom improvement, and 82% avoided a hysterectomy in a 7-year follow-up study.3,7
UAE presents a useful option for those who wish to avoid hysterectomy and prefer a minimally invasive technique without a hospital stay. 83.1% of patients who underwent UAE for adenomyosis demonstrated overall symptom improvement and 82% in a 7 year follow-up study were able to avoid a hysterectomy.3,7 Previous studies have also shown favorable outcomes with symptom relief after UAE for adenomyosis; however, recurrence rates are higher than for the treatment of fibroids, but it offers symptom relief in over two-thirds of patients and is uterine sparing.8
An honest note on expectations. Adenomyosis is not fibroids: recurrence rates after UAE are higher for adenomyosis than for fibroids.8 That's part of why the correct diagnosis and a frank conversation about your goals matter so much — and why our doctor reviews every option, surgical and non-surgical, with you.
Your care is directed by your doctor — with no outside influence
At CVI, every clinical decision is made by the physician who will perform your procedure — an embolization expert, with no outside influence on your care — so the doctor has the freedom to spend as much time as needed on your consultation and treatment.
At CVI, we provide devoted and specialized care for embolization. All clinical decisions are centered on the patient and made by our physician, who is an embolization expert — directed by the doctor alone, with no outside influence. He has the freedom to spend as much time as needed for patient consultations and medical procedures, and decisions are based on what is best for you and your treatment — nothing else. The staff are highly trained and dedicated to the patient experience. This allows us to provide the best care and experience for our patients.
Women continue to be thrilled with the totality of their care experience facilitated by our patient-centered approach. Read more about our practice here.
It matters who holds the wire
Embolizing an adenomyotic uterus means steering a hair-thin catheter into the uterine arteries and judging exactly how much of the abnormal blood supply to take — enough to stop the disease, not so much that healthy uterus is harmed. And it’s all done by reading a flat, two-dimensional X-ray of a three-dimensional vascular tree, in real time. That spatial ability is an innate talent that comes easily to very few: experience sharpens it, but it can’t manufacture it. Our board-certified Endovascular Physician brings over 2,000 complex embolizations — part of more than 10,000 image-guided procedures — and a special interest in fibroid and adenomyosis treatment — and because adenomyosis so often travels with fibroids, he treats both in the same session.
The doctor, every time
3D vision from a 2D image
Both conditions, one session
The right diagnosis first
Who performs your adenomyosis treatment?
At California Fibroid Center, your uterine artery embolization is performed by Dr. Atabak Allaei — a board-certified Interventional Radiologist and Endovascular Physician, the only specialty in medicine specifically trained to perform embolization procedures.
It matters who holds the wire. Treating an adenomyotic uterus means judging precisely how much of the abnormal blood supply to block while sparing the healthy uterus — all read from a flat 2D image of a 3D vascular tree. That spatial skill comes easily to very few, and experience alone can’t manufacture it — it can only sharpen it in a physician who already has it.
Atabak Allaei, MD
Adenomyosis treatment: common questions
What is adenomyosis?
Why is adenomyosis often misdiagnosed as fibroids?
Adenomyosis is often misdiagnosed as fibroids because it can have similar symptoms. While not every woman may have symptoms, for those who do these can vary and range in severity. One helpful distinction: patients with adenomyosis usually have pain that is worse than the bleeding, while for patients with fibroids it is typically the opposite — the bleeding is worse than the pain. Importantly, the non-surgical UAE procedure treats both fibroids and adenomyosis in one session.
What causes adenomyosis?
Though the cause isn’t known, studies have suggested that various hormones — including estrogen, progesterone, prolactin, and follicle-stimulating hormone — may trigger the condition, and women who have had prior uterine surgery may be at risk. Potential causes include inflammation during childbirth (a post-partum uterus may become inflamed, causing a break of the inner lining), invasive tissue growth (invasion of endometrial cells from surgical incisions such as a C-section), developmental factors (cells deposited inadvertently while the uterus was forming in utero), and hormone use (estrogen and progesterone).
How is adenomyosis diagnosed?
Previously the only definitive way to diagnose adenomyosis was to perform a hysterectomy and examine the uterine tissue under a microscope. Imaging technology has made it possible to diagnose adenomyosis without surgery. Transvaginal ultrasound (TVUS) and MRI are often used: ultrasound is good as an initial first study because it can help rule out other conditions with similar symptoms, though it has limitations for adenomyosis, while MRI is the best study because it can best delineate the characteristics of adenomyosis from other conditions.
What are the treatment options for adenomyosis?
Several factors determine the best course, including age, medical history, risk factors and symptoms. Symptom control with NSAIDs such as ibuprofen or naproxen may help manage pain, and birth control pills or a hormone-releasing IUD can help control heavy periods — but these do not treat the underlying cause and are limited by menopausal-like side effects and the inability to conceive. Non-surgical UAE addresses the core root of the problem while preserving the uterus. Adenomyomectomy (focal resection) is a surgical option for focal adenomyosis, with 75% of women experiencing symptom relief. Hysterectomy is the gold standard permanent solution for some patients, but it involves major surgery and results in infertility.
What is non-surgical uterine artery embolization (UAE)?
UAE is a non-surgical image-guided procedure that effectively treats adenomyosis (and fibroids) in one treatment. This is done by placing a tiny catheter into the uterine artery and blocking the blood flow to the abnormal lining using tiny particles. It can be performed as an outpatient procedure through a tiny pinhole in the skin, resulting in faster return to work and minimal risk (after 30 days) when compared to having a hysterectomy. It is also done with local and moderate IV sedation, avoiding the risks of general anesthesia.
How effective is UAE for adenomyosis?
UAE presents a useful option for those who wish to avoid hysterectomy and prefer a minimally invasive technique without a hospital stay. 83.1% of patients who underwent UAE for adenomyosis demonstrated overall symptom improvement, and 82% in a 7-year follow-up study were able to avoid a hysterectomy. Previous studies have also shown favorable outcomes with symptom relief; recurrence rates are higher than for fibroids, but it offers symptom relief in over two-thirds of patients and is uterine sparing. Most patients are back to normal activity after only one week.
Is uterine fibroid embolization safe and proven?
Yes — fibroid embolization has been an FDA-approved treatment for over 20 years, is recognized by the American College of Obstetrics and Gynecology, and has been successful for over two decades. Compared with hysterectomy, UFE offers a faster return to work and minimal risk after 30 days. It avoids general anesthesia, requires no hospital stay, and this clinically proven advancement has also paved the way for treatments in other areas of medicine, including cancer therapies.
Why choose California Fibroid Center for adenomyosis treatment?
At CVI we provide devoted and specialized care for embolization. All clinical decisions are centered on the patient and made by our physician, an embolization expert, with no outside influence on your care. The doctor has the freedom to spend as much time as needed for consultations and procedures, and decisions are based on what is best for you and your treatment. All appointments are conducted by our board-certified doctor and not assistants or non-physician providers. The treatment is performed by our Endovascular Physician, an Interventional Radiologist who has performed over 2,000 complex embolizations across more than 10,000 image-guided procedures, with a special interest in fibroid and adenomyosis treatment.
Explore related treatments
UFE for Fibroids
The same procedure, for uterine fibroids.
Fertility-Sparing UFE
When future pregnancy matters.
Hysterectomy
What the surgical option involves.
Comparison Chart
UFE, myomectomy, hysterectomy and ablation.
Symptoms Checker
See whether your symptoms fit.
Meet Our Specialist
The physician who performs your treatment.
