What should you know about using an IUD to treat adenomyosis?

Adenomyosis occurs when tissue similar to the womb lining grows into the muscular wall of the uterus. This can make periods heavy or painful and may cause ongoing pelvic pressure or pain. A hormonal coil releases progestogen locally, which can thin the womb lining and reduce menstrual bleeding. Some people also notice less cramping over time. It is a symptom-management option, not a cure, and it does not suit everyone.

A clinician will consider the size and shape of the uterus, bleeding pattern, pain, anaemia, medical history, and whether you want pregnancy soon. A copper IUD does not provide the same hormonal treatment and may worsen bleeding for some people.

Ask about insertion, expected bleeding changes, pain relief, and follow-up. Irregular bleeding can occur after insertion before the pattern settles. Keep a record of bleeding, cramps, pelvic pain, and any medication effects. Discuss alternatives if a hormonal coil is unsuitable or symptoms remain troublesome, including medicines, uterine artery embolisation, endometrial ablation in selected situations, or hysterectomy when other options have not met your goals. Pregnancy plans affect this choice.

Seek urgent care for severe pelvic pain, fainting, heavy bleeding causing weakness, fever, or a positive pregnancy test with pain. After insertion, prompt review is needed for worsening pain, fever, foul-smelling discharge, or a sudden change in the strings. Arrange a routine review if bleeding or pain remains disruptive, because adenomyosis symptoms may need a different approach.

Ask whether your symptoms fit adenomyosis, whether a hormonal coil is suitable for your uterus and pregnancy plans, and how long to allow for improvement. Ask how anaemia, pain, fertility goals, and other treatments should influence the decision.