What is the first treatment tried for adenomyosis?

Adenomyosis occurs when tissue similar to the womb lining grows into the muscle of the womb. It may cause heavy periods, painful periods, pelvic pain or pressure. Initial care usually targets the symptoms rather than removing the womb. A hormonal coil can release hormone inside the womb and may reduce bleeding and cramping for some people.

The choice depends on bleeding severity, pain, anaemia, age, desire for pregnancy, contraception needs and other health conditions. A clinician may also discuss non-hormonal medicines such as tranexamic acid for heavy bleeding.

Keep a record of bleeding, pain, fatigue and missed activities. Take medicines only as prescribed and discuss pregnancy plans before choosing a hormonal or surgical option. If symptoms continue, options may include [Endometrial Ablation](/treatments/gynaecological-surgery/endometrial-ablation/), [Uterine Artery Embolisation](/treatments/gynaecological-surgery/uterine-artery-embolisation/) or other specialist treatment.

Arrange medical review for bleeding that is becoming heavier, pain that disrupts daily life or tiredness that may reflect anaemia. Seek urgent care for very heavy bleeding with dizziness or fainting, severe worsening pelvic pain, or possible pregnancy with significant pain or bleeding.

Ask whether a hormonal coil or non-hormonal medicine fits your goals, how treatment may affect fertility, how anaemia will be checked, and when surgery such as [Hysterectomy](/treatments/gynaecological-surgery/hysterectomy/) would be considered.