When is hormonal coil recommended for adenomyosis?

Adenomyosis occurs when tissue similar to the womb lining grows into the muscular wall of the womb. This can cause heavy bleeding, painful periods and pelvic pain. A hormonal coil releases a progestogen in the womb, which can make the womb lining thinner and may reduce bleeding and period pain. It does not suit everyone, and it is not the only treatment choice. A clinician needs to check the womb, discuss contraception and consider pregnancy plans before insertion.

Discuss your bleeding pattern, pain, anaemia symptoms, past pelvic infections, unexplained bleeding and any previous coil problems. Tell the clinician if you may be pregnant or hope to conceive soon. They can explain insertion, expected bleeding changes during the first months, alternatives and how symptoms will be reviewed. Use the prescribed follow-up plan and report problems after insertion.

Seek prompt care for severe or increasing pelvic pain, fever, unusual or foul-smelling discharge, very heavy bleeding, faintness or concern that the coil has moved. A pregnancy with a coil in place needs urgent medical advice, especially with one-sided pain, shoulder-tip pain or dizziness. Emergency help is needed for collapse or severe bleeding.

Ask whether your symptoms fit adenomyosis, whether the womb’s size or shape affects insertion, and when improvement might be reviewed. Discuss fertility timing, other treatments, pain relief during insertion and what to do if bleeding remains troublesome.