Can Interventional Therapy Effectively Treat Adenomyosis?

Adenomyosis is a common but often debilitating gynecological condition where the endometrial tissue, which typically lines the uterus, begins to grow into the muscle layer of the uterus (myometrium). This abnormal growth leads to symptoms such as prolonged menstrual periods, increased menstrual flow, and severe dysmenorrhea (painful menstruation). Women aged 35 to 45, particularly those who have had children, are most commonly affected, though it can also occur in younger women who haven't yet given birth.

Patients with adenomyosis often endure significant suffering due to severe menstrual pain, heavy bleeding, and other related symptoms, including dyspareunia (pain during intercourse), anemia, and infertility. These issues not only cause physical discomfort but also affect the emotional and social well-being of patients, sometimes straining family life.

Interventional Therapy: A Minimally Invasive Option

One of the newer treatments for adenomyosis is interventional therapy, specifically uterine artery embolization (UAE). This minimally invasive procedure involves inserting a catheter into the uterine artery through angiography and injecting embolic particles. These particles block the blood supply to the uterus, leading to a reduction in the blood flow to the adenomyosis-affected areas. As a result, the abnormal tissue shrinks, and symptoms like dysmenorrhea and menorrhagia (excessive menstrual bleeding) are alleviated.

The primary benefits of interventional therapy include minimal trauma, quicker recovery times, and the preservation of the uterus, making it an appealing option for women who wish to avoid more invasive surgical procedures.

Effectiveness and Common Sequelae of Interventional Therapy

1. Ovarian Function Decline: The procedure may inadvertently cause damage to the ovaries, leading to a decrease in ovarian function and lower estrogen levels. For patients who do not wish to conceive, using a levonorgestrel-releasing intrauterine system (LNG-IUS) may help manage these symptoms.

2. Excessive Menstrual Bleeding: The treatment can sometimes cause damage to the endometrium, resulting in increased shedding and heavy menstrual bleeding. While mild symptoms might not require special treatment, severe cases may benefit from medications like Yunnan Baiyao capsules.

3. Damage to Surrounding Organs: Improper technique during the procedure could result in damage to surrounding tissues, potentially causing bladder or bowel injuries. In severe cases, particularly for patients who do not plan to have more children, a hysterectomy might be considered.

4. Irregular Vaginal Bleeding: Post-operative irregular vaginal bleeding is another possible complication, often related to the reduced blood supply caused by the procedure. Patients should monitor their bleeding patterns closely, and if heavy bleeding occurs, they should seek immediate medical attention.

5. Other Complications: Additional issues such as pelvic adhesions and ectopic pregnancy may arise following the procedure. If symptoms worsen, it is crucial to consult a gynecologist for further evaluation.

Managing Adenomyosis After Interventional Therapy

Despite the effectiveness of interventional therapy, there is a notable risk of recurrence. Many patients experience symptom relief in the short term, but the condition can return over time. To manage this, patients should adhere to the following post-treatment guidelines:

1. Regular Medical Check-ups: Regular follow-ups are essential to monitor the condition and catch any recurrence early.

2. Avoid Strenuous Physical Activity: Engage in mild activities like walking to avoid increasing pressure on the body, which could lead to complications.

3. Follow Medication Instructions: Taking prescribed medications, such as anticoagulants and pain relievers, as directed can help manage symptoms and prevent further complications.

4. Dietary Considerations: Avoid spicy and irritating foods. Instead, focus on a fiber-rich diet to promote intestinal health and reduce the risk of constipation.

5. Rest and Recovery: Ensure sufficient rest and avoid excessive fatigue to support the body’s healing process.

6. Moderate Sexual Activity: Excessive sexual activity could aggravate the condition, so it is advisable to refrain from intercourse temporarily post-surgery.

7. Emotional Well-being: Stress and emotional instability can worsen symptoms, so maintaining a positive emotional state is important.

A Safer Alternative: Traditional Chinese Medicine

While interventional therapy offers several advantages, the potential sequelae can be concerning. As a result, some patients and practitioners prefer Traditional Chinese Medicine (TCM) for treating adenomyosis. One such treatment, the Fuyan Pill, has been shown to effectively eliminate pathogens and reduce inflammation. Additionally, it promotes blood circulation, alleviates pain, and helps regulate menstrual abnormalities, providing a holistic and safer approach to managing adenomyosis without the risks associated with surgical interventions.