Managing Adenomyosis: Navigating Symptoms and Treatment Options

Q: Managing Adenomyosis: Navigating Symptoms and Treatment Options

Hello： If menstruation occurs, you may stop the medication and observe. <br>If there is abnormal bleeding, you should see a doctor to determine the issue. <br>Adenomyosis can lead to heavy menstrual bleeding, dysmenorrhea, and lower abdominal pain without causing anemia. <br>It i

Adenomyosis

I have been diagnosed with adenomyosis for two years, and I didn't take it seriously until this year.
After getting vaccinated and testing positive for COVID-19, my menstrual cycle became irregular.
I didn't have my period from January to February, had it for half a month in March, didn't have it in April, tested positive on May 7, and had my period from May 1 until July for almost three months.
In mid-July, I went for a consultation and underwent a minor procedure to remove endometrial blood clots.
The doctor did not think I needed to rest and said I could return to work.
However, I vomited everything I ate or drank and felt completely weak.
The next day, I went to work, but due to excessive blood loss, I felt very weak and had to go to the emergency room for a blood transfusion.
My hemoglobin dropped to 5.
The next day, I switched hospitals for treatment, rested for a week, and was prescribed hemostatic agents and progesterone for half a month.
Can I still take progesterone during my menstrual period?

An Baobei, 30~39 year old female. Ask Date: 2022/08/05

Dr. Lin Xinwang reply Obstetrics and Gynecology

Hello: If menstruation occurs, you may stop the medication and observe.
If there is abnormal bleeding, you should see a doctor to determine the issue.
Adenomyosis can lead to heavy menstrual bleeding, dysmenorrhea, and lower abdominal pain without causing anemia.
It is recommended to take estrogen (E) and progesterone (P) during the first week after menstruation, and then take progesterone from day 14 to day 21.
After stopping the medication, monitor the menstrual situation; this can help regulate for three months.
If the condition does not improve, the final option is surgical treatment.

Reply Date: 2022/08/05

More Info

Adenomyosis is a condition where the tissue that normally lines the uterus (the endometrium) grows into the muscular wall of the uterus. This can lead to a variety of symptoms, including heavy menstrual bleeding, severe cramping, and pelvic pain. Managing adenomyosis can be challenging, especially when symptoms are severe and impact daily life, as you've described.

Given your history of adenomyosis and the recent complications you've faced, including heavy bleeding and significant fatigue, it’s crucial to approach your treatment with care. The fact that you experienced a drop in hemoglobin to a dangerously low level (5 g/dL) indicates that you had a severe loss of blood, which can be life-threatening and requires immediate medical attention, as you experienced with your emergency visit for a blood transfusion.

In terms of treatment options for adenomyosis, they can vary depending on the severity of your symptoms and your overall health. Here are some common approaches:
1. Hormonal Treatments: Hormonal therapies, such as birth control pills, progestins (like the yellow hormone you mentioned), and hormonal IUDs, can help regulate menstrual cycles and reduce heavy bleeding. Since you are asking about taking progestins during your menstrual period, it is generally safe to continue hormonal treatments during menstruation, but this should be confirmed with your healthcare provider. They can provide specific guidance based on your individual health status and treatment plan.

2. Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain associated with adenomyosis. However, it's essential to use these medications as directed and to consult with your doctor if you have any concerns about their use, especially in the context of heavy bleeding.

3. Surgical Options: In cases where symptoms are severe and do not respond to medication, surgical options may be considered. This can include procedures to remove the adenomyosis or, in more severe cases, a hysterectomy (removal of the uterus). Given that you had a procedure to manage blood clots, it’s important to discuss with your doctor whether further surgical intervention might be necessary.

4. Lifestyle Modifications: Maintaining a healthy diet, staying hydrated, and managing stress can also play a role in managing symptoms. Given your recent experiences with vomiting and weakness, it’s crucial to focus on nutrition and hydration to help your body recover from the blood loss.

5. Regular Monitoring: Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary. Since you have experienced significant changes in your menstrual cycle and overall health, keeping an open line of communication with your doctor is vital.

6. Support Systems: Managing a chronic condition like adenomyosis can be emotionally taxing. Consider seeking support from friends, family, or support groups where you can share experiences and coping strategies.

In summary, it is essential to work closely with your healthcare provider to tailor a treatment plan that addresses your specific symptoms and health needs. If you have any doubts about continuing your current medications or if you experience any new symptoms, do not hesitate to reach out to your doctor for guidance. Your health and well-being are paramount, and proactive management can help improve your quality of life.

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