What is adenomyosis, and how can it be managed?

Written by: Mr Mahantesh Karoshi
Edited by: Conor Lynch

In this article below, esteemed consultant gynaecologist, Mr Mahantesh Karoshi, describes what adenomyosis is, and how women suffering from the condition can best manage it.

What is adenomyosis?

Adenomyosis is a common gynaecological condition characterised by the presence of endometrial glands and stroma within the myometrium.


What are the associated symptoms?

It can cause a range of symptoms, including heavy menstrual bleeding, dysmenorrhea, and infertility.


How can adenomyosis be managed most effectively?

Recent advances in preconception management of adenomyosis have focused on improving fertility outcomes and reducing the risk of complications during pregnancy. It can be managed in the following ways:


  1. Medical management: Gonadotropin-releasing hormone (GnRH) agonists have been used to suppress ovarian function and decrease the size of adenomyosis lesions prior to conception.
  2. Surgical management: Hysteroscopic resection of adenomyosis lesions has been shown to improve pregnancy rates in women with adenomyosis.
  3. Imaging techniques: Magnetic resonance imaging (MRI) has been used to accurately diagnose adenomyosis and assess the extent and severity of the disease.
  4. Personalised treatment: Personalised treatment based on the individual characteristics of adenomyosis lesions has been proposed as a potential approach to improve preconception management. In a study by Zhang et al., women with adenomyosis were classified into two subtypes based on the MRI characteristics of their lesions. Women in one subtype had a higher likelihood of pregnancy success with IVF, while women in the other subtype had a higher risk of miscarriage.


What are the suggested dietary modifications for women with adenomyosis?

Women with adenomyosis should focus on the following dietary recommendations:


  • Increase intake of fruits, vegetables, and whole grains: a vegan diet is typically high in plant-based foods, which are excellent sources of antioxidants, fiber, and essential nutrients that may help reduce inflammation and pain associated with adenomyosis.
  • Incorporate omega-3 fatty acids: since vegans don't consume fish, it's important to obtain omega-3 fatty acids from other sources such as flaxseeds, chia seeds, hemp seeds, and walnuts.
  • Include soy products: soy products such as tofu, tempeh, and soy milk contain phytoestrogens that may help regulate hormone levels and reduce symptoms of adenomyosis.
  • Avoid processed foods: Processed foods are often high in saturated fats and additives that can exacerbate inflammation and pain. Stick to whole, unprocessed foods as much as possible.
  • Consider supplements: If it's challenging to get enough nutrients from diet alone, consider taking supplements such as vitamin D, omega-3 fatty acids, and magnesium, as they may help alleviate symptoms of adenomyosis.


To book a consultation with Mr Mahantesh Karoshi, visit his Top Doctors profile today. 

By Mr Mahantesh Karoshi
Obstetrics & gynaecology

Mr Mahantesh Karoshi is a London-based women’s health expert and consultant gynaecologist, with a special interest in ovarian cysts, heavy menstrual bleeding, infertility, fibroids, and adenomyosis. He is currently one of the most highly-rated gynaecologists in London with a very good reputation amongst his patients and peers.

Mr Karoshi's work is recognised internationally, having volunteered in Ethiopia’s Gimbie Hospital, and later receiving the Bernhard Baron Travelling Fellowship from the Royal College of Obstetricians and Gynaecologists which led to his work in the University of Buenos Aires. Here he worked on the techniques needed to surgically manage morbidly adherent placental disorders - a serious condition that can occur in women with multiple caesarean sections.

He believes in an open doctor-patient relationship, being sure to include the patient and educating them so that they understand their condition better and they can be directly involved in their care and management at every stage. Aside from his clinical work, he is actively involved in research, which together with his experience, has given him the opportunity to publish the first stand-alone textbook on postpartum haemorrhage which was launched by HRH Princess Anne.

At the core of Mr Karoshi's practice is a high standard of professionalism where patients are involved in their treatment and where the latest techniques and advancements are used to provide an extremely high level of care.

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