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I’ve been diagnosed with adenomyosis — Ask Dr Jean

Ask Dr Jean 30 Sep 2018
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When it comes to women's health, there is no such thing as a silly question. Do you have a question you want answered, but have been too afraid or embarrassed to bring it up with your GP? Or you forgot to ask while you were in the doctor's surgery? Now, you can 'Ask Dr Jean'.


Answering your questions for this edition of 'Ask Dr Jean' is gynaecologist and Jean Hailes Medical Director, Dr Elizabeth Farrell AM

Dr Elizabeth Farrell

When it comes to women's health, there is no such thing as a silly question. Do you have a question you want answered, but have been too afraid or embarrassed to bring it up with your GP? Or you forgot to ask while you were in the doctor's surgery? Now, you can 'Ask Dr Jean'.

This question has been answered by Jean Hailes medical director and gynaecologist Dr Elizabeth Farrell AM (pictured).

Question

I'm 48 and have undergone an endometrial ablation in February of this year, performed by my gynaecologist. The problem is, four months after the procedure, I've got my periods again. I've been diagnosed with adenomyosis. I've discussed this with my gyno, and in my case, I have opted for the laparoscopic hysterectomy. I would like to hear your thoughts. My periods are very heavy and painful.

Answer

Endometrial ablation is a very effective surgical procedure for heavy periods, where the lining of the uterus – the endometrium – is destroyed by one of various techniques, such as diathermy (burning), or microwave, or radio frequency ablation.

In adenomyosis the periods can return to being heavy after some time, post-ablation. The reason is that, in adenomyoisis, the endometrial cells are growing in the muscle layer of the uterus and are not able to be ablated by the procedure. Therefore, they can grow back down into the uterine cavity and cause a resumption of periods.

Hysterectomy is the only permanent treatment for adenomyosis. Adenomyosis can be a debilitating condition in some women and if all other treatments have failed, hysterectomy would therefore be recommended.