Adenomyosis: Choosing Between Pregnancy Preparation or Treatment First

Almost every woman is familiar with the discomfort of dysmenorrhea. The pain level may vary, but if you experience a sudden increase in pain, be cautious, as it could be a sign of adenomyosis, with dysmenorrhea being a typical symptom. For expectant mothers, whether to prioritize pregnancy preparation or seek treatment for adenomyosis.

First, let's explore the causes of adenomyosis:

1. Progesterone: Experts have found a higher incidence of adenomyosis among menopausal women, suggesting a link to progesterone.

2. Uterine Surgery and Improper Operations: During uterine surgery, such as cesarean section, fibroid removal, or correction of uterine deformities, endometrial fragments might enter the myometrium, leading to adenomyosis.

3. Reproductive Tract Obstruction: Congenital or acquired conditions obstructing the reproductive tract can trap menstrual blood, contributing to adenomyosis.

4. Age Factors: Adenomyosis usually occurs in women aged 40-50. During menopause, estrogen levels remain high when ovarian function declines, and progesterone levels decrease. This hormonal imbalance can trigger adenomyosis.

Should women prioritize pregnancy preparation or seek treatment first for adenomyosis?

This decision can be challenging for those with adenomyosis. Opting for pregnancy first raises concerns about successful conception and potential abortion due to the compromised uterine environment. On the other hand, choosing treatment first, especially surgery may cause anxiety about uterine damage and recovery time, with uncertainty about subsequent pregnancy prospects.

The decision should depend on the patient's specific situation. Pregnancy preparation can be considered if adenomyosis is mild and has little impact on pregnancy. However, if natural conception proves difficult, a comprehensive examination is necessary. Based on the examination results, suitable treatment can be chosen. After adenomyosis improves, pregnancy can be contemplated.

For younger patients, symptomatic treatment is recommended initially. Symptomatic treatment focuses on alleviating specific symptoms. For instance, pain relievers can address dysmenorrhea, while blood supplements help with anemia resulting from heavy menstruation.

Traditional Chinese medicine, like Herbal medicine Fuyan Pill, can alleviate symptoms and improve the uterine cavity environment, increasing the chances of natural conception. During treatment, maintaining genital hygiene, wearing loose, breathable underwear, and adopting a light diet while avoiding spicy foods are beneficial.

For married patients without children, attempting to conceive is encouraged. It is essential to relax and avoid becoming overly anxious. Many adenomyosis patients have successfully given birth, some even discovering the condition during pregnancy and delivering successfully. So, remain optimistic; having a baby is achievable.

However, not everyone is equally fortunate. Some patients may have large uteruses, poor uterine conditions, and no history of childbirth or pregnancies. IVF (in vitro fertilization) may be a suitable option in such cases. Nonetheless, some may still experience miscarriages after pregnancy, leading to the consideration of surgery.

When should surgery be considered? In severe cases where dysmenorrhea is particularly intense, the uterus is significantly enlarged, significantly impacting daily life and work, and multiple years of attempting to conceive have been unsuccessful, surgical intervention should be considered before attempting pregnancy. Surgery aims to address the cause and preserve the uterus, allowing for pregnancy consideration post-operation. The goal is to eliminate regrets. For instance, if a noticeable adenomyoma is blocking the fusion of sperm and eggs, pregnancy can be contemplated after surgery.

In conclusion, whether to prepare for pregnancy or seek treatment first should be based on the patient's condition. Pregnancy preparation can be prioritized for mild adenomyosis that does not significantly affect pregnancy. Having children can provide temporary relief and therapeutic benefits for adenomyosis. Regardless, taking proactive action when dealing with adenomyosis and avoiding undue delays is essential.