Is Hysterectomy Always Needed for a Common, Painful Gynecologic Condition?

• September 14, 2021
• Steven Reinberg

A hysterectomy isn't necessarily needed to treat a common women's health problem, researchers report.

Adenomyosis is abnormal tissue growth in the wall of the uterus, which causes cramps and heavy menstrual bleeding. The condition affects as many as one in three women.

But it often goes undiagnosed until it results in a hysterectomy, according to a broad review of medical literature by gynecologists at the University of Texas Southwestern Medical Center. Several other treatments can improve symptoms without removing a woman's uterus, they stressed.

"Many women come to me and say the only solution they've ever been offered is a hysterectomy," said Dr. Kimberly Kho, associate chief of gynecology at the Dallas medical center. "Other low-cost, low-risk options such as medical management or less invasive options have existed for more than 20 years."

Ultrasound and an MRI along with a pelvic exam can often spot the condition, Kho said. She and her colleagues urge greater awareness of this condition.

"Physicians often consider adenomyosis to be a condition of women in their 40s and 50s, because that's when they have their uteruses removed and receive a diagnosis, but it develops much earlier," Kho said in a university news release. "Improved clinical awareness is needed to ensure appropriate patient care and encourage additional studies to improve the understanding of adenomyosis."

While no U.S. Food and Drug Administration-approved therapies are specifically indicated for treating adenomyosis, it can be managed with drugs developed for contraception, or for symptoms of other conditions, such as fibroids or endometriosis.

The researchers said further studies are needed, including a look at the ages and ethnicities of women most often affected.

The study was published recently in the Journal of the American Medical Association.

More information

To learn more about adenomyosis, visit the Endometriosis Foundation of America.

SOURCE: University of Texas Southwestern Medical Center, news release, Sept. 11, 2021

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