Adenomyosis: IUD or Hysterectomy?

I am 28 yrs old. I have 3 children (1 vaginal, 2 c sections). After my last c section (05/2013), I had a tubal ligation and have not stopped bleeding since. I've tried progesterone pills (8 months, no change). The pain gradually got worse causing me to follow up and was diagnosed with adenomyosis and I had a uterine ablation (April 2014).

For 3 months I noticed no change, then Sept, Oct, and Nov I had (what I considered the new normal) "normal" periods. 10 days later the severe pain and bleeding returned and here I am. I feel like I'm in back labor almost constantly. The pain doesn't stop on those few days when I'm not bleeding.

My insurance forced me to see a new dr and he surpringly new exactly what was going on and said if I wanted a hysterectomy he'd do it. He also mentioned mirena and said he'd be doing me a disservice if he didn't offer that option to me. That being said, he'd support whatever decision I made.

The earliest surgery date available is August. Has anyone tried the iud for adenomyosis and had positive results? I've had a history of depression and heard the iud can trigger depression. I'd prefer to not go back to that dark place. Unfortunately I can't afford to drag this on much longer. My husband is disabled and I am the primary caregiver around the house.

Thanks!

I also have adenomyosis. I have 3 kids, 2 cesarean and 1 vaginal. Mine started with pain after my first child, 8 years ago, and got much worse after my last, 3 years ago.

It would get so bad during a period that I would be on my hands and knees screaming in the bathroom feeling like I needed to push a baby out to get relief. That's when I got scared.

I got the Mirena because my gallbladder needed to be removed while this was going on and I needed a temporary fix to deal with that. I did get relief for 5 months, and then it all came back. I will be having a hysterectomy in june.

That's how they explained it to me, that it's a bandaid fix. Adenomyosis only gets worse, Mirena covers up the symptoms temporarily but doesn't stop the progression of the disease. The bandaid might last a month, 6 months, a year.

Mine is severe. I have pain 4 weeks out of every month, in my uterus, back, bladder and rectum. It ranges from hard labor pain to pms type cramping. And we havent had sex in months, its too pAinful. So for me, we already knew Mirena wasn't going to last long.

I think if you need time to think about if you are ready for major surgery, and you don't mind feeling like you are pregnant, than I would definitely give it a try. You could have it put in and schedule the hysterectomy, then cancel the surgery if it ends up working.

If you do end up going for surgery, keep your ovaries. Adenomyosis does not affect the ovaries and if you leave them in you won't need hrt.

Be cautious because it's my understanding Mirena can cause cysts on the ovaries, can be expelled with adeno clots and doesn't improve the pain of adeno. It's like the poster said, a bandaid fix. Adeno takes over your quality of life. I had been bedridden for most of the day. I'm over a year out and glad to be free of the pain. I kept my one ovary and ovulate still. Yeah adeno is a 'trip' for sure and you'll be glad when it's over. I'm in my 40s and life is much improved ! I do wished there were more options, but glad to be rid of awful periods as well.

I did anti inflammatories for years, tried waiting it out, progesterone, lo loestrin, and finally just couldn't take it anymore !

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Originally Posted by Georgiarose Be cautious because it's my understanding Mirena can cause cysts on the ovaries, can be expelled with adeno clots and doesn't improve the pain of adeno. It's like the poster said, a bandaid fix. Adeno takes over your quality of life. I had been bedridden for most of the day. I'm over a year out and glad to be free of the pain. I kept my one ovary and ovulate still. Yeah adeno is a 'trip' for sure and you'll be glad when it's over. I'm in my 40s and life is much improved ! I do wished there were more options, but glad to be rid of awful periods as well. I did anti inflammatories for years, tried waiting it out, progesterone, lo loestrin, and finally just couldn't take it anymore !

That's actually a really good point about the cysts, I do believe I had one for about 2 months but the pain went away before my appointment so I forgot to mention it to him.

Why women use this for birth control I don't understand. If that's what I used it for I would of had it removed for sure within 3 months.

Well... that is slightly frightening. I am prone to cysts anyway and was in the hospital 7 times during my second pregnancy from complications from cysts rupturing. I'm at a loss right now. I just feel so lost and don't know what to do. I feel like I owe it to myself to exhaust every option before I go through with a hysterectomy, but the more I hear about Mirena, the more I don't even want to try it. Part of me is hoping that when I get my u/s later today, it reveals some reason why I'm not a candidate for the IUD. So I can still feel like I've exhausted all of my options without jumping straight to "extremes". Thank you for all of your input ladies. I have to make a decision by Thursday. I hope I make the right one.

I had my left ovary removed, because it was full of cysts. As you know, if it is possible to keep your ovaries, most will say that that's the preferred method as a hyst. Mirena did not cause my cyst covered ovary, but when you only have one ovary left to last ya, you need to know these things. My Dr. said the Mirena might help my periods, but also said it probably would not help with the daily pain. So, I wanted a definitive answer and hyst was that for me. But we are all different and at different stages. Each hyst case is unique and should be treated that way. Each lady is probably also at times at a dift point in her journey. Hyst worked for me, because I didn't want the stress of trying methods ( had already tried some methods) that obviously don't work on everyone or there wouldn't be so many hysts for adeno. Just sayin......

Choose what your comfortable with, get the facts and you'll rest comfortably knowing you make the right decision for you.

I was able to keep my ovary and was a good candidate for a vaginal hyst, so all is good. I also kept my ability to ovulate, which gives that 'sexy feel' each month, so I was happy with that, plus not having the bad bad periods, helps ya to feel a lil' sexier, if that's an issue for ya. My love life is important to me and so I was glad to hear that. If you keep the ovaries, you probably will still have PMS type stuff. My PMS stuff is migraines, sore boobs and tiredness. But amazing how that becomes 'easier to handle' when the awful cycles are done with. I guess I should say 'periods' because your body still goes through the cycle, if ovaries are retained.

In the exact same boat with Andenomyosis...

History of depression, pregnancy and postpartum were really really hard! Did BC pills and rings to try and control the bleeding after the pregnancies and I couldn't handle needing anti depressants to deal with the birth control. Thought diet and exercise would cure it all... it helped quite a bit with the depression but bleeding just got worse over the last ten years.

Now 36 and after only 3 weeks with the IUD, I had to have them pull it out. It was so hard to ask my gyno to do that, I felt like I was letting them down. Like I didn't even give it a try. I felt like the pain and the 10 days of bleeding 4 so heavy that I have to work from home those days was better than feeling depressed all the time. I HATE the dark place. It is suffocating. Even though the depression wasn't as bad as BC, it was enough to make me scared of trying to wait the IUD for 6 months.

That being said, I don't think that is typical of the IUD. It just didn't work for me and though I am new here, I have been grateful for all the awesome reminders that everyone is different and their thresholds for what is manageable and what isn't is all different. Which is what I tell myself every time I talk myself into thinking that my periods aren't that bad and are probably normal and I shouldn't be complaining.

I too have been diagnosed with adenomyosis. I have four children, all vaginal deliveries. I am booked in to have a TVH on may 27th. Prior to the diagnoses, I had used mirena, implanon and all sorts of birth control to try and calm the dysmenorreah and pain. It eventually got so bad, and I had been bleeding for so long, that I went to my doctor and cried. This is when all the tests started. So I can say for me, that NO mirena didn't work effectively for long. I had about 12mths of semi relief (ie. I had no periods, but still lower pelvic pain and cramps) and after about 18mths I started bleeding profusely. I thought I was going to have to go to the emergency department it was that sudden and that severe.

As life would have it, now that I'm booked in for the hysterectomy, my period pain level has been manageable (not the other pains, just period pain). Which has me second guessing the surgery lol.

Good luck

Thing is with adeno , it doesn't improve. Have heard some say it gets better w meno, but for those of us in our 30's and 40's that's a long time to be in pain. I'm so glad lotsa ladies weighed in on this. I wished there were more treatment/cure options for adeno ladies

Hi there, I too have been dx with adenomyosis and recently dx with thick uterine lining that might be hyperplasia. I am 42 have 2 children both vaginal deliveries ages 22 and 10. I was dx with the adenomyosis 8 years ago and have just delt with it but then my periods became increasingly heavy with very very large clots the last 2 years. Ultrasound was done to check on the status of the adenomyosis and I was only on day 8 of my cycle with thick lining. I was put on a drug (can't remember the name ) that cost over $80 for 2 weeks worth and it made my pain much worse. Then was put on provera for 3 months it lightened my periods and increased pain. (It was to be a medicinal d &c) however at ultrasound this month at 8 days into cycle lining was again very thick. Was given 3 options, mirena, ablation or hysterectomy. I almost went with the mirena but after much research it scared me and as for ablation it's another bandaid. So I'm having hysterectomy next month. None of our options are easy decisions, and everybody's body reacts differently. I wish you the best of luck I know I'm still half scared to death about having the surgery and what might be lerking or what if it's all the wrong dx. My mind is my worst enemy.