Post menopaus with adenomyosis

Hello,  I'm 50 yrs old and 2 years postmenopausal.  I have just been diagnosed through M.R.I with probable adenomyosis. From what I've read, adenomyosis usually resolves itself after menopause.  What confuses me is, I had no symptoms of it pre-menopausal, my periods were like clockwork, very normal, no pelvic pain or cramps, and no spotting between cycles. Now I'm having almost constant pain with some spotting.
Since I've been diagnosed with this postmenopausal, would it be advisable to have a hysterectomy like my Doctor suggested or would it be alright to watch and wait?   Just need another Doctor's input.
Thank you.  

[Elaine Brown, MD]

Hi!
You are correct that adenomyosis usually resolves itself after menopause.  If you were my patient, I would definitely do an ultrasound guided endometrial biopsy to rule out cancer/polyps of the endometrium (uterine lining).  I would also look carefully at the ovaries to be certain that there was no evidence of metastatic or other disease there.
But I would probably NOT do any major surgery unless one of these tests showed a problem.
I wonder, since you mention the breast cancer, if you are on Tamoxifen.  If so, that is probably what is causing the spotting.
I would also be looking for other problems that might be causing the pain, because it seems quite unlikely that adenomyosis is the culprit.


Long answer above, short answer below:

Yes, its OK to watch and wait.  In fact, that is probably the right thing to do!

Good luck!
Dr B

[carolann644]

I forgot to mention that I'm a breast cancer survivor

[carolann644]

Thanks Dr. Brown,  My Doctor tried to do an edometrial biopsy then a d&c, but because I have servere cervical stenosis, he was unable to get through my cervix.  That is why I had the MRI, to see what it would tell.  Ultrasounds have come up normal.
I'm not on tamoxifen, so I can't blame that on the spotting.
Thanks again for your response,  I'm definitely not going to rush into anything until I have all my bases covered.
Carol~