adenomyosis options please

I have been diagnosed with adenomyosis, it is very painful and consequently some periods are very heavy, painful and more frequent than they should be. I have seen my gynacologist and had an ultrasound examination, and his recommendation is an hysterectomy. The alternative of HRT therapy is not an option as I have fibroadenomas in my breasts and a haemangioma in my liver; also despite those I would rather avoid HRT anyway.
My dilema is do I have the hysterectomy, are the potential complications and weeks of  dibilitation worth the risk, or should I try to live with the condition wait and for it to cessate at menopause? Will the condition worsen with time? I am 44 years old and a way off menopause I think. I would be grateful for some feedback

[Elaine Brown, MD]

Hi!
One other possibility that you didn't mention was endometrial ablation.  If you were my patient, I would discuss this with you.  At your age, there is good possibility that you would  have a good result from the surgery, unless your uterus is quite enlarged.
Ablation is a day procedure with very little "down" time.

Actually, there is not really much down time with a hysterectomy, especially if done vaginally.  If you were my patient and had decided to go for the hysterectomy, I would try to use a laparoscopic or robotic assisted procedure if a simple vaginal hysterectomy would be too technically difficult.

You should at least be able to add these options to your list.
I hope this helps!
Dr B