Treatment Options for Managing Adenomyosis Before Pregnancy

BySamradni Pradhan
Updated: 25 Jul 2025, 3:30 pm

It is crucial to understand adenomyosis if you are planning a pregnancy with this condition. It may affect your fertility, but several treatments can help you manage it before pregnancy. They will ease your discomfort and also support your fertility health. It will improve your chances of conceiving naturally or with medical support.

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It is natural to feel worried or confused about getting diagnosed with any condition when you are trying to get pregnant. Adenomyosis is one such condition that makes it harder to get pregnant. You may wonder what you can do about it or if there is a treatment available.

In this article:


You will find it comforting to know that various treatment options are available to help manage adenomyosis. Understanding them will let you make informed decisions and feel more confident about conceiving. It is essential to receive the correct treatment before beginning your pregnancy journey.


What is Adenomyosis?

Adenomyosis is a condition that makes your uterine tissues grow into the muscular wall instead of the lining of the uterus. This can make your uterus larger and may cause symptoms such as:

  • Heavy menstrual bleeding
  • Severe menstrual cramps
  • Pain during intercourse
  • Pelvic pressure or bloating


How Does Adenomyosis Affect Fertility?

You may be concerned about how adenomyosis can interfere with your plans to get pregnant. While some women with adenomyosis conceive naturally, others may face challenges.

Adenomyosis may affect fertility in different ways for every woman.

  • It may disrupt the implantation process in the uterus.
  • It may cause inflammation that affects the uterine environment.
  • The thickened uterine wall may make it harder for sperm to reach the egg.


Treatment Goals Before Pregnancy

Here are the most common treatment options to help manage adenomyosis before pregnancy.

  1. Medication Therapy

Medication is often the first step in managing adenomyosis, especially if your symptoms are mild. It is also recommended when you want to delay pregnancy for a short time.

  1. Hormonal Treatments

Hormonal medications can help reduce heavy bleeding and pain by controlling the menstrual cycle. These include:

  • Oral contraceptive pills
  • Progesterone-only pills or injections
  • GnRH agonists (which lower estrogen levels temporarily)
These treatments can help reduce the thickness of the uterine lining and ease inflammation. However, they are not suitable if you are actively trying to conceive, since they usually prevent ovulation.

  1. Non-Hormonal Options

Pain relievers such as ibuprofen can help manage discomfort but do not treat the main cause. These work best when they are used with other treatments.

  1. Surgical Options

Your doctor may suggest surgery if medications are not effective or if you have severe symptoms. These options follow a targeted approach and may be helpful for women who are trying to conceive.

  1. Conservative Surgery

This surgical method removes all the abnormal tissues without any damage to the uterus. It is called adenomyomectomy. This surgery is more complex than surgery for fibroids, but it can relieve symptoms and improve fertility outcomes.

Conservative surgery is usually recommended for women with focal adenomyosis, where the affected area is limited. If your adenomyosis is widespread (diffuse), surgery may not be possible or may carry higher risks.

  1. Hysteroscopic Surgery

Your doctor may recommend hysteroscopic removal if small areas of adenomyosis are accessible through the cervix. This is a less invasive method and may be combined with other fertility treatments.

  1. Non-Surgical, Uterus-Preserving Procedures

There are newer treatments that may help manage adenomyosis if you want to avoid surgery but need more than medication.

  1. Uterine Artery Embolisation (UAE)

It is a minimally invasive procedure that blocks the blood supply to the adenomyotic tissue, causing it to shrink. While the UAE method has been successful in symptom relief, it is not suitable for women who want to get pregnant.

Some studies suggest it may affect the uterus in ways that make pregnancy riskier. Discuss all the aspects of this treatment with your doctor and understand them thoroughly.

  1. High-Intensity Focused Ultrasound (HIFU)

HIFU uses focused sound waves to eliminate the affected tissue without any cuts or surgery. It is a newer method and not widely available in all locations, but it increases the chance of successful pregnancies.

Ask your doctor if this is a suitable option for you and whether it is performed in your area.

  1. Fertility Treatments

Fertility treatments such as In Vitro Fertilisation (IVF) are the options when natural conception has been challenging and your adenomyosis is affecting your chances.

Your doctor may recommend medical or surgical treatments to manage adenomyosis before IVF to improve the chances of embryo implantation.

Also, GnRH therapy for a few months before starting IVF may improve success rates in some women.


Making the Right Decision for You

The correct treatment for managing adenomyosis before pregnancy depends on many factors:

  • Your age
  • Severity of symptoms
  • Whether you have focal or diffuse adenomyosis
  • When are you planning your pregnancy
  • Your response to past treatments
It is essential to work closely with your gynaecologist or fertility specialist. They can create a plan that respects both your comfort and your family-building goals.

Every woman’s experience with adenomyosis varies, and your care should be made to suit your needs.

Being diagnosed with adenomyosis when you are planning a pregnancy can feel overwhelming. Most women lead a healthy pregnancy after receiving the correct treatment and care.

Understanding your condition and discussing your options with your doctor is the first step. Managing adenomyosis before pregnancy gives you the best possible chance at a successful and healthy pregnancy, whether you begin with medication, explore surgical options, or consider fertility treatments.

FAQs on Treatment Options for Managing Adenomyosis Before Pregnancy

  1. Can I get pregnant naturally if I have adenomyosis?
    Yes, it is possible to conceive naturally even with adenomyosis. However, your doctor may suggest additional treatments to improve your chances if you have been trying for several months without success.
  2. Is surgery the only way to treat adenomyosis before pregnancy?
    Most women find relief with medication or hormone therapy, so surgery is not always required. Your doctor may recommend surgery only if symptoms are severe or if other treatments have not worked.
  3. How soon after treatment can I try to conceive?
    It depends on your treatment method, whether it is medicines or surgery. You may get a clearance from your doctor to try again within a few weeks if you were prescribed medicines. However, you may have to wait almost three months to let your uterus heal before trying again in case of surgery.
Disclaimer: Medically approved by Dr Sandhya Rani, Sr. Consultant - Obstetrics & Gynaecology, Aster Women & Children Hospital, Bengaluru

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