Adenomyosis treatment, by a BSGE-accredited specialist.

Prices vary by hospital, by consultant and by the extent of surgery. Robotic and adenomyomectomy cases sit at the higher end because of theatre time and disposables. We confirm a firm quote within one working day.

1. 01

   Before

   You send us your symptom history and any scans

   A short, confidential form. Bleeding pattern, pain score, prior imaging, fertility plans, and any medical treatments already tried.

2. 02

   Before

   We come back with a shortlist

   Within one working day: two or three consultants, whether MRI is needed first, and a clear cost range across medical, uterus-sparing and definitive options.

3. 03

   Before

   Consultation and imaging

   A 45 to 60 minute gynaecology consultation, transvaginal ultrasound in clinic, and MRI pelvis if the picture is unclear or surgery is on the table.

4. 04

   On the day

   Your chosen treatment

   Mirena insertion in clinic, GnRH antagonist start, uterine artery embolisation in interventional radiology, HIFU day case, or laparoscopic or robotic surgery in theatre.

5. 05

   On the day

   Recovery to plan

   Day case for Mirena, UAE and HIFU. One to three nights for laparoscopic hysterectomy or adenomyomectomy. Written aftercare and 24/7 contact.

6. 06

   After

   Symptom review at 3 and 6 months

   A structured review of bleeding, pain and quality of life. MRI reassessment if UAE or HIFU was used. Fertility pathway handover if that was the goal.

7. 07

   After

   Long-term follow-up

   Mirena review at 5 years. Menopause planning if oophorectomy was performed. Endometriosis and PCOS pathways linked in where they coexist.

• Heavy menstrual bleeding (menorrhagia)

  Flooding, clots, changing protection every hour, iron deficiency anaemia. The most common reason people come to us.

• Severe period pain (dysmenorrhoea)

  Cramping that starts days before bleeding, needs strong analgesia and stops you working. Often worse than typical primary dysmenorrhoea.

• Chronic pelvic pain outside periods

  A dull, dragging pelvic ache, dyspareunia and pain with bowel movements. Distinct from cyclical pain and often shared with endometriosis.

• A boggy, tender, enlarged uterus

  A globular, softer, larger than expected uterus on examination or scan. Classic on transvaginal ultrasound alongside cystic myometrial changes.

• Subfertility or recurrent IVF failure

  Adenomyosis is associated with lower implantation rates. A pre-transfer plan can matter for those going into IVF.

• Coexisting endometriosis or fibroids

  Around a third of people with adenomyosis have endometriosis, and many have fibroids. A single plan covers all three where possible.

• Failed first-line medical treatment

  Tranexamic acid, NSAIDs or the combined pill have not touched the symptoms. Time to escalate to LNG-IUS, GnRH antagonist or a procedure.

• Red flag: post-menopausal bleeding

  Any bleeding after menopause needs urgent gynaecology assessment on a two-week-wait pathway, not a private booking.

• Mirena expulsion and irregular bleeding

  Around one in twenty Mirenas are expelled, most in the first year. Irregular spotting for the first three to six months is common and usually settles.

• GnRH antagonist side effects

  Ryeqo is generally well tolerated because of the add-back. Occasional headache, hot flushes, mood change and reduction in bone density on longer courses. We monitor accordingly.

• UAE risks

  Post-embolisation syndrome (pain, low-grade fever, malaise) for a few days. Premature ovarian insufficiency in around 5 to 10 percent. Not first choice if immediate fertility is planned.

• HIFU limits

  Best for focal, accessible disease. Not suitable for extensive diffuse adenomyosis, bowel loops in the beam path, or scars in the target zone. Skin burn is uncommon.

• Adenomyomectomy and pregnancy

  Excision can compromise myometrial integrity. Subsequent pregnancies are usually delivered by planned caesarean at 37 to 39 weeks to reduce uterine rupture risk.

• Hysterectomy is definitive

  Cures symptoms and confirms the diagnosis on histology. Loss of fertility is permanent. Ovaries usually kept unless there is a separate reason to remove them.

• Anaemia should be corrected first

  Iron infusion or oral iron before any procedure improves recovery and reduces transfusion risk. We build this into the plan.

• Red flags after any procedure

  Heavy fresh bleeding, fever above 38 degrees, severe unremitting pain, offensive discharge or leg swelling. Call the unit or go to A&E the same day.

• Fertility planning is a separate conversation

  If pregnancy is the goal, treatment order matters. Ultra-long GnRH agonist protocols before IVF have limited but promising evidence and are discussed case by case.