There are many ways to treat adenomyosis, which can be described as “charming”, and in detail, a book can be published, but what specific treatment method to choose is good? It also needs to be determined by the individual patient’s situation. Generally speaking, adenomyosis patients’ age, symptoms, fertility requirements and other factors have a significant impact on the choice of treatment. Here, I will roughly introduce a few of the more common methods, which are also frequently encountered by adenomyosis patients in the clinic. Medication: If adenomyosis patients were to play a game of drug name relay, it is estimated that this game could be played for a long time. In fact, whether it’s birth control pills, painkillers, hemostatic drugs and other kinds of drugs, your doctor should tell you clearly when he prescribes them to you: these can temporarily relieve painful symptoms, but do not achieve the purpose of treatment. The Mannorrhea Ring: The Mannorrhea Ring is a contraceptive ring, which is actually the same as the pill when it comes to adenomyosis. Some of the patients I see with adenomyosis have also used the Mannorrhea ring, and some even had the ring in place when they had their adenomyosis conserving U surgery, and then it was only removed during the surgery. How effective is Mannorrhea? It is effective for some patients. The only way to know if the Mannorrhea ring is effective for the patients themselves is to try it. In terms of the adenomyosis patients I see on a daily basis, a small percentage of adenomyosis patients have experienced relief of dysmenorrhea and excessive menstruation with the use of Mannorrhea, but the number of people for whom it does not work is very large, as Mannorrhea was not originally developed to deal with adenomyosis. In addition, patients with a large uterus are not suitable for the use of Mannorrhea, and the ring will easily fall off. As for the symptoms of incomplete menstruation, fatness and discoloration after the IUD, patients should not be too panic, because they are not caused by other diseases, but are basically the side effects of Manuel. For Manuelle, if adenomyosis patients have the intention to use it, they can also try it. The adaptation period of Manuelle is usually within six months, if it is more than six months, the side effects of wearing the ring are still very high, then it is not suitable to continue using it. The Hefei knife: Speaking of the Hefei knife, it is somewhat similar to the “origin” of the Manuel ring, both of which are somewhat coincidental in the treatment of adenomyosis. It is because initially, the Manuel was for contraception, while the Helio knife was for tumors, and later they were “created” to treat adenomyosis. The working principle of Helioplasty is just like using a convex lens to focus sunlight to produce a high temperature focus, Helioplasty is to focus ultrasonic waves to produce instant high temperature, which causes coagulative necrosis of the lesion tissue and destroys the tissue in the treatment area. However, the damaged tissues will not disappear directly, it will be gradually absorbed by the body or become scar. However, it has obvious limitations in the treatment of adenomyosis. If the focus area of the knife is too large, the surrounding tissues, such as the bladder and intestines, may be injured. Of course, this is not to deny the usefulness of the Helio knife in the treatment of adenomyosis. For example, if a patient with adenomyosis wants to have a baby, he or she can try to get rid of some of the larger adenomyosis lesions first, thus creating some favorable conditions for pregnancy. Frankly speaking, among the adenomyosis patients that I see on a daily basis, there are some who have undergone the Helio knife and their condition has improved significantly or even completely cured, which is a fact and cannot be denied. It’s just that relatively speaking, there are more patients who have had a recurrence and a second surgery after having done the HEF to. More patients are those who have had the HEF to and then the adenomyosis is significantly relieved for a while or even disappears, but after a period of time, the condition recurs and the pain returns, and they need to continue the treatment. Therefore, it is not that adenomyosis patients with related needs cannot try HEFL treatment, they just have to be prepared for the corresponding psychological expectations. Laparoscopy alone: If there is a place for laparoscopy for limited adenomyosis, then for diffuse adenomyosis, laparoscopy alone is not enough. The reality is that most adenomyosis is diffuse, so this is embarrassing. The spread of focal tissue in adenomyosis is very extensive and irregular, especially for extrinsic endometriosis, where some foci can be ectopic to the rectum, fallopian tubes, bladder, cervix, etc. Especially in the cervix, laparoscopic surgery can be very difficult to handle because of the many blood vessels and complex anatomy. Laparoscopy can be done for uterine fibroids, adenomyosis is not suitable. Uterus-conserving surgery: Uterus-conserving surgery, also known as adenomyosis U-shaped lesion excavation, is simply a surgical treatment for patients with adenomyosis that preserves the uterus and removes the pain of adenomyosis. After the operation, the uterus and cavity return to normal size, the patient can have menstruation, most of the menstrual flow is reduced, anemia is corrected, pain is relieved, and some patients can prepare for pregnancy and childbirth two years after the operation. However, this is an open surgery, which will more or less cause some damage to the uterus, so patients with adenomyosis who have fertility requirements are advised to try to get pregnant and have children first, and then consider surgery afterwards. Uterine artery embolization: This is a minimally invasive intervention that I call “starving adenomyosis”. Uterine artery embolization (UAE) has been used clinically for more than 20 years, originally for the treatment of acute uterine bleeding and later for the treatment of uterine fibroids. Currently the procedure is used to treat acute gynecologic and obstetric bleeding, gynecologic tumors and vascular malformations, and is also used to treat adenomyosis. The uterus is one of the most vascular tissues in the body for women, and it also has a relatively well-developed vascular network. Therefore, if the uterine arteries of adenomyosis patients are blocked, the uterus will not receive normal nutrients and the adenomyosis lesions will be “starved to death”. Uterine artery embolization for adenomyosis has many advantages, for example, it does not affect the endocrine and menstrual cycles of women, and it can be performed without damaging the normal tissues and organs of the uterus. In addition, it is minimally invasive and non-invasive, and you can be discharged from the hospital in 1-2 days after the operation. However, there is no doubt that this treatment is not perfect, and there are several points that need to be taken as a precautionary measure for patients: 1. The effectiveness of uterine artery embolization is highly dependent on the level of personal experience of the physician, and some doctors may even confess that the symptoms related to adenomyosis will be significantly reduced within 2-3 years, but the recurrence rate may be as high as 50% after 5 years. 2.Uterine artery embolization can significantly relieve the dysmenorrhea caused by adenomyosis, but the effect of obtaining complete disappearance of dysmenorrhea is very small. 3.Uterine artery embolization can contribute to the shrinkage of adenomyosis lesions to varying degrees, but the effect varies from person to person. 4.Uterine artery embolization has certain complications, and patients with fertility needs should consider carefully. In summary, if the symptoms of adenomyosis are severe and painful, you can consider using this method to temporarily relieve the pain and alleviate the torture and suffering according to your situation and doctor’s advice. Hysterectomy: In severe cases of adenomyosis, hysterectomy is a routine medical recommendation for patients. A hysterectomy can remove the lesion, treat the pain and improve the patient’s quality of life. However, when I hear the suggestion of hysterectomy, I believe that every female patient, at heart, has a hard time accepting it. This is why many of the adenomyosis patients I have seen in the past few years have had the disease for 5, 10, or 15 years, and many of them have received such advice from their local hospitals more than once, but they have chosen to suffer through the pain, not wanting their bodies to be without this unique organ of women. The most important thing is that “cutting the uterus” is unacceptable to a woman’s heart. Adenomyosis is a “benign tumor” among gynecological diseases, so patients are reluctant to have their uterus cut as a last resort.