Key facts
- What it treats: heavy, painful periods and pelvic pain caused by adenomyosis — where uterine lining tissue grows into the uterine muscle wall.
- How it works: the same embolisation technique used for fibroids — blocking blood flow to reduce the abnormal tissue and its symptoms.
- Uterus-preserving: an alternative to hysterectomy, which has traditionally been the definitive treatment for adenomyosis.
- Evidence base: growing and generally supportive, though less extensive than the well-established evidence for fibroid embolisation.
Adenomyosis is a condition where the tissue that normally lines the uterus (the endometrium) grows into the muscular wall of the uterus itself. This causes the uterine wall to thicken, and commonly leads to heavy, prolonged, and painful periods, along with chronic pelvic pain. Adenomyosis embolisation offers a uterus-preserving alternative to hysterectomy, using the same embolisation technique developed for uterine fibroids.
How it works
A catheter is guided into the uterine arteries under X-ray guidance, and embolic particles are injected to reduce blood flow to the affected uterine tissue. This reduces the bulk and activity of the adenomyotic tissue, easing the heavy bleeding and pain it causes — without removing the uterus.
What the evidence shows
What's established: uterine artery embolisation for adenomyosis has been used for over two decades, with published case series and cohort studies generally reporting significant improvement in bleeding and pain symptoms in the majority of appropriately selected patients.
What's still developing: compared with uterine fibroid embolisation — which has decades of large-scale, high-quality trial data behind it — the evidence base for adenomyosis embolisation, while growing and generally positive, is smaller in scale. Patient selection and honest expectation-setting matter more here than for the fibroid indication.
Who it suits
- Women with imaging-confirmed adenomyosis causing heavy menstrual bleeding or chronic pelvic pain
- Those wanting to avoid or delay hysterectomy while managing symptoms
- Women who've had an incomplete response to hormonal or medical management
Adenomyosis can coexist with fibroids or endometriosis, so a thorough diagnostic workup — including MRI in many cases — is important to confirm the diagnosis and rule out other contributing factors before proceeding.
Common questions
What is adenomyosis?
Adenomyosis is a condition where the tissue that normally lines the uterus grows into the muscular wall of the uterus, causing heavy, painful periods and an enlarged, tender uterus.
How is adenomyosis embolisation different from UFE?
The technique is similar — both block blood flow through the uterine arteries — but adenomyosis embolisation targets diffusely infiltrated uterine muscle tissue rather than the discrete masses of fibroids, and the evidence base, while growing, is less extensive than for UFE.
Is adenomyosis embolisation as well studied as UFE?
Uterine fibroid embolisation has a larger and longer-standing evidence base. Evidence for adenomyosis embolisation is growing and generally supportive, but is less extensive, and this is discussed honestly as part of the informed decision.
Next step
Living with adenomyosis symptoms?
Ask your GP about a referral, or get in touch directly to discuss suitability.
Get in touch