Can I wait for menopause with adenomyosis at 38?

Question

Hello doctor,

I am 38 years old and was recently diagnosed with adenomyosis. I also have diabetes, varicose veins, irregular cycles, and very painful, heavy periods. My weight is low, around 94.8 pounds. In the past, I sometimes had left-sided pelvic pain, but I am not experiencing that currently.

My periods tend to be prolonged and heavy when they occur, and I occasionally feel vaginal discomfort. Recently, my cycle has also been irregular.

I want to know

What treatment options would be most suitable in my case, considering my age and existing health conditions?
Is it reasonable to wait for menopause, or should I consider starting medical treatment or even surgery now?
Are there lifestyle changes or non-hormonal approaches that may help reduce symptoms and pain?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

At 38, with adenomyosis along with diabetes, varicose veins, and a low body weight, your treatment really needs an individualized and cautious approach. The goal is to ease your heavy, painful periods while also keeping your overall health risks in mind.

Because you are still having heavy bleeding and irregular cycles, the first step is usually medical (non-surgical) treatment. Hormonal options, such as a progestin-releasing IUD (intrauterine device) like Mirena (Levonorgestrel-releasing intrauterine system) or certain oral progesterone-based medicines, can significantly reduce bleeding and pain in many women with adenomyosis.

However, in your case, these choices may need careful discussion. Diabetes and varicose veins can increase the risk of vascular complications, so estrogen-containing pills are generally avoided, and even progesterone options should be selected thoughtfully.

If hormones are not suitable or preferred in your case, then non-hormonal medicines like Tranexamic acid (taken only during periods) may help you reduce heavy bleeding. Pain relievers such as anti-inflammatory medications may also help during painful days.

And surgery, including hysterectomy, which is a surgical procedure that removes your uterus, is usually considered only when:

When the symptoms are severe and affect the quality of life.
If there is ongoing anemia from heavy bleeding.
Other treatments have failed.
You are sure you do not want a future pregnancy.

Also, if you are waiting for menopause, it can be reasonable if symptoms are tolerable, since adenomyosis often improves afterward. However, natural menopause may still be several years away at 38, so symptom control during this time is important.

Lifestyle steps will not cure adenomyosis (tissue from the lining of your uterus grows into your uterine wall), but they may help you reduce discomfort by:

Doing gentle regular exercise (such as walking, stretching, or yoga).
Applying heat during the painful days.
Getting an anti-inflammatory diet.
Ensuring adequate iron if bleeding is heavy.
Taking magnesium or omega-3 supplements (after discussing with your doctor).

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.