Women's Health · Adenomyosis

Relief from adenomyosis while keeping your uterus

Uterine artery embolization (UAE) treats the heavy, painful periods caused by adenomyosis by reducing blood flow to the affected muscle of the uterus. It is done through a pinhole in an artery, with no incision and no general anesthesia, and you go home the same day.

Call to book: 737-241-2184 How it works
Understanding the condition

What is adenomyosis, and how does embolization help?

In adenomyosis, tissue that normally lines the inside of the uterus grows into the muscular wall of the uterus. Each month this tissue swells and bleeds, which can enlarge the uterus and cause heavy, painful periods and pelvic pain.

Adenomyosis can affect the whole uterine wall or form a localized lump (an adenomyoma), and it often occurs together with fibroids. Unlike a fibroid, it cannot simply be cut out, which is why hysterectomy has traditionally been the definitive treatment.

In UAE, tiny particles are placed into the uterine arteries to reduce blood flow to the affected muscle. Over the following months, the uterus shrinks and bleeding and pain ease, while the uterus is preserved.1,4

Diagram of an enlarged uterus with a thickened, adenomyosis-affected wall fed by the uterine arteries, and the same uterus after embolization with a thinner wall Adenomyosis Thickened, enlarged uterine wall uterine arteries After embolization Uterus shrinks, symptoms ease blood flow to affected muscle reduced
Simplified illustration. Embolization reduces blood flow to the muscle affected by adenomyosis, which then shrinks while the uterus is preserved.
Is embolization right for me?

Who is a good candidate?

UAE is often a good fit if you:

  • Have adenomyosis that causes heavy bleeding or pain despite medication or a hormonal IUD.1
  • Want to keep your uterus or avoid a hysterectomy.2
  • Have both adenomyosis and fibroids, since UAE treats both at the same time.1,3
  • Still have symptoms after endometrial ablation.5
  • Prefer a shorter recovery than surgery, or want to avoid general anesthesia.

UAE is not done during pregnancy, and the data on pregnancy after UAE are limited. If you hope to become pregnant in the future, we will discuss your options carefully with you and your gynecologist.

Evaluation

How we decide whether embolization is right for you

We work with your gynecologist to confirm that adenomyosis is the cause of your symptoms and that UAE is a safe choice for you.

1

Consultation

We review your symptoms, periods, medical history and plans for future pregnancy, and explain all of your treatment options.

2

Pelvic MRI

MRI confirms adenomyosis, shows how much of the uterine wall is affected, and checks for fibroids. The thickness of the affected layer can help predict how well UAE will work.3

3

Gynecology check

An up-to-date gynecologic exam and Pap test and, when needed, a sample of the uterine lining make sure nothing else is causing the bleeding.

Treatment

How embolization compares with other options

The right treatment depends on your symptoms, your plans for the future and what matters most to you.

OptionHow it worksThings to know
Medication & hormonal IUD Hormonal and non-hormonal treatments reduce bleeding and pain Helps many women; symptoms often return when treatment stops
Endometrial ablation The lining of the uterus is destroyed to reduce bleeding Treats the lining only, so it may not help when adenomyosis is deep in the muscle5
Hysterectomy The uterus is surgically removed The only permanent cure, but major surgery with no future pregnancy2
Uterine artery embolization Blood flow to the affected muscle is reduced through a pinhole in an artery No incision, uterus kept, same-day discharge; some women later need further treatment1,3
The procedure

What happens during embolization for adenomyosis

The procedure typically takes about an hour. You are awake but relaxed, and we focus closely on keeping you comfortable during and after the procedure.

  1. Preparation

    You receive light sedation, pain medication and local anesthetic at the access site. No general anesthesia is needed.

  2. A pinhole in the wrist or groin

    A thin tube (catheter) is placed into an artery in your wrist or upper thigh through a tiny puncture. No incision is made.

  3. Mapping the arteries

    Using X-ray guidance and contrast dye, a microcatheter is steered into the uterine artery on each side.

  4. Embolization

    Tiny particles are slowly injected to reduce blood flow to the affected muscle. This is repeated on the other side.

  5. Recovery

    The catheter is removed and a small dressing applied. You rest for about 60 minutes while your pain is controlled, then go home the same day with medication and clear instructions.

What the research shows

Results

UAE for adenomyosis has been studied in more than 1,000 women, and has been compared with hysterectomy in a Dutch multicenter study.1,2

83%

Women whose symptoms improved after UAE, in a meta-analysis of 1,049 patients. Uterine volume decreased in all patients by 3 months.1

82%

Women who kept their uterus at an average of more than 5 years after UAE in a long-term follow-up study. Most of them no longer had symptoms.3

80–88%

Women with less heavy bleeding after UAE in recent studies, and 76–80% with less period pain.4

In the Dutch QUESTA study, quality of life improved after both UAE and hysterectomy. Pain improved more after hysterectomy, satisfaction was 73% after UAE versus 95% after hysterectomy, and the study could not show that UAE was as good as hysterectomy. The authors describe UAE as a valid, less invasive alternative for women who want to keep their uterus, and hysterectomy as the choice for those who want a definitive solution.2 Long-term results are somewhat better when adenomyosis occurs together with fibroids than for adenomyosis alone.1 Individual results vary, and no treatment can guarantee success.

Safety

Risks and side effects

We discuss all risks with you in detail beforehand:4

  • Cramping and pelvic pain, strongest in the first day or two, along with nausea, tiredness or low-grade fever for several days. This is expected and managed with medication.
  • Vaginal discharge for a few weeks, and occasionally the passage of treated tissue
  • Infection of the uterus, which is uncommon and usually treated with antibiotics
  • Rarely, scarring inside the uterus
  • Earlier menopause, a risk that is higher in women in their mid-40s and older
  • Bruising or tenderness at the wrist or groin puncture site
  • Symptoms continuing or returning, which may need repeat treatment or hysterectomy
Questions

Frequently asked questions

Is the procedure painful?

The procedure itself is done under sedation and local anesthesia. Cramping afterward is common, especially in the first 24 to 48 hours, and we give you medication to manage it.

How soon can I go back to work?

Most women return to normal activities within one to two weeks, much sooner than after a hysterectomy.

How soon will my symptoms improve?

Many women notice lighter, less painful periods within the first few cycles, with further improvement over several months as the uterus shrinks.

Can I get pregnant after embolization?

The data on pregnancy after UAE are limited. If future pregnancy is important to you, we will discuss your options carefully with you and your gynecologist before treatment.

What if I have fibroids too?

Adenomyosis and fibroids often occur together. UAE treats both in the same procedure. Learn more about uterine fibroid embolization.

Is it covered by insurance?

Coverage varies by policy. We will navigate out-of-pocket costs with you. Call us at 737-241-2184 with questions.

Find out whether embolization is right for you

If adenomyosis is causing heavy or painful periods and you want to keep your uterus, an evaluation can show whether uterine artery embolization is a good option.

Call 737-241-2184 to schedule

References

  1. de Bruijn AM, Smink M, Lohle PNM, et al. Uterine artery embolization for the treatment of adenomyosis: a systematic review and meta-analysis. J Vasc Interv Radiol. 2017;28(12). doi:10.1016/j.jvir.2017.07.034
  2. Trommelen LM, Semmler A, de Bruijn AM, et al. Quality of life 1 year after uterine artery embolization vs hysterectomy for symptomatic adenomyosis (QUESTA study). Acta Obstet Gynecol Scand. 2025;104(8):1558–1574. doi:10.1111/aogs.15165
  3. Smeets AJ, Nijenhuis RJ, Boekkooi PF, et al. Long-term follow-up of uterine artery embolization for symptomatic adenomyosis. Cardiovasc Intervent Radiol. 2012;35:815–819. doi:10.1007/s00270-011-0203-1
  4. Knapman BL, Abbott J, Vyas MA. The advantages and disadvantages of uterine artery embolization in women with adenomyosis: what's new? Curr Obstet Gynecol Rep. 2021;10(4):92–100. doi:10.1007/s13669-021-00309-0
  5. Liang E, Parvez R, Ng S, et al. Uterine artery embolisation for adenomyosis in women who failed prior endometrial ablation. CVIR Endovasc. 2024;7:59. doi:10.1186/s42155-024-00471-5

This page provides general information and does not replace a personal medical consultation. Study results describe groups of patients and cannot predict the outcome for an individual. Urology Austin and IR Centers · 8701 N. Mopac, Suite 100, Austin, Texas 78759 · 737-241-2184