Adenomyosis is the invasion of endometrial glands and mesenchyme into the myometrium to form a diffuse or limited lesion, which belongs to a kind of endometriosis. Adenomyosis is a common and challenging disease in gynecology.

The clinical manifestations of adenomyosis are mainly: excessive menstrual flow, prolonged menstrual period, infertility, and pain that progressively worsens from year to year. Patients usually have no obvious pain, and most have obvious dysmenorrhea at the onset of menstruation.

Some patients think that they are approaching menopause and that adenomyosis is only painful when there is menstruation, so when they are menopausal, there will be no menstrual pain. They think they have to live with the pain until menopause, is that right?

In fact, two scenarios occur when a patient with adenomyosis goes through menopause. One is that the patient's symptoms of dysmenorrhea disappear with the onset of menopause; the other is that the patient's lower abdominal pain remains even after menopause.

First of all, in general, most patients with adenomyosis, their symptoms will disappear with menopause. If there is no menstruation, no bleeding, and the lesions slowly shrink and disappear, the patient will not experience pain. Most of these patients have mild pain and relatively small lesions.

Postmenopausal adenomyosis in this group of patients does not affect their normal life, but they must go to the hospital for regular review so as not to cause other lesions. It is recommended that patients should subsequently avoid estrogen-rich foods or estrogen-rich health care.

In contrast, those patients whose pain persists after menopause suffer from symptoms that have not disappeared for two reasons.

One reason for this is that the patient has a large uterus. What is the basis for uterine size? A large uterus is a uterus that is under 8 centimeters. The normal size of the uterus in a normal person is about 5 centimeters, and a uterus that is more than 8 centimeters is considered a large uterus. In some cases, the uterus is more than 10 centimeters, and even after menopause, it is difficult for the uterus to shrink to less than 8 centimeters. A too-large uterus is unsafe and may produce other changes.

The second reason is that there are more foci in the uterus, and the extrusion causes the uterine body to be larger than that of a normal woman. Even if the patient does not have menstruation, more foci still exist in the body and are difficult to disappear, tormenting the patient and making her pain unbearable.

Therefore, patients with adenomyosis who are approaching menopause and have either of these conditions are advised to take aggressive treatment to resolve the disorder.

Treatments may include TCM modification and surgery.

According to traditional Chinese medicine, adenomyosis is an endocrine disorder that leads to poor functioning of Qi and blood. The treatment should start with tonifying the liver and kidney, regulating qi and blood, promoting blood circulation and removing blood stasis, clearing away heat and detoxifying, and comprehensively regulating endocrine.

Traditional Chinese medicine Fuyan pill has the effect of clearing away heat and detoxifying, promoting blood circulation and removing blood stasis, strengthening the spleen, and removing dampness. It can effectively regulate qi and blood, eliminate tissue lesions, regulate menstruation, and eliminate pain.

Surgery can be chosen for women with severe symptoms, poor medication effects, and no fertility requirements. Surgery includes conservative surgery to remove only the lesion and hysterectomy, each with advantages and disadvantages.

In conclusion, for patients with adenomyosis approaching menopause, whether treatment is needed depends on the patient's condition. 

It is recommended that patients with symptoms must receive standardized diagnosis and treatment, timely detect the cause of the disease, and actively be treated, which are beneficial to their health.

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