I now have 3 blogs that are almost finished, but I'm starting another new one. Why? Because this topic is overwhelming me, so I want to write about it now.
I need another surgery for endometriosis. I am scheduled for an endo-specific MRI in 3 weeks, and then I'll schedule the surgery after that. My last surgery was in 2018. Now in 2026 my surgery will be more advanced. I learned a few things to share here:
1. The last time I had surgery, I had an ultrasound first. That ultrasound did show possible adenomyosis, but my doctor never talked to me about it. It's likely she wasn't trained in it. My new doctor told me about it after reading the notes. I also learned that my ovary was tied to my fallopian tube with endo adhesive, and it's possible that they are stuck together again. So I had another ultrasound a few weeks ago, and it still shows probable adenomyosis. I was becoming suspicious of adenomyosis on my own because 1-3 times per year I do tend to bleed heavily for more than a week during ovulation. Last month I bleed through 2 periods and two ovulations before it finally stopped.
My ultrasound also showed free fluid in a place where I had endo removed before, so it's probably endo. It also showed that my right ovary is 3x larger than my left, and the cyst that was previously removed must have grown back. My last surgeon warned me that she couldn't remove all of the endo on my ovary without removing the ovary, and when endo isn't fully removed, it grows back.
2. My doctor suggested this new type of MRI that's specific for finding endometriosis. It can't see it all, but it should help locate some of it before she does surgery. She said this helps her prepare, and possibly schedule a second doctor to help if the MRI shows it on my colon. Regular MRIs cannot see endometriosis, but this new version might. It might also help diagnose what type of adenomyosis I have, which could help me choose treatment plans.
3. After the MRI I'll have surgery, but I hope to delay it if possible. I'm going to attend a wedding and work my job for a couple of weeks because it's a busy time of year at work. Then I'll do the surgery, and I'm expecting I'll need at least 3 weeks of recovery time, maybe more. If they find something very urgent that needs to be surgically handled, then I suppose I can't wait. My pain really has increased too much and I know something is wrong, so we'll see what they find. But I have to wait weeks for the MRI anyway.
My new doctor is much more advanced in endo surgery than my last (I'm not saying my last doctor was bad - she did as good of a job as possible in that situation), and she told me that if I choose to travel to one of the best surgeons that she will help refer me and get me in. I'm torn on this one, because she may be capable of doing a really good job for me and she's right here in town. I really don't want to have to travel. She was trained at Mayo and is using the latest techniques, and she gets all the continuing education available. She isn't an endo-specific surgeon, but she is much more focused on endo and more highly trained than the average gynecologist. The surgeon we choose is extremely important, because if the surgeon isn't capable of removing ALL of the endo, the endo will come back and we'll need more surgeries. That's what happened to me, and it's normal. The best surgeons reduce the risk of needing multiple surgeries.
This doctor, if I choose her (and I probably will, depending on the MRI results,) will do a different surgical method than my previous surgery called a Peritonectomy, or Peritoneal Stripping. I understand that the recovery period is longer. In this version, she will remove the top layer of my internal skin. That will help remove the roots of the endo that might be invisible to our eyes and cameras. The tissue will regenerate, but I understand it's going to be a slow and painful process.
I can't find a good website to explain the peritonectomy surgery, just various studies about it which are not in lay-people terms. I did find this video that briefly explains why it should be done:
4. Treating the adenomyosis? This is what I'm really unsure about, especially since I've been trying to treat it naturally for so many years, and because of where I live I've lost access to treatments that were helping (like acupuncture!) I have 2 medical options: remove the uterus, or insert a progestin-only IUD like Mirena. I'm not willing to remove my uterus unless it's trying to kill me, and it's not that bad right now. I'm really uncomfortable with the idea of the IUD, but I understand it. I already use bioidentical progesterone, but it can't make it into the uterus where it's needed to treat the adenomyosis. An IUD is used because it can release Progestin inside the uterus where it can do its job. Natural progesterone can't be used because the half-life is too short. I would need to replace the IUD very frequently, which is unsustainable and very painful. Synthetic Progestin has a much longer half-life, so it makes the IUD sustainable.
But am I willing to use Progestin? I really don't want to because I'm too familiar with the side effects, and I tend to be extra sensitive. I don't know for sure, but I think I prefer the heavy bleeding and pain over the change of personality from the Progestin. I don't like the increased risk of ovarian cysts from it too. I don't like how it changes our sense of smell and cause weight gain too. I'm not a fan of the risks.
I have read that there are newer treatments for specific types of adeno, such as a new type of ultrasound machine that can help shed it off. I don't know what type mine is, and I don't know if anyone locally offers that treatment. I need the MRI results first.
What can I do naturally? Well, maybe I need to stop eating goat cheese and be totally dairy-free again. Maybe I need to increase my fiber. Maybe I need to go totally carnivore. Maybe I need to reduce my sugar intake to zero again. Maybe I need glutathione IVs again. Maybe I need to drink more red raspberry leaf and hibiscus, except that my blood pressure already runs low. Maybe I need to do daily castor oil packs. Maybe I need to go back on my previous herbal blend pills. Maybe I need to travel for an acupuncturist who knows what they're doing. The thing is, I've done all this since 2013. I was able to improve about 50% at best (which is really good!) If I've slipped into some bad habits and that's why my symptoms are increasing, then I can fix that. But the fact is, I was never able to fully manage naturally. And I was working with excellent natural doctors.
So, I'm undecided on what to do about the adenomyosis. My head is too tired, and I think I'd prefer to get the MRI results first anyway.
There's more and more research about endo coming out - such as the estrogen and histamine link, the mast cell link, the new saliva biomarker, and so on. Maybe adeno will be similar and we'll find ways to help manage it soon.










