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CASE REPORT article

Front. Med.

Sec. Obstetrics and Gynecology

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1708029

Endometrial Ablation as a Safe Treatment for Adenomyosis-Related Abnormal Uterine Bleeding in Women with Cerebral Infarction: A Case Report

Provisionally accepted
Limei  ZhengLimei Zheng1Hong  ZhangHong Zhang2Wei  FangWei Fang3Jianhua  YangJianhua Yang1*
  • 1Department of Obstetrics and Gynecology in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, China
  • 2Putuo Hospital, Zhoushan, China
  • 3Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China

The final, formatted version of the article will be published soon.

Background: Adenomyosis is often associated with abnormal uterine bleeding (AUB), which can lead to anemia. Recurrent bleeding, especially in the presence of cerebral infarction risk, may exacerbate the likelihood of cerebral infarction through a hypercoagulable state. Although the relationship between adenomyosis and ischemic stroke is less frequently explored, controlling AUB and maintaining antithrombotic therapy remain clinical challenges. This report presents the application of endometrial ablation in a patient with adenomyosis, AUB, and cerebral infarction. Methods: We report a case of a 50-year-old female patient who developed acute ischemic stroke due to adenomyosis-related AUB. During the acute phase, the patient underwent endometrial ablation, successfully controlling the bleeding while continuing antiplatelet therapy. Results: After endometrial ablation, the patient's abnormal uterine bleeding was effectively controlled, with no recurrence of cerebral infarction. At a 37-month follow-up, the patient had no further vaginal bleeding or recurrence of cerebral infarction. Conclusion: This case is the first to report the use of endometrial ablation in a patient with adenomyosis and cerebral infarction, demonstrating the potential of this procedure in emergency hemostasis and maintaining antithrombotic therapy. Endometrial ablation is an effective, minimally invasive treatment with a quick recovery, making it a viable option for patients who cannot tolerate major surgery.

Keywords: Adenomyosis, Cerebral Infarction, Abnormal uterine bleeding, Hysteroscopicendometrium ablation, case report

Received: 18 Sep 2025; Accepted: 20 Oct 2025.

Copyright: © 2025 Zheng, Zhang, Fang and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jianhua Yang, yjh2006@zju.edu.cn

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