Having heard from the doctor the diagnosis of "adenomyosis of the uterus", what it is - the patients know not always. The disease is often called internal endometriosis, equating it with a variety of this pathology. However, most doctors even differentiate these diseases, even if there are certain similarities.
Adenomyosis of the uterus - what is this an accessible language?
Before finding out what adenomyosis is in women, it is necessary to consider briefly the structure of the genital organ. The walls of the uterus consist of three layers, the inner one being the endometrium. This layer is often called functional - every month it undergoes cyclic changes. At the end of the menstrual cycle, he is rejected, if there is no pregnancy, and the woman fixes the monthly discharge.
With adenomyosis, there is an increased proliferation of endometrial cells. They multiply rapidly and gradually start to go beyond the mucous membrane. Over time, endometrial cells penetrate the muscle layer and even into neighboring organs. In pathology, the growth of the endometrium is observed not inside the uterus, by thickening it, but outwards - in the direction of the myometrium.
Adenomyosis - Causes
Precisely to name the reason, because of which adenomyosis develops, or as it is called - internal endometriosis, doctors can not. Most experts are inclined to the theory, according to which the disease develops against the background of hormonal changes in the body. Among the mechanisms of the development of the disease, gynecologists distinguish:
- Implant theory - foci of adenomyosis are formed as a result of the dropping of blood through the uterine tubes into the cavity of the peritoneum.
- Metoplasia of coelomic epithelium - foci of the disease are formed from the remains of embryonic tissue that have not undergone regression in the formation of tissues of organs of the reproductive system.
- Induction - the formation of focal adenomyosis under the influence of adverse factors.
In the development of the disease, doctors identify and predisposing factors, the presence of which increases the risk of pathology. Among them are:
- hereditary predisposition to neoplasms;
- late or early onset of menstruation ;
- overweight;
- late onset of sexual activity;
- presence of operations on the reproductive system;
- complications of childbirth;
- use of intrauterine spirals.
What is the danger of internal endometriosis?
Adenomyosis of the uterus body with untimely detection, the absence of therapy can result in negative consequences. Against adenomyosis, there are often:
- acute or chronic anemia (due to abundant periods );
- distribution of foci to adjacent tissues and organs: intestinal obstruction , hemothorax;
- malignization of foci of adenomyosis.
Adenomyosis - forms
Internal endometriosis of the uterus has several morphological forms. Depending on the nature, structure and sprouting allocate:
- Dysfunctional adenomyosis - characterized by a uniform expansion of endometrial cells throughout the surface of the uterine cavity.
- Focal (nodular) - an increase in the number of endometrial cells is noted in several places, foci.
- Mixed form - there are signs of both named species.
There is also a classification of adenomyosis depending on the degree of penetration of cells deep into:
- 1 degree - growths are fixed in the region of the submucosal membrane of the uterus;
- 2 degree - proliferation spread on the muscle layer, but not more than 50% of its thickness;
- 3 degree - more than half of the myometrium is affected;
- 4 degree - endometrial cells leave the muscular layer, involving in the process the adjacent organs.
Focal adenomyosis
Nodular adenomyosis is characterized by penetration into the muscle layer of cells of endometrial origin. When performing ultrasound, physicians detect nodal formations of varying size and localization. Often they can be filled with a liquid of brown color or blood. As they progress, their number increases, and the distance between them decreases significantly.
Diffuse form of adenomyosis
Diffuse adenomyosis is observed when the endometrial cells grow evenly over the surface of the mucosa. In the inner layer, so-called blind pockets are formed, which penetrate the various depths of the inner layers of the uterus, first of the muscle. In this case, there is a predisposition to the formation of fistulas in the abdominal cavity, with the through penetration of endometrial cells into the organs of the small pelvis. Diffuse form can pass into malignant formations.
Mixed form of adenomyosis
Mixed or diffuse-focal form of adenomyosis is characterized by the presence of signs of both stages of pathology. When examining the genital organ with ultrasound, doctors fix combinations of through germination along with foci of adenomyosis. This disease is observed in the absence of proper treatment of focal forms, their late detection by physicians. In the pathological process, other organs of the small pelvis are involved:
- intestines;
- bladder;
- ovaries and fallopian tubes.
Adenomyosis - symptoms
Depending on the degree of adenomyosis, the severity of the symptoms of the disease may change. The most common and characteristic symptom of the disease is the change in the nature and volume of menstrual flow. With adenomyosis, menstruation lasts 7 days or more, while the amount of menstrual blood exceeds 80 ml. Clots are often found in it. In addition, 2-3 days before and how much time later there are brown spotting discharges. In some cases, patients may themselves suspect adenomyosis of the uterus, the symptoms of which are as follows:
- strong painful sensations in the lower abdomen, giving to the pelvic region, not related to the monthly;
- pain during intercourse;
- a decrease in hemoglobin against a background of high blood loss;
- fast fatiguability;
- weakness;
- dizziness.
Pain in adenomyosis
Considering the signs of adenomyosis, it is necessary to separate the characteristic pains in the lower part of the abdomen. With the onset of the disease, they are of low intensity, so many women do not attach importance to them, writing off them on the PMS. Painful sensations will swing 2-3 days before the menstrual period and may last for 3 more days after their termination. The nature of pain and its location are due to the localization of foci of adenomyosis, their number. If the growth of endometrial cells is observed in the region of the isthmus, the pain irradiates into the perineum, if the angle of the uterus is struck - it hurts left or right in the groin.
Echo signs of internal endometriosis
Preliminary diagnosis is made on the basis of the collected anamnesis, after an assessment of the existing symptoms of the disorder. To make an opinion, ultrasound of the pelvic organs is performed. Define adenomyosis on ultrasound can be based on the characteristic features:
- globular shape of the uterus;
- an increase in the size of the body;
- different thickness of the walls of the uterus;
- cystic formations 3 mm and larger in diameter;
- inclusion in the endometrium of an oval or round shape, without a shadow behind;
- high echo density of formations.
With diffuse adenomyosis of the uterus (which is this - described above), the effectiveness of ultrasound is significantly reduced. With this form of pathology, hysteroscopy is the main diagnostic method. This study is aimed at studying the tissue with the help of special video equipment. The sensor is inserted through the vagina and neck directly into the uterine cavity.
Adenomyosis - treatment
Having examined the signs and manifestations of such a disease as adenomyosis of the uterus, what it is for pathology, it is necessary to stop on the features of therapy. Before treating adenomyosis, doctors carry out complex diagnostics aimed at establishing the cause of the disease. The basis of therapeutic measures is hormonal therapy, since the disorder is accompanied by a change in the hormonal background. As drugs, oral contraceptives and estrogens are more often prescribed:
- Janine ;
- Jess;
- Duphaston;
- Norkolut;
- Buserilin.
However, in order to eliminate adenomyosis of the uterus, treatment requires an integrated approach. Among the main areas of therapy, the following should be highlighted:
- nonspecific anti-inflammatory therapy - Ibuprofen, Paracetamol;
- reception of sedatives - Phytoset, Dormiplant;
- use of immunomodulators - Immunal, Immunomax;
- elimination of anemia - Sorbifer;
- maintenance of liver function - Essentiale;
- physiotherapy - electrocoagulation, embolization, ablation.
Adenomyosis of the uterus (which is this - indicated above) is often treated surgically. In this case, the need for surgical intervention is determined by the doctor. How to treat adenomyosis of the uterus in a specific situation - the doctor determines. Indications for the operation are:
- diffuse adenomyosis of 3-4 degrees;
- Nodal or mixed forms in the absence of the effect of hormonal treatment;
- severe pain syndrome;
- a combination with other pathological conditions of the uterus (myoma, pathology of the neck), an ovarian tumor.
Separately, we need to talk about the treatment of adenomyosis with folk remedies. There are many methods that facilitate the course of the disease. However, they can only be used after consultation with the doctor.
Herbal Remedies
Ingredients:
- shepherd's bag - 1 teaspoon;
- roots aira - 1 teaspoon;
- coil - 1 teaspoon;
- cotton spoon - 1 teaspoon;
- leaves of nettle - 1 teaspoon;
- sporish - 1 teaspoon;
- water - 1 liter.
Preparation, application
- Herbs are mixed, poured with boiling water.
- Insist 2 hours.
- Filter and take 0.5 cup 3 times a day. The duration of the course is 1 month.
Adenomyosis and pregnancy
Problems with conception are often observed with gynecological diseases. Having learned about internal endometriosis, whether it is possible to become pregnant, whether the disease is reflected in the reproductive function - every woman is interested. Adenomyosis is often accompanied by a violation of the cycle, so pregnancy on its background may not occur. However, the disease is not a 100% barrier to conception. Western experts argue that adenomyosis prevents pregnancy only if there are other pathologies.