The uterine cavity is covered with a mucous membrane, it is also called the endometrium. During the menstrual cycle, it grows, and is preparing to take a fertilized egg. If pregnancy does not happen, then its upper layer departs, and this is all accompanied by bleeding. But the endometrium remains in the uterus, from which a new layer will grow next month.
Endometrium is separate from the muscles of the uterus, they are separated by a special thin tissue. With adenomyosis, the disorder occurs in such a way that the endometrium sprouts into the tissue that separates the endometrium and muscles, and grows into the muscle tissue. The implantation goes in parts, not all along the wall. The uterus reacts, increases, and becomes spherical.
- 1 Adenomyosis Forms
- 1 Adenomyosis Forms
- 3 Symptoms of Ademomyosis
- 4 Diagnosis of Adenomyosis
- 5 Treatment of Adenomyosis
- 6 Infertility and Adenomyosis
If the form is focal, this means that the ingrown endometrium formed clusters in the muscle tissue. If the implantation occurred without foci, then the form is called diffuse. Two forms can be combined simultaneously: nodal and diffuse.
The nodular form is when the endometrium, which has already implanted into the uterus, forms nodes that are similar to the uterine myoma. These nodes contain a large amount of glandular component together with a connective tissue.
These two diseases are very difficult to distinguish with ultrasound. Moreover, there is such a possibility that the endometrium can enter the existing myomatous nodes. It is very important to put the right diagnosis, because the treatment is not much different, but nevertheless the effectiveness will be different.
The cause of adenominosis
It can not be determined exactly. Perhaps these are all those factors that serve as a breach of protection between the muscle layer and the endometrium. And this is: operations on the uterus, inflammation of the uterus, childbirth, cesarean section, removal of myoma nodes, dissection of the uterine cavity, abortion and curettage.
Although there are cases when adenomyosis was in women who did not tolerate the above operations, and in young girls who have just started menstruating. Then the reasons can be such: first, the disturbances are still in prenatal development, and secondly, the reason may be that when the cervical canal opens during the menstrual period, the intrauterine pressure increases and it can put strain on the endometrium and render traumaticimpact. Thus, the endometrium will be introduced into the uterine walls.
Symptoms of ademomyosis
Most often it occurs without any symptoms. So can be very painful, strong and long menstruation. There may be clots, clots, brown discharge, pain during intercourse. With adenomyosis, the pain is usually strong, spastic, cutting. The usual painkillers do not relieve this pain, but with age, the pain increases more and more.
Diagnosis of adenomyosis
It is determined by ultrasound. The enlarged uterus, the heterogeneous structure of the myometrium, the boundary between the myometrium and the endometrium is not visible, there may be foci in the myometrium. It may be that one wall is noticeably thicker than the other, this can be read in the diagnosis of almost everyone. The most important conclusion that will tell about this disease is the "round uterus".You can also perform hysteroscopy. In this case, you can see the "moves", that is, the red dots, they show that the endometrium has implanted into the wall of the uterus. Less often, but still use and MRI.This is necessary to confirm the diagnosis and choose a method of treatment.
Adenomyosis is a fairly common disease, it can worsen and develop faster after menopause. And the symptoms of the disease may never manifest themselves. If there are no favorable conditions for the disease, such as scraping or abortion, adenomyosis may not progress. For most women, it is formed as a background and does not need treatment, only in prevention. As a serious underlying problem, adenomyosis is less common, but in this case it must be carefully treated.
Treatment of adenomyosis
Completely cure the disease is impossible. One option, but not suitable for all - removal of the uterus. After menopause - the disease progresses. Before menopause, you can achieve a regressive state, and stop development.
Treatment is the same as with uterine myoma. Use medicines GnRH agonists( lucrin, zoladex, buserelin-depot), they create a state of menopause, which removes all symptoms of the disease and leads to regression. To save the result, that is, the option of establishing a spiral, or the use of hormonal contraceptives, because menstrual function can not be restored. You can embolize the fallopian tubes. Although there are different versions about the effectiveness of this method.
They also resort to surgical methods, remove adenominosis tissue while maintaining the uterus, or completely amputate the uterus. Surgical intervention is treated very rarely, in extreme cases, if nothing is already helping. Having established a spiral, menstruation can stop, and with them pain. Hormonal contraceptives provide a stopping of the disease only in the early stages.
Infertility and adenomyosis
Many authors believe that there is no connection with infertility. That is, you can safely become pregnant. But it can be strongly influenced by the fertility of a woman.
In conclusion, we can say that:
- adenominosis occurs in 60-70 percent of cases among women;
- increases the size of the uterus;
- diagnosis is performed at the age of after 30 years;
- to development are different operations with the uterus: inflammatory processes, operations on the uterus, childbirth, cesarean section, abortions, scraping;
- usually the disease proceeds asymptomatically;
- menstruation painful, frequent, with clots, abundant;
- sharp pain during intercourse;
- diagnosis is performed with ultrasound and hysteroscopy;
- often manifests itself with uterine myoma, it is difficult to distinguish from the myomatous node;
- treatment is performed by medication and by using a spiral fitting, creating menopause;
- can sometimes be used to embolize the fallopian tubes;
- does not result in infertility.