Adenomyosis or internal endometriosis is a gynecological disease, most often diagnosed in women after 35-40 years. It is characterized by the ingrowth of the uterine mucosa into its muscular layer. In this case, the work of the female organs is disrupted, immunity is reduced, the patient may experience severe, prolonged pain. The fact that this is uterine adenomyosis became known not very long ago, the disease has not yet been fully studied and effective ways have not been found to completely get rid of the pathology and prevent development.
Definition
The uterine mucosa or endometrium covers the uterine cavity and tends to increase in volume during menstruation, and later envelops the fertilized egg. During normal operation of the organ, the membrane remains in the uterine recess, but in case of damage, weakened immunity or other provoking factors, the mucousthe membrane begins to penetrate into the inner layers of the uterus.
In more complex cases, the endometrium can even penetrate into neighboring organs and this is very similar to a malignant tumor. This problem is often detected during the examination for infertility. The exact reasons why there are failures in the growth of the endometrium are not fully known.
Types of adenomyosis
According to statistics, adenomyosis most often occurs in women after 40 years of age, when the body is undergoing serious hormonal changes associated with the onset of menopause. Internal endometriosis is divided into three types:
- nodular - with this form, the tissues of the uterine mucosa enter the muscle layer and contribute to the formation of nodes of various sizes, which during the menstrual cycle are filled with blood or brown liquid;
- diffuse adenomyosis - characterized by the formation of blind pockets in the tissues, penetrating into neighboring tissues and even organs, fistula formation in the pelvic cavity is often observed here;
- mixed - this form is distinguished by the combination of all the above features.
Today, the medical communities are trying to educate more people about what adenomyosis in women is. Photos and descriptions of the signs of the disease can be found in the corridors of women's departments and clinics.
Risks of disease progression
There is a classification of the levels of immersion of endometrial cells in the uterine tissue, that is, the stage of development of the disease. It is applicable only in the diffuse form of the disease:
- I degree –here the cells begin to grow so far only in one area of the uterus;
- II degree - endometrial cells penetrate deeper into the uterus, spread to almost half of the muscle tissue;
- III degree - more than half of the cells are immersed in the muscles of the uterus;
- IV degree - the most dangerous, cells grow outside the uterus and can affect other organs of the small pelvis.
Neglected cases can lead to serious deviations in the work of not only female functions, but the whole organism, up to the development of oncology.
How does the disease progress?
Not many patients know what adenomyosis in women is and what causes it. Meanwhile, the problem is very serious and covers more than 40% of women after 40 years. The resulting tumor is considered benign, since when the tissues of the mucous membrane “relocate” to other organs, up to the bladder, no genetic changes occur in the cells. In the later stages of the development of the disease, endometriosis tissues actively spread throughout the body and gradually deplete it. The process can take years or even decades. In rare cases, adenomyosis may qualify as a malignancy.
Drug treatment is not always effective, and even with a positive trend, the disease may continue to progress after "calming down". In the later stages, surgery is recommended. In advanced cases or with provoking factors, adenomyosis can lead to severe bleeding, and, therefore, threaten human life and he alth.
Causes of disease development
To date, doctors around the world have not come to a consensus on the etiology of the disease. The only proven version is that the disease is associated with hormones, possible age-related or artificial malfunctions in the body.
Known versions of the development of adenomyosis in women:
- mechanical damage to the membrane during surgery: caesarean section, abortion or curettage;
- failures in the growth and reproduction of endometrial cells occur even during uterine development, subsequently hormonal failure becomes a trigger for the development of the disease;
- genetic predisposition to the development of benign and malignant tumors;
- too early or, conversely, late onset of menstruation;
- used to protect uterine coils;
- some doctors associate the development of pathology with the malfunction of the endocrine system, this deviation manifests itself in a severe violation of the menstrual cycle;
- general weakening of the immune system contributes to the development of hidden pathologies that the body could previously cope with on its own, an indicator of the weakening of the body will be frequent and prolonged infectious diseases;
- heavy physical activity is as harmful as no exercise at all;
- also the reason may be a weak opening of the cervix during the passage of the egg, in this case, the endometrial cells receive double pressure and move from their location.
From the above, it is clear that the exact cause will be determined in each case, based on the signs of adenomyosis of the uterus. Doctors sometimes cite extreme stress, a sedentary lifestyle, and even a late onset of sexual activity as the main causes.
Symptoms
The problem is that it is very difficult to detect the disease in time and take urgent measures for treatment. Symptoms of adenomyosis in women strongly resemble irregular periods:
- long periods, 7 to 15 days;
- Coarse discharge, large clots;
- even after the end of the cycle, spotting appears;
- sometimes, on the contrary, the menstrual cycle is halved;
- pain during intercourse;
- with adenomyosis, pain occurs before and after the menstrual cycle;
- may develop anemia: pallor, weakness, decreased activity and peeling of the skin of the hands, face.
Associated symptoms are weakness, drowsiness, a general decrease in immunity. In the later stages of the development of the disease, shortness of breath, dizziness, loss of activity, and in some cases, general disability appear. The main symptom is abundant discharge before and after menstruation. All these signs individually do not speak specifically about problems with the uterus, but in the aggregate there is already a reason to think and consult a gynecologist to confirm the symptoms of uterine adenomyosis and treatment.
Diagnosis
One of the main signsdevelopment of the disease - severe pain in the pelvic area a few days before and after menstruation. Often, determining the location of pain sensations helps in making a diagnosis. When the isthmus of the uterus is affected, pain radiates to the rectum and vagina, when endometriosis cells spread to the corner of the cervix - to the inguinal region.
Accurate diagnosis of adenomyosis is possible only after examination by a gynecologist:
- at the first examination, the doctor collects an accurate history based on the patient's complaints; important information about the onset of pain: when emptying, during intercourse or under other circumstances;
- disease detected by ultrasound; during the study, the doctor draws attention to the possible increase in the uterus, the presence of the mucous membrane and reveals the fact of possible germination in the tissue of the organ;
- Some doctors prescribe hysteroscopy to confirm the diagnosis and exclude other diseases, as similar symptoms can occur with uterine fibroids, malignant tumors or uterine polyps.
But the most effective method for detecting adenomyosis is the use of a transvaginal regulator. This collection is called a biopsy. The device is inserted into the uterine cavity under anesthesia and reveals the condition of the walls of the organ. Already on the basis of all these data, the doctor makes a diagnosis.
Problems in Diagnosis
Because adenomyosis is a poorly understood disease, many doctors overlook it, attributing the symptoms to other gynecological abnormalities. Longbleeding is also a sign of uterine fibroids, malignant tumors or hormonal age-related disorders. Therefore, experienced doctors try to exclude all other possible options in order to accurately verify the diagnosis of adenomyosis.
Features of treatment
Today there are several sources of information about adenomyosis in women, treatment and possible complications of the disease. You can find information on the Internet, on medical forums, and also ask your gynecologist.
Therapy depends on the degree of the course of the disease, on how far the endometrial cells have managed to deepen into the uterine tissues. There are two well-known methods: medical and surgical. Both methods will be discussed in more detail below, including based on feedback on the treatment of adenomyosis.
Hormonal treatment
Conservative therapy consists in the appointment of hormonal drugs, and, if necessary, anti-inflammatory drugs and vitamins to increase immunity. Some patients experience a manifestation of neurosis due to severe pain or problems when trying to get pregnant. In this case, the woman is sent for a consultation with a psychiatrist, since the right attitude is the main guarantee of effective treatment.
According to some reviews, the treatment of adenomyosis with a weak expression may not be carried out at all. If the doctor, or rather several, came to the conclusion that nothing threatens the life and he alth of the woman, the patient is prescribed only general strengthening vitamins. But, the course of the disease must be monitored.
Surgery
There are othersreviews of adenomyosis as a serious disease, with untimely treatment, capable of moving to a difficult stage of development, bordering on a malignant tumor. Therefore, they consider the surgical method of treatment the most productive, and in some cases the only one.
Usually, the indication for surgery is the lack of effect of drug therapy, the appearance of suppuration, adhesions and the development of hyperplasia. Before the operation, all possible tests are carried out to identify contraindications to surgery. The operation is not complicated, it is considered ordinary, and the recovery period takes no more than a week. After removal of neoplasms, a woman is recommended to install a hormonal coil. Firstly, it is an excellent contraceptive, and secondly, the spiral has a good effect on uterine cells.
If a woman over 40 has progression of adenomyosis, the surgeon may prescribe removal of the uterus. Since the III degree of development, moreover, complicated by nodular neoplasms and fibroids, can lead to the development of a malignant tumor.
Treatment in pregnant women
All women planning a pregnancy are recommended to be screened for endometriosis, as this factor can significantly affect the conception and further development of the fetus. If during the study a woman is diagnosed with adenomyosis, the patient is prescribed a course of hormonal drugs. After the course, you must wait at least six months before you conceive.
When determining the disease onIn the second or third trimester, the decision on treatment is made after studying the condition of the cells of the uterine mucosa. The fact is that at this time the mother's body secretes a lot of hormones that contribute to the normalization of cell function, and special treatment may not be needed.
Treatment with folk remedies
Tinctures, decoctions and lotions from herbs are unlikely to cure fibroids, tumors or help stabilize hormones. You should not choose folk remedies as a panacea for all diseases, and, among other things, replace medication or surgery with "grandmother's secrets of longevity." But, as an auxiliary measure for the treatment of adenomyosis, folk remedies can help improve the patient's condition.
To relieve inflammation and improve immunity, a decoction of cinquefoil herb and boron uterus is suitable. One tablespoon is placed in a 10-liter saucepan and filled with water. Boil for 25-30 minutes, let the decoction cool, and take one spoon a day after meals.
In addition, it is recommended to take soothing herbal teas, such as an infusion of white willow bark. It has anti-inflammatory and antispasmodic effects. The Asian plant angelica has always been used to treat various women's ailments. It contains substances that promote the expansion of blood vessels and stimulate the central nervous system. Observation of patients speaks of the ability of angelica to influence the tissues of the female organs, allowing the muscles of the uterus to relax.
The use of folk remedies or additional vitamins must be discussed withyour doctor and beware of prescribing treatment yourself.
Complications
Reviews of adenomyosis confirm the danger of this disease. Endometrial cells tend to spread not only to the genitals, but also to the digestive and urinary systems. In this case, systemic failures occur in the work of the affected organs. As a result, intestinal obstruction develops, blood can enter the pleural cavity and provoke pneumonia. In addition, the disease is not fully understood, and many doctors still express concern about the possible transition of adenomyosis to cancer.
Prevention
The best remedy for preventing the serious consequences of any gynecological disease is regular visits to the doctor. In addition, frequent and intense sunbathing should be avoided, solar radiation also causes hormonal disruption and can cause changes in cell division.
As a preventive measure, gynecologists recommend the installation of hormonal intrauterine devices. This device affects the focus of the disease and normalizes the hormonal background. The spiral is installed for 5 years and helps to reduce the duration and abundance of menstruation.
Do not forget that any disease can again make itself felt. Therefore, if medication was prescribed or an operation was performed, it is necessary to take hormonal contraceptives or install a spiral. Otherwise, a relapse can be much stronger and more destructive thanprevious stage.
Possible consequences
The mechanism of the development and impact of the disease on the body is not fully understood. Many doctors believe that the main consequence of adenomyosis is infertility. However, another group of specialists believe that as an independent disease, internal endometriosis cannot lead to such serious consequences. The last statement is true only for the initial stages, when the cells of the uterine mucosa have not yet penetrated deep into the organ and have not caused serious damage to the female body.
At stages III and IV, adhesions, nodes with blood and other pathological changes develop. Lack of treatment leads to a stable remission, and in difficult cases to serious inflammation and even a cancerous tumor. Gynecologists consider adenomyosis the first sign of a malfunction in the female body.
