Adenomyosis of the uterus is a disease faced by many young women. Pathology is accompanied by the germination of the inner lining of the uterus into the muscle layers, which leads to disruption of the functioning of the entire reproductive system.
Of course, patients faced with a similar diagnosis are looking for any additional information. Why does the disease develop? What symptoms are accompanied? How to treat adenomyosis of the uterus? Can this be done at home? The answers to these questions are important to many women.
What is a disease?
Some women experience adenomyosis of the uterus. Symptoms and treatment, causes and possible complications are important information that you should definitely study. But first you need to learn more about the anatomical features of the female reproductive system.
The uterus, as you know, is a hollow muscle bag. Inside the cavity is lined with a mucous membrane, which is called the endometrium. The cells of this layer are sensitive to hormonal changes. The endometrium grows in preparation for the implantation of the egg. If fertilizationdoes not happen, then this surface layer is rejected - the woman begins menstruation.
The endometrium is separated from the muscle layer by a thin layer. If, for one reason or another, the cells of the mucous membrane begin to grow towards the muscle layer, then the patient is diagnosed with adenomyosis of the uterus. What it is? In an accessible language, this is a disease that is accompanied by the "germination" of endometrial cells inside the muscles of the uterus.
It is worth noting that the mucous membrane retains its properties even after being introduced into other tissues - it continues to grow, develop and be rejected depending on the period of the menstrual cycle. Such processes have a negative impact on the entire reproductive system.
According to statistics, adenomyosis is very common, and most often it is diagnosed in women aged 27 to 30 years. In patients after the onset of menopause, such a disease is not common, which is associated with a decrease in the synthesis of sex hormones, to which the endometrium is so sensitive.
Reasons for the development of the disease
To date, the exact mechanisms of the development of such a disease are still being studied. However, researchers were able to identify some risk factors.
It is believed that adenomyosis often develops against the background of damage to the plate that separates the endometrium and the muscle layer. In turn, such damage can be associated with diagnostic curettage, the establishment of an intrauterine device, abortions, operations, inflammatory pathologies.
It has also been proven that there is some kind of geneticpredisposition. The penetration of the endometrium may be associated with disorders in the functioning of the organs of the endocrine system. There are some other risk factors:
- late onset of sexual activity;
- too late or early onset of menses;
- taking oral contraceptives;
- uncontrolled intake of hormonal drugs;
- obesity (it is accompanied by an increase in estrogen levels in the body);
- poor environmental situation;
- diseases of the immune system;
- various kinds of allergies;
- common infectious diseases in the patient's history;
- presence of foci of chronic inflammation;
- hypertension;
- sedentary lifestyle;
- frequent stress, nervous strain.
Rarely, cases of congenital adenomyosis are reported, the occurrence of which is associated with disorders during fetal development.
Basic forms of adenomyosis
Adenomyosis of the uterus is accompanied by the penetration of endometrial cells, but the process does not cover the entire muscle layer. If we take into account the morphological features, then we can distinguish several types of adenomyosis:
- In the focal form, the endometrium is embedded in the tissues, forming separate foci with clear edges.
- Nodular adenomyosis is characterized by the formation of nodules in the myometrium, which are a collection of endometrial cells. As a rule, there is a cavity inside the node, and outside the structure is protected by denseconnective tissue sheath. The endometrium in the node continues to function, so blood often accumulates in the cavity.
- In the diffuse form of the disease, the endometrium grows into the underlying layers, but randomly - there are no nodes or foci with clear edges.
- Some patients are diagnosed with the so-called mixed adenomyosis, which combines the features of a diffuse pathological process and the formation of nodes.
In the process of diagnosis, it is very important to determine the type of pathological process, since the treatment regimen chosen by the doctor depends on this.
Degrees of development of the pathological process
Signs of uterine adenomyosis are directly related to the phase of pathology development. To date, there are four degrees of progression of pathology.
- The first degree of development of the disease is accompanied by the penetration of endometrial cells into the submucosal layer of the uterus.
- The second degree is characterized by damage to the upper layers of the muscular membrane.
- The third degree is accompanied by the germination of endometrial tissue to more than half the depth of the muscular layer of the uterus.
- The fourth degree is the most severe. The pathological process extends to the entire depth of the muscle layer. Moreover, the endometrium also grows into neighboring structures (for example, damage to the large intestine is possible, which is fraught with the development of intestinal obstruction).
What are the symptoms of the disease?
The clinical picture with such a pathology directly depends on the degreelesions of the uterus, forms and stages of development of the disease. Doctors identify several characteristic symptoms:
- Patients have prolonged (at least seven days) periods, which are accompanied by copious bleeding (sometimes with the formation of whole clots). Sometimes brownish discharge appears 2-3 days before and after the end of menstruation.
- Symptoms also include uterine bleeding and intermittent spotting between periods.
- Adenomyosis patients suffer from severe premenstrual syndrome.
- A typical sign of the disease is pain in the lower abdomen, which can spread to the hips, perineum and lower back. Discomfort usually appears a few days before the onset of menstruation. Sometimes the pain is so severe that the woman loses consciousness. Unpleasant sensations can also appear during intercourse.
It is worth noting that any type of endometriosis (including adenomyosis) can lead to the formation of adhesions in the fallopian tubes, which, in turn, is fraught with infertility.
Possible Complications
If untreated, uterine adenomyosis progresses, leading to dangerous complications. The fact is that heavy menstruation, constant blood loss provokes the development of iron deficiency anemia.
Lack of hemoglobin and a decrease in the number of red blood cells leads to disruption of all organ systems. Patients suffering from anemia complain of drowsiness, constant weakness, fatigue, shortness of breath,that appears with the slightest physical activity. The woman's skin, as well as the mucous membranes, take on a pale hue.
Against the background of anemia, the activity of the immune system decreases - patients are more susceptible to various colds and inflammatory diseases. In addition, constant weakness and fatigue can lead to depression and neurosis.
To this day, there is not enough information about whether adenomyosis of the uterus is the cause of infertility. Experts' opinions, however, indicate that every third patient with a similar diagnosis faces difficulties when trying to get pregnant.
In addition, there is a small chance of malignant degeneration of the altered endometrium - which is why patients need to be regularly tested and checked for the presence of tumor markers.
Diagnostic measures
The appearance of pain, a change in the nature of menstruation are good reasons to consult a gynecologist.
- To begin with, the specialist will ask if the patient has certain symptoms, take an anamnesis, study information about previous diseases and procedures.
- Followed by a general gynecological examination. During the procedure, the doctor may notice a change in the shape of the uterus (it becomes spherical), the formation of nodes and tubercles in its tissues. By the way, it is better to conduct such a study on the eve of menstruation - the only way it will be informative.
- The main diagnostic method in this case is ultrasound. Signs of uterine adenomyosis can be noticed by performing a transvaginal scan 1 to 2 days before the onset of menstruation. During the procedure, a specialist may notice a change in the shape and size of the uterus, thickening of the walls of this organ, the presence of cystic formations.
- Hysteroscopy is also performed. This is an endoscopic procedure that allows the doctor to carefully examine the uterine cavity using special optical equipment. This technique allows for differential diagnosis, excluding from the list other diseases accompanied by similar symptoms (polyposis, endometrial hyperplasia, fibroids).
- In some cases, the patient is additionally referred for magnetic resonance imaging.
- Laboratory studies are also mandatory. For example, it is important to determine the level of sex hormones, the number of red blood cells (confirms the presence of anemia), leukocytes (an increase in their number indicates the presence of an inflammatory process).
The treatment regimen for uterine adenomyosis is based on the results obtained during the diagnosis. It is very important to determine the cause of the development of diseases, as well as to identify the presence of certain complications.
Adenomyosis of the uterus: treatment with drugs
Therapy regimen is compiled individually. It all depends on the causes of the development of the disease, the degree of spread of the pathological process, the woman's desire to have a baby in the future. Medical treatment must be comprehensive. Typically, patientsrecommend taking the following medications:
- hormonal drugs - help normalize the work of the endocrine glands (drugs such as Duphaston, Norkolut, Gestrinone, Janine, Jess are used);
- anti-inflammatory drugs, in particular Ibuprofen, Nurofen, Paracetamol;
- immunomodulators that help normalize the functioning of the immune system, which has a positive effect on the hormonal background;
- vitamin complexes (also help to improve the functioning of many organ systems);
- drugs aimed at normalizing liver function.
Hormone therapy helps to get rid of already existing nodes / foci and prevent further growth of endometrial tissue. Such treatment lasts up to six months.
In the presence of anemia, preparations containing iron are introduced into the treatment regimen, this stimulates the production of red blood cells. If there is depression and neurosis, then patients are prescribed sedatives, antidepressants, sessions with a psychologist.
Surgery
Unfortunately, successful drug therapy gives results only in the initial stages of the disease. How to treat adenomyosis of the uterus if the drugs were ineffective? The doctor may decide on surgery.
Such a procedure as endocoagulation helps to preserve the reproductive functions of the body. Indications for the procedure are endometrial hyperplasia, the formation of adhesions in the fallopian tubes, the presence of purulentfoci. The essence of the technique is to cauterize the affected tissues using special endoscopic equipment. Such treatment is necessarily supplemented by taking hormonal drugs.
Unfortunately, severe cases require more drastic procedures.
- Pangisterectomy is a radical abdominal operation during which the surgeon completely removes the body and cervix, ovaries and fallopian tubes.
- Hysterectomy involves the removal of the uterus. At the same time, the ovaries are preserved, which ensures the production of sex hormones that the body needs.
- Supravaginal amputation of the uterus - a procedure during which only the body of the uterus is removed.
It is worth noting that such treatments are prescribed only in extreme cases.
Adenomyosis of the uterus: folk remedies. Home treatment reviews
Of course, drug therapy helps to eliminate symptoms and prevent further progression of the disease. But is it possible to do something at home? How to treat adenomyosis of the uterus? Folk remedies, of course, exist:
- A decoction of medicinal herbs will help to cope with such disorders. To prepare an effective mixture, you need to mix equal amounts of serpentine root, shepherd's purse grass, nettle leaves, calamus root and cinquefoil, knotweed grass. Pour two tablespoons of the product with two cups of boiling water. Cover the container with a lid and let it brew for an hour. You need to drink half a glass of filtered medicine three times a day. The therapy lasts about a month, after which you need to take a break for 2 weeks. If necessary, you can resume reception.
- Treatment of uterine adenomyosis with folk remedies can also be done with the help of blue clay (it is sold in almost any pharmacy). The powder must be mixed with a small amount of water and slightly heated in a water bath, stirring constantly. The result should be a thick mass, which why you need to roll out on cling film. Such a cake is applied to the lower abdomen (just below the navel) and kept for two hours.
- Helps to cope with the disease and a mixture of herbs cinquefoil and boron uterus. You need to take a tablespoon of each component, place in different containers, pour 0.5 liters of water and boil (15 minutes will be enough). The resulting broths are filtered after cooling. You need to take a tablespoon of decoction: a boron uterus about 60 minutes before a meal, and a cinquefoil half an hour after a meal. The course of treatment lasts two weeks.
Of course, the alternative treatment of uterine adenomyosis can neither completely cure a woman of the disease, nor eliminate the causes of its development. However, properly selected home remedies can help relieve symptoms, relieve pain, and eliminate discomfort. Of course, in no case should you take such funds without the knowledge of a doctor - you first need to consult a specialist.
Prognosis for patients: is it possible to completely get rid of the disease?
Adenomyosis of the uterus is characterized by a chronic course. If the patient was treated with drugs, then the likelihood of relapsein the first year is about 20%. Within five years, the pathological process begins again in 70% of patients. Organ-preserving surgical treatment of uterine adenomyosis leads to the same result.
Reviews of experts indicate that it is almost impossible to completely get rid of this disease without resorting to the removal of certain organs of the reproductive system. However, closer to the onset of menopause, the disease begins to fade on its own, which is associated with the attenuation of the hormonal activity of the ovaries.
