04 May 2024

Adenomyosis is a gynecological disease in which the mucous membrane of the uterine cavity - the endometrium - germinates the dividing tissue that lies between the endometrium itself and the uterine muscle and starts to enter into the muscular tissue of the uterus.

Usually the endometrium grows during the menstrual cycle, preparing to receive a fertilized egg. Normally, the endometrium can grow only inward - towards the uterine cavity, because it is separated from the muscular layer of the uterus by a thin layer of separating tissue. However, with adenomyosis, a failure occurs, and the endometrium in some places grows into the uterine wall.

In response to the appearance of endometrial tissue in the wrong place, the uterus begins to respond to the invasion - to defend itself. It thickens around the focus of the endometrium, trying to limit the area of intrusion and stop the spread of this pathological process. The muscle increases in size - therefore the uterus also increases in size and acquires a spherical shape.

Symptoms of adenomyosis

One of the problems of this disease is that in more than half of women adenomyosis at the early stage of development is asymptomatic. Strongly expressed symptoms can appear only at the late severe stage of the disease, when adenomyosis is already difficult to treat.

One of the characteristic symptoms of adenomyosis, which appear as the disease worsens, are painful, profuse, and prolonged menstruation. Often brownish discharge persists for a long time after the end of menstruation. Sometimes there are intermenstrual bleeding.

With adenomyosis, pain can occur, and pain is strong enough - cutting, spastic, sometimes they are also called "daggers". Such pains are poorly treated with the usual pain medication. The intensity of pain can grow with age and with the development of the disease.

Diagnosis of adenomyosis

The diagnosis of adenomyosis is based on the results of ultrasound. On the screen a doctor sees an enlarged uterus, an inhomogeneous structure of the myometrium. Very often in conclusion, they indicate heterogeneous echogenicity, the absence of a clear boundary between the endometrium and myometrium, the serration in the area of this boundary, the presence of endometriotic foci in myometrium. Sometimes in the description it is noted that one of the walls of the uterus is strongly thickened in comparison with the other.

During the gynecological examination, the doctor can also diagnose adenomyosis - with this disease the uterus is increased in size, but the most important sign is the shape of the uterus - with adenomyosis it is very characteristic - the uterus is round.

Causes of adenomyosis

It is assumed that all those factors that can break the barrier between the endometrium and the muscular layer of the uterus can lead to the development of adenomyosis:

- Abortion and curettage
- Cesarean section
- Childbirth
- Operations on the uterus
- Inflammatory processes in the uterus (endometritis)

In addition to these factors, the occurrence of adenomyosis can lead to violations of intrauterine development, as well as features of the anatomical structure - is the case when young girls do not properly open the cervical canal during menstruation. Muscular contractions of the uterus during menstruation create an excessive internal pressure in the uterus, and this can lead to a disruption of the barrier between the endometrium and the muscle layer.

Treatment of adenomyosis

Adenomyosis can be cured.
This disease completely regresses after the onset of menopause. Moreover, adenomyosis is a very common condition of the uterus, and if adenomyosis is detected at an early stage, then it can simply exist as a "background" and subject to regular medical and preventive measures not to manifest itself!

The sparing medical and preventive measures include the use of hormonal contraceptives. To achieve the greatest effect of treatment of adenomyosis, the doctor usually prescribes the use of contraceptives on a prolonged schedule.

A good remedy for the treatment of adenomyosis is the hormonal hormone intrauterine device. It is set for 5 years. The intrauterine device is a reliable contraceptive, and in addition, it directly affects the foci of adenomyosis. On her background, menstruation becomes meager and strong pain disappears.

Adenomyosis as a serious problem is much less common, most often with this are women who rarely visit a gynecologist. In this situation, adenomyosis shows itself pronounced symptoms - heavy bleeding and severe pain and requires immediate serious treatment.

So, strong hormonal preparations are applied, which lead to a reversible state of menopause, during which regression of adenomyosis occurs.

It is important to remember that after the termination of the course of treatment and restoration of menstrual function in most cases adenomyosis can quickly recur, therefore after the main course of therapy it is necessary to switch to hormonal contraceptives or to install an intrauterine device. This will consolidate and stabilize the results achieved by the main course of treatment.

In particularly severe cases, it is necessary to resort to surgical intervention - removal of adenomyosis tissue with preservation of the uterus, and sometimes, in extremely rare cases, one has to resort to a radical solution of the problem - amputation of the uterus.