Miscellaneous

Uterine adenomyosis: symptoms, treatment, prognosis

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uterine adenomyosis (internal endometriosis) - uterine disease benign nature, in which diagnose pathological proliferation inner mucosa layer Body (endometrium) in muscle body structures. The endometrium is composed of a functional layer which is peeled off spontaneously after closure of the menstrual cycle, and basal taking part in the formation of new cell structures of the uterine lining, the new functional layer.

Most often, this pathology is diagnosed in women after the age of thirty years of age go abroad. Abnormal growth of endometrial cell structures can affect other organs, leading to disruption of the functioning and disorders of homeostasis in the body.

uterine adenomyosis: what it is in simple language?

The inner surface of the uterine tissue cell covering layer, which is called the endometrium. At the beginning of the menstrual cycle, it does not take up much space and is only a shell sprout. Hence, the endometrium starts to development and growth. Throughout the month of cellular tissue matures and prepares to accept a fertilized egg. If this does not occur, the endometrium rejected overgrown and out of the uterus. This phenomenon is called menstruation.

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In normal operation, the female body the process is repeated on a monthly basis during the reproductive age. When adenomyosis a different picture. Endometrium and muscle tissue of the uterus are separated by a special layer. In the normal course cycle endometrial cells grow only inside the uterus. If pregnancy has not occurred for this month, the functional layer is removed, leaving the germ shell. When adenomyosis endometrium penetrates through the separating tissue of the uterus and grows into the muscle. And it happens not uniform, and at several points.

In those places where the muscle fibers of the other layer invaded cells responsible thickening uterus muscle tissue. This process causes a deformation of the reproductive organ. The menstrual cycle goes astray, which ultimately affect the ability to conceive a child.

Causes of

Knowing what uterine adenomyosis and how dangerous this disease, consider the etiology of this dangerous disease. The reasons that lead to the development of adenomyosis is not fully understood. In modern medicine, there are several theories that explain the etiology of this disease.

Thus, the pathological proliferation of the endothelium may be caused by:

  • menstrual irregularities;
  • genetic predisposition;
  • violation of metabolic processes;
  • hormonal imbalance, the sudden change in the concentration of sex hormones (estrogen, prolactin, progesterone, FSH);
  • prolonged exposure to the sun under the scorching rays of the sun, excessive passion for tanning beds, mud baths at the wrong use of them;
  • age-related changes, as this pathology in the majority of cases are diagnosed in women after 30-45 years;
  • casting menstrual blood with particles of the endometrium into the fallopian tubes, abdominal organs;

The risk group includes women after Caesarean section, surgical procedures in the uterine cavity, abdominal organs.

Forms, types and degrees of adenomyosis

Morphological forms of the disease are:

nodular type Penetration into the muscle layer of the uterine glandular epithelium in multiple endometrial "nodules" of different sizes. These tumors have a dense consistency because of the proliferating connective tissue. Inside they are filled with fluid or blood.
diffuse type The presence of "blind pocket" of varying depth, which in complicated forms contribute to the formation of fistulas throughout the uterine cavity.
mixed Presented diffuse and nodular form in the aggregate.

The severity of disease is determined by the depth of penetration grows connective tissue (typically, this classification is used to form a diffuse adenomyosis):

  • defeat submucosal layer body.
  • growth of up to 1 \ 2 in the muscle layer of the uterus.
  • penetration of the muscle layer body more than 1 \ 2.
  • lesion serous membrane of the uterus and to engage a surrounding pelvic organs (ovaries, fallopian tubes, vagina).

Symptoms of uterine adenomyosis

The main and patognomichnym (only characteristic for the given disease) sign adenomyosis are abundant and / or prolonged menstrual bleeding, leading to secondary iron deficiency anemia.

Anemia, in turn, manifested by the following symptoms:

  • weakness;
  • drowsiness;
  • tendency to various infectious diseases;
  • pale skin and visible mucous membranes;
  • in severe cases - dyspnea on little exertion;
  • dizziness;
  • a sharp decline in performance and capacity for an adequate assessment of their own state.

By patognomichnym for adenomyosis symptoms are also the appearance of brown spotting for 2-3 days before menstruation, and 2-3 days after it. When common forms of adenomyosis can develop metrorragii - uterine bleeding occurring in the middle of the menstrual cycle.

Another characteristic feature is adenomyosis pain syndrome that occurs a few days before the onset of menstruation and usually disappear within 2-3 days after its beginning (or dysmenorrhea algomenoreya). The nature and severity of the pain depends on the localization process. Particularly strong pain occurs in lesions of the uterine isthmus, as well as in the event of widespread adenomyosis with the development of adhesions.

Adenomyosis is common in such pathology, as additional uterine horn, at which endometriosis lesions Clinic It may resemble an acute abdomen (menstrual blood is thrown into the pelvic cavity, and causes a symptomatology peritonitis). By irradiation of pain can often establish the localization of the pathological process. So, with the defeat of the uterine angle, the pain gives to the respective groin and in the defeat of the isthmus - in the vagina or rectum. Another characteristic symptom of adenomyosis - pain during sexual intercourse, especially on the eve of menstruation (the most commonly found in lesions of the uterus isthmus).

Clinical examination of patients with adenomyosis determined by the increase in the uterus, especially before menstruation and expressed in the early days of the menstrual cycle. To diffuse form characterized by "spherical" uterus. sometimes it is possible to test the units at a gnarled adenomyosis.

It should be noted that the severity of adenomyosis symptoms to some extent dependent on the extent of the process. Thus, the degree of diffuse adenomyosis 1 is a random finding during the various surveys and asymptomatic. However, if diffuse adenomyosis 2 and 3 degrees, and in the form of nodular adenomyosis, clinical symptoms did not always coincide with the extent of the process and the size of the nodes.

Diagnostics

The diagnosis of this disease is based on the following procedures:

  • gynecological examination with the help of mirrors;
  • colposcopy (the procedure is carried out using a special device that allows to increase about 30-fold), this procedure allows to investigate the state of the cervix;
  • Pelvic ultrasound, smears (for analysis of vaginal microflora);
  • hysteroscopy and laparoscopy;
  • general examination of the body (respiratory, circulatory, digestive and urinary system).

To be able to identify contraindications to the medications that can be prescribed for the treatment, recommended consultation and examination by a physician, endocrinologist, gastroenterologist, hematologist.

adenomyosis uterus and pregnancy

Pathology of the spread of endometrial cells in the reproductive age is common. The consequence of such diseases - infertility, which manifests the impossibility of conception or childbearing. Sometimes you do not become pregnant while adenomyosis due to the fact that there is a blockage of the fallopian tubes, and it does not give sperm to unite with the egg.

To motherhood did not prevent the disease, before planning a child, it is necessary to get rid of internal endometriosis. The choice of treatment depends on the cause of infertility. Become pregnant while such pathology often possible after taking contraceptives (Yasmin, Janine). Oral contraceptives contain hormones as part of lining material balance in a woman's body. Contraceptives inhibit the ovaries that after the cancellation of admission stimulates their activity.

uterine adenomyosis treatment

There are two ways of treatment in the event of uterine adenomyosis: conservative and operative. Naturally, the method of treatment depends on the extent of adenomyosis. Typically, the first and second degree, at least three, amenable to conservative treatment, and the fourth only treated promptly.

The first woman to be appointed by hormones, artificially creating menopause (cessation of menstruation for a certain period). Duration of treatment - from two to four months. At the end of the treatment course should be continued hormone therapy.

Quite often and widely used in gynecological practice, uterine artery embolization. This method of treatment considerably improves blood circulation in tissues, which is important for blood stasis and energy in the pelvis.

Electrocoagulation - another common way to treat adenomyosis. Using this method eliminates the affected portions of the uterus.

Radical method of treatment includes two main ways:

  1. Laparoscopy - the most gentle. Genital organ is not removed completely, but only the affected areas are excised.
  2. Complete removal of the uterus (hysterectomy), sometimes together with appendages.

To prevent a recurrence adenomyosis women hormonal contraceptives may be assigned, and at 1-2 degrees - as a method of treatment. Many gynecologists recommend special IUDs, reduces pain and normalizes the menstrual bleeding.

In addition to specific therapy is necessary and restorative treatment. For pain relief are assigned analgesics, e.g., ibuprofen or Nurofen. It is often accompanied by anemia adenomyosis, so it is advisable to undergo treatment with iron. For the body of maintaining the gynecologists recommend taking vitamins. Some women are necessary and sedatives (sedative) drugs.

Folk remedies

At the same time with the treatment of disease medicines, there are also folk remedies for elimination of a very unpleasant disease, but the use of such methods can be at the sole discretion specialist. This treatment is based on the herbal, medicinal herbs, treatment with leeches or compresses with blue clay, because of its medicinal properties are legendary for a long time.

This treatment based infusions and decoctions of herbs, as indicated by multiple ratings, countless the number of which can be found on the Women's Forum, state that improves hormonal balance by means of this treatment, metabolism. As well as reducing the amount of uterine bleeding, improved overall health. However, treatment of folk remedies may not be used together with drugs, especially hormonal.

To prepare medicinal tinctures, which are used as irrigation must be taken:

  • nettles.
  • tansy.
  • eucalyptus.
  • oak.
  • sup.
  • St. John's wort.
  • plantain.
  • bark viburnum.

On the packaging of herbs should be instruction on cooking broth. In addition, it is necessary to take into account the period of the menstrual cycle, because some herbs can be used only at the beginning and the other at the end.

forecast treatment

Adenomyosis - a chronic disease with a high probability of relapse. After the conservative therapy and organ surgery within the first year of relapses adenomyosis identified one in five women of reproductive age. Within five years of the recurrence observed in more than 70% of patients.

Patients age preklimaktericheskogo prognosis of adenomyosis more favorable, due to the gradual fading of ovarian function. After pangisterektomii relapses are possible. The menopause occurs independent recovery.

prevention

In most cases, women visit a gynecologist if they have a concern, or during pregnancy. This setting leads to irreversible consequences, because often the disease progresses without any symptoms. Detecting diseases in the early stages amenable to conservative treatment without further consequences. In connection with this, women should visit the gynecologist 2 times a year.

If you do the hard work physically or emotionally, you experience constant stress, and as a result, and pain the abdomen, the experts recommend more often to relax, leave the stress states by relaxing procedures. This will reduce the risk of developing the disease.

It should limit the use of sunbathing or solarium. If attentive and good to listen to your body, pay attention to timely and respond to emerging changes, it is possible to significantly reduce the likelihood of developing gynecological deviations.

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