Uterine adenomyosis is a disease that many young women experience. Pathology is accompanied by the germination of the inner lining of the uterus into the muscle layers, which leads to impaired 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 are the symptoms associated with? How to treat uterine adenomyosis? Is it possible to do this at home? Answers to these questions are important for many women.
What is a disease?
Some women are faced with a disease such as uterine adenomyosis. Symptoms and treatment, causes and possible complications are important information that is definitely worth exploring. But first you need to learn more about the anatomical features of the female reproductive system.
The uterus is known to be a hollow muscle sac. Inside the cavity is lined with a mucous membrane, which is called endometrium. The cells of this layer are sensitive to hormonal changes. The endometrium grows in preparation for the implantation of an egg. If fertilization has not occurred, 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 uterine adenomyosis. What it is? In plain 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 tear away depending on the period of the menstrual cycle. Such processes adversely affect the functioning of 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 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.
Causes of the development of the disease
To date, the exact mechanisms for the development of such a disease are still being studied. However, the researchers were able to find out some risk factors.
It is believed that adenomyosis often develops against the background of damage to the plate, which separates the endometrium and the muscle layer. In turn, such injuries can be associated with diagnostic curettage, the establishment of an intrauterine device, abortions, operations, and inflammatory pathologies.
It is also proven that there is a certain genetic predisposition. Penetration of the endometrium may be associated with disorders in the functioning of the organs of the endocrine system. There are also some other risk factors:
- late onset of sexual activity;
- too late or early onset of menstruation;
- taking oral contraceptives;
- uncontrolled intake of hormonal drugs;
- obesity (it is accompanied by an increase in estrogen levels in the body);
- poor environmental conditions;
- diseases of the immune system;
- various kinds of allergies;
- frequent infectious diseases in the patient’s history;
- the presence of foci of chronic inflammation;
- hypertonic disease;
- sedentary lifestyle;
- frequent stresses, nervous overstrain.
Cases of congenital adenomyosis, the occurrence of which is associated with disorders during intrauterine development, are occasionally recorded.
The main forms of adenomyosis
Uterine adenomyosis 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:
- With a focal form, the endometrium is introduced into the tissue, forming separate foci with clear edges.
- Nodular adenomyosis is characterized by the formation of nodes in the myometrium, which are a collection of endometrial cells. As a rule, there is a cavity inside the assembly, and outside the structure is protected by a dense connective tissue sheath. The endometrium in the node continues to function, therefore, blood often accumulates in the cavity.
- With the diffuse form of the disease, the endometrium grows into the layers lying below, but randomly - there are no nodes or foci with clear edges.
- In some patients, the so-called mixed adenomyosis is diagnosed, 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.
The degree of development of the pathological process
Signs of uterine adenomyosis are directly related to the phase of development of the pathology. To date, four degrees of pathology progression are distinguished.
- The first degree of development of the disease is accompanied by the penetration of endometrial cells into the submucous layer of the uterus.
- The second degree is characterized by damage to the upper layers of the muscle membrane.
- The third degree is accompanied by the germination of endometrial tissue to more than half the depth of the uterine muscle layer.
- The fourth degree is the most severe. The pathological process extends to the entire depth of the muscle layer. Moreover, the endometrium also grows in neighboring structures (for example, it may damage the colon, which is fraught with the development of intestinal obstruction).
What are the symptoms of the disease?
The clinical picture with a similar pathology directly depends on the degree of damage to the uterus, the form and stage of development of the disease. Doctors distinguish several characteristic symptoms:
- Patients have long (at least seven days) menstruation, which are accompanied by abundant blood flow (sometimes with the formation of whole clots). Sometimes, 2-3 days before and after menstruation, brownish discharge appears.
- The list of symptoms also includes uterine bleeding and the periodic appearance of scanty spotting between periods.
- Patients with adenomyosis 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, as a rule, appears a few days before the onset of menstruation. Sometimes the pain is so intense that a woman faints. Unpleasant sensations can appear during intercourse.
It is worth noting that any type of endometriosis (including adenomyosis) can lead to the formation of adhesions in the area of ​​the fallopian tubes, which, in turn, is fraught with infertility.
Possible complications
If untreated, uterine adenomyosis progresses, which leads to the appearance of dangerous complications. The fact is that heavy menstruation, constant loss of blood 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, which appears with the slightest physical activity. The skin of a woman, as well as the mucous membranes, acquire a pale shade.
Against the background of anemia, the activity of the immune system decreases - patients are more susceptible to various colds and inflammatory diseases. In addition, persistent weakness and fatigue can lead to depression and neurosis.
And to date, there is not enough information about whether uterine adenomyosis is the cause of infertility. The reviews of experts, however, indicate that every third patient with a similar diagnosis encounters difficulties in 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 tested regularly 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 contact a gynecologist.
- To begin with, the specialist will be interested in the presence of certain symptoms in the patient, make an anamnesis, examine information about previously transferred diseases and procedures.
- In the future, a general gynecological examination is performed. 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, such a study is better to carry out 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 seen by conducting a transvaginal scan 1 to 2 days before the onset of menstruation. During the procedure, a specialist can notice a change in the shape and size of the uterus, thickening of the walls of this organ, and 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 tests 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), white blood cells (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 diagnosis. It is very important to determine the cause of the development of diseases, as well as to identify the presence of certain complications.
Uterine adenomyosis: treatment with drugs
The treatment regimen is compiled individually. It all depends on the causes of the disease, the degree of spread of the pathological process, the woman’s desire to give birth to a child in the future. Drug treatment must be comprehensive. As a rule, patients are recommended to take the following drugs:
- hormonal drugs - help normalize the work of the endocrine glands (such drugs as Duphaston, Norkolut, Gestrinon, Zhanin, Jess are used);
- anti-inflammatory drugs, in particular, “Ibuprofen”, “Nurofen”, “Paracetamol”;
- immunomodulators that help normalize the functioning of the immune system, which positively affects the hormonal background;
- vitamin complexes (also help to establish the functioning of many organ systems);
- drugs aimed at normalizing the liver.
Hormone therapy helps to get rid of existing nodes / foci and prevent further growth of endometrial tissues. 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, classes with a psychologist.
Surgical intervention
Unfortunately, successful drug therapy gives a result only in the initial stages of the development of the disease. How to treat uterine adenomyosis if the drugs are ineffective? The doctor may decide on surgery.
A procedure like endocoagulation helps 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 purulent foci. The essence of the technique is to cauterize the affected tissue using special endoscopic equipment. Such treatment is necessarily supplemented by the use of hormonal drugs.
Unfortunately, in severe cases, more radical procedures are required.
- Panhysterectomy is a radical abdominal operation during which the surgeon completely removes the body and cervix, ovaries and fallopian tubes.
- A hysterectomy involves removal of the uterus. At the same time, the ovaries are preserved, which ensures the production of sex hormones necessary for the body.
- Subvaginal uterine amputation is a procedure during which only the uterine body is removed.
It is worth noting that such treatment methods are prescribed only in extreme cases.
Uterine adenomyosis: folk remedies. Home Treatment Reviews
Of course, drug therapy helps to eliminate the symptoms and prevent the further progression of the disease. But is it possible to do something at home? How to treat uterine adenomyosis? Folk remedies, of course, exist:
- A decoction of herbs will help to cope with such violations. To prepare an effective mixture, you need to mix in equal quantities the root of the coil, the grass of a shepherd’s bag, the leaves of nettle, the root of calamus and cinquefoil, grass of knotweed. Two tablespoons of the product is poured with two glasses 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. Therapy lasts about a month, after which you need to take a break for 2 weeks. If necessary, you can resume the reception.
- Treatment of uterine adenomyosis with folk remedies can also be carried out 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 warmed in a water bath, stirring constantly. As a result, a thick mass should be obtained, which for what needs to be rolled out on cling film. Such a cake is applied to the lower abdomen (just below the belly button) and held for two hours.
- A mixture of herbs of the cinquefoil and the pine forest will help to cope with the disease. 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 the decoction: the uterus is about 60 minutes before eating, and the saber is half an hour after eating. The course of treatment lasts two weeks.
Of course, 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, taking such funds without the knowledge of a doctor is by no means worthwhile - first you need to consult a specialist.
Predictions for patients: is it possible to completely get rid of the disease?
Uterine adenomyosis is characterized by a chronic course. If the patient underwent therapy with drugs, then the probability of relapse in 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.
The reviews of experts indicate that it is almost impossible to completely get rid of this ailment without resorting to the removal of any 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.