In this article, we consider the symptoms, signs, treatment of uterine adenomyosis. What it is? Is this disease dangerous? Let's figure it out.
Adenomyosis or otherwise endometriosis is a disease of the uterus. In the course of this disease, the endometrium, which acts as an internal mucosa, begins to grow into various layers of the uterus. By its nature, adenomyosis, the symptoms of which we will consider in this article, is considered a benign disease.
General description of the pathology
A new position, which is occupied by endometrial cells against the background of adenomyosis, is localized in the region of external, and, in addition, internal genital organs. This can occur within the uterus, its tubes or ovaries. In addition, the process may affect other tissues and organs, for example, the urinary system, the navel, and so on.
Against the background of genital adenomyosis, endometrial cells concentrate in the vagina. This form of the disease can be external, then doctors talk about endometriosis of the ovaries and vagina, or internal. The internal form suggests the presence of uterine endometriosis.
Endometrial cells that are outside the uterus can continue to function according to the normal monthly cycle, which, in turn, provokes the emergence of local inflammatory processes, after which there are changes that seriously disrupt the activity of the organ they populated.
The literal translation of the medical concept of "adenomyosis" implies glandular degeneration that occurs in muscle tissue. The influence of the endometrial glands on the myometrium leads to the formation of a pathological change in the muscle layer of the uterus, which contributes to the degeneration of this organ.
Symptoms of adenomyosis are of interest to many.
Forms
Pathology is divided into diffuse, nodular and mixed form.
- The morphological features of diffuse adenomyosis are the formation in the endometrium of blind pockets that penetrate to different depths of the uterine layers from its cavity. It often happens that this form of the disease leads to the formation of fistulas in the pelvic cavity.
- The form of nodular adenomyosis is characterized by getting into the muscular uterine layers of the epithelium while simultaneously forming nodes of different sizes. As a rule, they are multiple in type of formation and are filled with blood or brown liquid is present in them. It, in turn, is formed due to the activity of the endometrial glands according to the usual cycle of menstruation.
- The mixed form is a combination of both of the above elements.
Symptoms and treatment of adenomyosis will be discussed later.
Degrees of severity
The severity of the pathology, as a rule, corresponds to one of the four degrees offered by the international classification. Each of these degrees corresponds to the depth of penetration of endometrial cells into the underlying structures of the uterus. It should also be noted that the classification below applies solely to the diffuse form of the pathology in question.
- The first degree is determined by the proliferation of endometrial cells, which occurs in the region of the uterine mucosa.
- The second degree is marked by the penetration of pathology, the process of which is concentrated in the muscular uterine layer, while no more than half of its part is captured.
- Against the background of the third degree, the muscle layer is involved in the pathological process more than half.
- The fourth degree is characterized by the growth of cells outside the muscle layer. The cells are concentrated in the serous uterine membrane. Further, this leads to the transition of cells to the peritoneum, and, in addition, to the involvement of organs that are in the pelvic area in the pathological process.
According to reviews, the symptoms of adenomyosis are quite unpleasant.
What is the danger of the disease?
As already noted, adenomyosis is a benign pathological growth that occurs in the tissues. The main reason for meeting this definition is the preservation of the genetic structures of endometrial cells against the background of its migration to other tissues and organs. But, meanwhile, the ability of cells to germinate in these tissues, along with its function of subsequent spreading throughout the body with resistance to external influences, equates this pathological process with malignant tumors. Reviews of the symptoms and treatment of adenomyosis are presented at the end of the article.
Determining the benign nature of the disease makes it possible to indicate its prognosis. Such a pathology can continue for many years or decades, while the process does not cause the depletion of the female body or its death. In parallel with this, similarly to the malignant course of hyperplasia, adenomyosis with great difficulty lends itself to the conservative treatment carried out in his address. If we talk about surgical interventions in order to eliminate this pathology, then the elimination of the disease appears to be much more extensive in comparison with methods oriented to a benign education. The reason is the difficulty in defining boundaries that indicate diseased and healthy tissue. Identification of symptoms and treatment of adenomyosis after 40 years is a particular problem.
Complication
Often the main complication is the feature, which is that endometrial cells, functioning in accordance with the monthly cycle, are the main cause of heavy bleeding. This factor, in turn, can cause an acute form of anemia. In some cases, there may be a need for urgent hospitalization, and, in addition, surgery due to the causes of a serious threat to life due to possible bleeding for patients.
What other symptoms and signs of uterine adenomyosis are there?
The pathology under consideration is also characterized by a tendency to spread the disease process to other tissues of the body, which, in turn, can lead to certain systemic lesions. The extragenital position of endometrial cells can cause a whole complex of various complications, against the background of which medical intervention becomes mandatory. Such complications most often include intestinal obstruction, provoked by endometriosis of the digestive system, and, in addition, hemothorax - pathology, which is characterized by filling the pleural region with blood, which is caused by lung damage.
To the dangerous consequences of a disease such as adenomyosis, the urgent threat of the formation of malignant transformations of cells that have undergone a relocation taking place at the genetic level should also be added.
Adenomyosis and its causes
The reasons that provoke the occurrence of adenomyosis, along with the mechanisms affecting its development, have not yet been fully determined. The only thing that can be noted with certainty is that the disease is hormone-dependent. Thus, most likely, its development is carried out under the influence of violations of the immune system. Among the main risk factors for the development of the pathology under consideration, the following are distinguished:
- The presence of a hereditary predisposition to adenomyosis. Including the predisposition of the body to the appearance of benign or malignant neoplasms, which are concentrated in the area of the female genital area, is implied.
- Late or early onset of the menstrual cycle.
- The presence of excess weight.
- Too late sex life started.
- Late birth or with complications.
- These or other manipulations on the uterus, for example, abortion, diagnostic curettage, and so on.
- Use in order to protect against unwanted pregnancy uterine spirals along with oral contraceptives.
- Pathologies of an inflammatory scale in the region of the uterus and appendages along with bleeding of a dysfunctional nature, especially against the background of surgical intervention or prolonged hormonal treatment.
- Frequent infectious diseases along with allergic reactions that indicate functional disorders of the immune system.
- Low social status.
- Occupation by heavy physical activity.
- A sedentary lifestyle along with stress.
- Extragenital pathologies, for example, diseases of the digestive system, hypertension and so on.
- Living in a bad environment.
Symptoms of adenomyosis
The main characteristic only for this disease is the profusion or excessive duration of menstrual bleeding. This factor, in turn, provokes the development of secondary iron deficiency anemia.
With the development of anemia due to this reason, the following symptoms are felt:
- The presence of drowsiness and weakness.
- Pallor of the skin and mucous membranes.
- Exposure to various infectious diseases.
- Against the background of severe cases, there is shortness of breath, which occurs even with minor physical exertion.
- The presence of dizziness.
- A significant drop in disability.
- Loss of ability to adequately assess the current state.
A characteristic symptom for the development of adenomyosis is the presence of secretions that occur several days before the start of the menstrual cycle, and, in addition, some time after its end. Common forms of pathology can lead to the development of metrorrhagia - uterine bleeding, which occurs in the middle of the menstrual cycle.
Another symptom typical for the described disease is pain, which appears before menstruation and lasts for several days. Such a syndrome disappears after a few days from the onset of menstruation.
The severity of pain, and, in addition, their nature, are determined directly by the localization of the pathological process. The most severe pain is observed with damage to the uterus isthmus. It also is no less pronounced if the ailment is associated with the development of the process of adhesion formation.
It often happens that the symptoms of adenomyosis appear during the formation of the disease in the form of an additional uterine horn. Such a lesion can be characterized by acute abdominal phenomena, the cause of which will be the throwing of menstrual blood into the region of the pelvic cavity, which is typical for the symptoms of peritonitis.
Irradiation of pain often makes it possible to determine the localization of the concentration of pathological processes. For example, lesion of the uterine corner causes pain, which radiates to the inguinal region from the corresponding side. The presence of damage to the isthmus will be given to the rectum or to the vaginal area.
Another symptom of uterine adenomyosis typical of the pathology under consideration is the appearance of a feeling of pain that occurs during intercourse, which is especially important immediately before menstruation and will most often indicate damage to the uterus isthmus area.
It is also important to note that the severity of the symptoms of this pathology directly depends on the level of prevalence of its characteristic course. For example, in the presence of a diffuse form of adenomyosis, which corresponds to the first degree, its detection can occur randomly, which will be explained by the asymptomatic course of pathology. As for the second and third degrees of diffuse and nodular adenomyosis, in these cases the severity of symptoms can rarely coincide with a specific level of distribution of the whole process, and, in addition, with the size of the nodes.
So, we talked about the symptoms. The treatment of adenomyosis will be discussed later.
Treatment
Two methods are used to treat this disease: therapy or surgery. Therapy involves the use of medications that are focused on normalizing the functional characteristics of the hormonal system and immunity. Surgical treatment, in turn, is based on the restoration of the normal anatomical features inherent in the genital organs. In addition, surgery involves the removal of the maximum number of foci in the area of their localization. Diagnosis of the disease is carried out by a gynecologist, who should be consulted if any of the above symptoms occurs.
If the conservative treatment is ineffective with signs and symptoms of adenomyosis, surgery should be performed. Operations can be radical, for example, in such cases, a panhisterectomy is performed along with a hysterectomy, supravaginal amputation of the uterus, and so on. Or organ-preserving operations can be carried out, for example, performing endocoagulation of foci of endometriosis.
Indications for endocoagulation are the presence of endometrial hyperplasia, suppuration or adhesions, which prevent the egg from entering the uterus. Another indication in this case is the absence of any effect after treatment with hormonal drugs for three months, along with contraindications to hormonal therapy.
As part of the indications for removal of the uterus, the progression of adenomyosis among patients older than forty years is considered, along with the ineffectiveness of conservative treatment and organ-preserving surgical interventions, a diffuse or nodular form of pathology in combination with myoma, and, in addition, the risk of malignancy.
In the event that adenomyosis is detected in a woman who is planning a pregnancy, she will be advised to make attempts to conceive no earlier than six months after a course of conservative treatment or endocoagulation. During the first trimester, patients are prescribed gestagens. The question of the advisability of hormonal treatment in the second or third trimester with symptoms of adenomyosis in women is decided taking into account the result of blood tests for the content of progesterone in it. Pregnancy is a physiological menopause, which is accompanied by serious changes in the hormonal background and has a positive effect on the course of the disease, which reduces the growth rate and spread of heterotopic endometrial cells.
Adenomyosis is a chronic disease with a high probability of relapse. After conservative treatment, and, in addition, organ-preserving surgery during the first year, relapses of this disease can be detected in every fifth woman of reproductive age. Over the course of five years, the relapse process is observed in more than seventy percent of patients.
In women of premenopausal age, the prognosis for the development of adenomyosis is more favorable, which is due to a gradual decrease in the functioning of the ovaries. After panhisterectomy, the appearance of relapse is impossible. Within the climacteric period, an independent recovery of the female body occurs.
We continue to consider the symptoms of uterine adenomyosis and treatment with folk remedies.
ethnoscience
In the treatment of many gynecological pathologies, traditional medicine may become indispensable. They are often used as an addition to the main course of treatment, it is important to get a gynecologist's consultation before that.
The first place in popularity is given to medicinal plants. Consider a few recipes:
- For douching, a collection is taken from the root of incense, cinnamon, bedstraw, nettle, mistletoe, oak bark, celandine, yarrow, peony, marigold and eucalyptus. Equal parts of plants should be taken. 3 tbsp. l spoons are poured with 1 liter of boiling water, infused, filtered and used for douching.
- Plantain, tansy, buds of birch and poplar, the fruits of juniper are taken in equal proportions. Everything is poured with boiling water, infused for 2 hours. Next, the infusion should be filtered and taken in a throat after eating (three times a day).
- Pine uterus is often used in the treatment of female ailments. 2 tbsp. l herbs are poured with a liter of boiling water, insist for an hour. Strained infusion is taken half a glass before meals three times a day. The course lasts at least 5-6 weeks.
Hirudotherapy is an effective way to treat adenomyosis. At its core is the use of medical leeches. The active substances that saliva contains leeches have a strong anti-inflammatory effect when released into the blood.
This will help normalize the hormonal background, eliminate venous stasis, strengthen blood supply to organs in the small pelvis. You can only entrust such treatment to a doctor who has the appropriate certificate. If leeches are improperly staged, severe bleeding can begin.
Reviews of the symptoms of uterine adenomyosis and treatment will be considered further.
Reviews
Reviews about this pathology are contradictory. People write that after diagnosis, treatment is prescribed that often does not help. Then curettage is carried out, which also does not give a result. Then doctors advise to become pregnant in order to suspend the pathological process. But what to do when the child is not included in the plans? Also, pregnancy with such a pathology can be problematic. Reviews confirm that the main symptom of the disease is profuse painful menstruation. Most often, hormone therapy ("Utrozhestan") is prescribed as therapy. It is necessary to level the hormonal background, to avoid stress.
We examined the symptoms, signs, treatment, causes of uterine adenomyosis.