One of the most mysterious and insidious diseases in gynecology is endometriosis. Specialists still do not quite understand the mechanisms of its occurrence. One of the varieties of this pathology is internal uterine endometriosis. It is interesting that in some women it does not manifest itself, while for others it causes a lot of suffering and deprives the joy of motherhood.
When a gynecologist discovers this pathology in a woman, her question usually arises: What is uterine endometriosis and what are its consequences? With adenomyosis, the cells of the endometrium (mucous membrane) of the uterus penetrate the myometrium (muscle layer). During the cycle, under the influence of hormones, they undergo changes and are rejected during menstruation.
However, the myometrium is not suitable for this, therefore hemorrhages, swelling and inflammation occur. At the same time, its functioning is disrupted. Internal uterine endometriosis is accompanied by an increase in its size, in addition, it acquires a spherical shape.
Symptoms of adenomyosis:
- painful, long and heavy menstruation;
- severe premenstrual syndrome;
- spotting before and after menstruation;
However, internal endometriosis is a disease that may not manifest itself, then it does not require treatment. Many women live with him all their lives, without even realizing it, they are not worried about anything, and they give birth to healthy children.
Quite often, adenomyosis is accidentally diagnosed with a planned ultrasound. Ladies with such a pathology, it is advisable to plan a pregnancy after consultation with a gynecologist-endocrinologist and be observed with him.
Experts believe that the main cause of adenomyosis is an imbalance of the main female hormones. This pathology occurs with a high level of estrogen or a low concentration of progesterone. Therefore, hormone therapy is used to treat it.
Doctors are also sure that heredity, surgical manipulations on the uterus, constant stress, inflammation, mud baths, prolonged exposure to the sun, immune disorders and a number of other factors play a role in the occurrence of adenomyosis. Women with this disease are not recommended to overheat, as this may contribute to its progression.
Internal uterine endometriosis is diagnosed using gynecological examination, ultrasound, hysterosalpingography and hysteroscopy. The doctor during a two-handed examination can detect an enlarged uterus before menstruation and a decrease in its size after.
During an ultrasound with adenomyosis, the specialist sees a diffuse thickening of the myometrium and a heterogeneous cellular structure of the affected wall. With the nodular form of the disease, he discovers a node with a heterogeneous structure.
Hysterosalpingography for the diagnosis of adenomyosis is carried out from the 7th to the 9th day of the cycle. During this period, the rejected endometrium does not interfere with the penetration of the radiopaque substance introduced into the uterus through the vagina into the endometrioid passages. This manipulation also allows you to check the patency of the fallopian tubes.
During hysteroscopy with adenomyosis, the gynecologist sees in the region of the side walls and the bottom multiple or single openings of a linear, oval or round shape. During this study, a special optical device is inserted into the uterine cavity through the cervical canal.
Hormonal drugs are used to treat adenomyosis. In preparation for pregnancy and at the initial stage of the disease, gestagens are used. If the patient does not plan the birth of a child in the near future, then she is offered oral contraceptives or the intrauterine system Mirena.
In more severe forms and in premenopause, drugs that cause artificial menopause are more often prescribed. If hormone therapy does not give results, then resort to surgical intervention.
A very good treatment for adenomyosis is pregnancy. This is due to hormonal changes in the body and the absence of menstruation. At this time, foci of endometriosis regress.
So, internal endometriosis of the uterus may not manifest itself, however, it worries some women seriously, and then requires treatment. This disease can interfere with the conception and bearing of a child. In addition, menstruation can become very painful, heavy and long, causing anemia and lowering the quality of life.