- Causes of adenomyosis
- Symptoms of adenomyosis
- Types of adenomyosis
- Degrees of adenomyosis
- Diagnosis of adenomyosis
- Medication for adenomyosis
- Treatment with folk remedies
- Prevention of adenomyosis
- Adenomyosis and infertility
- Adenomyosis and pregnancy
- Prognosis for adenomyosis
A benign disease in which the inner layer of the uterus (endometrium) grows into the uterus itself is called adenomyosis. In gynecology, there is another, more complex, definition of this disease: adenomyosis is internal genital endometriosis. We can say that this disease is not an independent phenomenon, that is, it is a definite form of endometriosis.
The main feature of adenomyosis is that the endometrium grows only in the myometrium (the middle layer of the uterus) and does not spread beyond its limits, that is, does not affect nearby organs. It is worth noting that in endometrial cells of the endometrium, on the contrary, do not have a specific localization. Independent foci of the disease can occur on any organ: whether the liver, intestines or external genitalia.
Sprouted cells of endometriosis tissue into the uterus (myometrium), still continues to perform its basic functions associated with the menstrual cycle. As a rule, this contributes to the development of the local inflammatory process, and frequent relapses cause degenerative changes in myometrium. Naturally, with time adenomyosis leads to pathological abnormalities of the functions of the uterus as a whole.
Causes of adenomyosis
The mechanism of adenomyosis development, it can be said, is quite simple. Under the influence of certain factors, the endometrium begins to expand gradually into the muscular tissue of the uterus, while retaining its basic functions. As expected, in the middle of the menstrual cycle, endometriosis cells increase in size for the possible fixation of a fertilized egg. The same thing happens with the endometrium, which has grown in myometrium.
If pregnancy does not occur, the excess endometrium leaves the uterine cavity in the form of menstruation. But in the muscular tissue of the uterus there is no way out for enlarged endometrial cells, so the uterine organ can not get rid of unnecessary "ballast" in any way. As a consequence, a so-called "small hemorrhage" occurs in the myometrium, which leads to the development of an inflammatory process.
In gynecology, there are still no specific reasons that lead to the development of adenomyosis in women. However, there are a number of factors that can contribute to the germination of the endometrium into the uterus, as well as its further growth. According to statistics, women who have a history of uterine surgery or abortions are more likely to develop this disease. Women who have crossed the 35-year age limit are also at risk.
Some scientists are inclined to believe that adenomyosis has a genetic predisposition. But there is no one hundred percent guarantee that a woman whose mother had adenomyosis must necessarily get the same. Based on these observations, most gynecologists deny some connection between the development of genital internal endometriosis and genetic predisposition.
The opinion of many female doctors converges in one: stress, heavy physical stress, a very active lifestyle, constant stress are the main factors contributing to the "birth" of adenomyosis. It should be noted that sedentary lifestyle can also affect the development of this disease. In the organs of the small pelvis stagnation of energy and blood occurs, which leads to a thickening of endometriosis tissue, and then to adenomyosis.
Women who have any problems or failures in the endocrine system should carefully monitor their health. Diseases of the pituitary gland, thyroid gland, adrenal glands and female reproductive glands, as a rule, negatively affect the hormonal background of a woman and lead to disruption of the menstrual cycle. Naturally, such failures always contribute to the development of adenomyosis.
According to statistics, lovers of sunbathing and tanning beds, suffer from this disease more often than women who do not abuse the ultraviolet. To young women these observations are not relevant, because only after 30 years the susceptibility to ultraviolet irradiation increases. So newfangled and popular among women mud baths are another factor in the development of adenomyosis.
Symptoms of adenomyosis
The main feature of adenomyosis is an asymptomatic course. As a rule, for a long time women do not notice any signs of disease. The only thing that can force a woman to think about the development of the disease is:
- profuse menstruation
- unusually long menstrual bleeding
- menstruation with large blood clots
As a result of excessive blood loss in the majority of affected women, a decrease in hemoglobin is observed, which leads to iron deficiency anemia.
Against the background of developed anemia, a woman has other signs of "disorder" in the body. The skin is pale, there is weakness and drowsiness. As a rule, disability decreases, and with the slightest physical exertion, dyspnea appears. Most women complain of constant dizziness, and sometimes short-term fainting.
Not unimportant symptom of adenomyosis can be considered painful sensations during intimacy. Women are acutely aware of the increase in pain several days before or immediately after menstruation. Unpleasant and painful sensations have a clear localization - this is the area of the isthmus of the uterus.
Bloody discharge is another characteristic sign of genital internal endometriosis. Many women who suffer from this disease, note the appearance of a smearing brown discharge within a few days (three to five) before the onset of menstruation. After the end of menstrual bleeding, smearing spotting persists for some time (about three days). Quite often, along with the discharge, there are aching pains in the area of the uterus affected by the pathological process.
A characteristic sign of adenomyosis can be safely considered - a pronounced pain syndrome. Severe pain in the abdomen begins a few days before menstrual bleeding, continues throughout the entire period, and persists after their termination for one or two days. As a rule, spotting and pain syndrome - this is a single whole, that is, there are discharges, respectively, there are pain.
The pain has a clear localization, so it is easy to determine the exact location of the pathological process. If the uterine isthmus is affected, the pain radiates to the vagina or rectum. When the pathological endometrium is located in the corner of the uterus, the pain passes to the inguinal region corresponding to the affected side. When palpation - the soreness of the entire body of the uterus.
One should know that the bright clinical picture of adenomyosis directly depends on its degree and type. In gynecological practice, there are rare cases of detection of the disease by symptoms in the early stages, because the course of the disease is almost asymptomatic. Rather, it is a matter of chance. Diffuse adenomyosis of 1-2 degree can only be determined by accident. A little better than the situation with the nodal appearance - the more nodes, the brighter the clinical picture, and, accordingly, it is easier to establish an accurate diagnosis.
Types of adenomyosis
In gynecological practice, three main types of genital internal endometriosis are distinguished:
- mixed or combined (diffuse-nodal)
The last form of adenomyosis is much more common than the two previous ones.
Diffuse adenomyosis is characterized by ingrowth into the thickness of the uterus of the endometrium, forming deep foci with a pathological endometriosis tissue. The penetration depth varies. In gynecology, cases are known where the diffuse form of the disease leads to fistula formation.
With nodal adenomyosis cells pseudoendometry are introduced into the myometrium and form endometriotic passages, in which they then safely grow. It is worth noting that pseudoendometry is endowed with the same hormonal functions as the real endometrium. During menstruation, new endometriosis cells are also rejected, but there is no way out. This is how nodes appear.
Multiple nodes are filled with brown fluid or blood that appears as a result of the functional activity of pseudoendometry, that is, during menstruation. Outside, the nodes are covered with a dense connective tissue that forms the capsule.
Degrees of adenomyosis
The degree of adenomyosis on the straight line depends on the depth of penetration of the endometrium into the uterus.
The first degree . The first degree of adenomyosis is characterized by the germination of the endometrium to the upper layer of the myometrium. In other words: the mucous layer does not affect the muscular tissue of the uterus, but only forms small indentations in it. At inspection any changes in structure and a relief of a uterus are not observed.
The second degree of adenomyosis is characterized by the germination of the endometrium to the middle of the muscular layer. The myometrium thickens, becomes uneven, and the uterine cavity loses its former elasticity. With this degree of disease a woman can already have the first problems with conception or fetal bearing.
Third degree of adenomia. The pathological process affects the myometrium to the serous layer. The structure and surface of the uterus body changes significantly. During the examination, certain areas that are enlarged in volume are visible, which do not have clear boundaries and contours. The walls of the uterus thicken considerably.
Fourth degree . Adenomyosis of this degree is exhibited if there are sprouting of the endometrium beyond the uterine body. For example, in the abdominal cavity, ovaries, fallopian tubes, bladder. If the pathological process has affected the cervix, the diagnosis is cervical adenomyosis, if the ovaries are adenomyosis of the ovaries.
The first degree and the second do not require surgical intervention, which can not be said about the third and fourth. The last two - difficult to give in to conservative treatment, more often two methods are taken in the complex.
Diagnosis of adenomyosis
Diagnosing adenomyosis in the early stages is difficult. To find it, a woman needs to undergo a thorough and in-depth clinical examination. The complex of diagnostic measures includes:
- Bimanual or objective gynecological examination. During the study, the size of the uterus, its position, shape, mobility and soreness are assessed. It is important to determine the presence of formations, the state of the ovaries and the fallopian tubes. With adenomyosis, the uterus increases in size and takes a spherical shape.
- Obligatory sampling of smears on the degree of purity of the vagina and cytological analysis
- Examination of the cervix by colposcope. Under the microscope, you can see even single sprouted endometrial cells. After all, for the 4th degree of adenomyosis, the germination of the pathological process on the cervix is characteristic.
- Ultrasound of the pelvic organs. The most commonly used transvaginal echography. In gynecological practice, several echogenic signs of adenomyosis have been identified: serration of the basal layer of the endometrium, asymmetric compaction of the uterine walls, increased echogenicity in the affected areas and a rounded uterine shape.
- Hysteroscopy. With visual examination of the inner surface of the uterus, endometriotic passages are seen. The smooth pale pink color of the uterine mucosa is disturbed by dark brown inclusions, from which blood is periodically released.
- Complex clinical study of all organ systems: respiratory, urogenital, cardiovascular and digestive.
Only due to such a deep complex examination it is possible to diagnose adenomyosis at an early stage, and later to correctly determine the degree of lesion of the pathological process and its severity.
Medication for adenomyosis
There are two ways to treat genital internal endometriosis: conservative and surgical treatment. Naturally, the method of treatment directly depends on the degree of adenomyosis. As a rule, the first and second degree, less often the third, yields to conservative treatment, and the fourth is treated only promptly.
First of all, women are prescribed hormonal drugs that artificially create menopause (stopping menstruation for a certain period). Duration of treatment - from two to four months. At the end of the treatment course, hormonal therapy should be continued.
Often and widely in gynecological practice, uterine artery embolization is used. This method of treatment significantly improves blood circulation in the tissues, which is important for stagnant blood and energy in the small pelvis.
Electrocoagulation is another common treatment for adenomyosis. With this method, the affected areas of the uterus are eliminated.
The radical method of treatment includes two main methods:
- Laparoscopy is the most sparing. The genital organ is not completely removed, but only the lesions are excised.
- Complete removal of the uterus (hysterectomy), sometimes together with the appendages.
To prevent the recurrence of adenomyosis, women can be prescribed hormonal contraceptives, and at 1-2 degrees - as a method of treatment. Many gynecologists recommend special intrauterine spirals that reduce pain and normalize menstrual bleeding.
In addition to specific therapy, it is necessary and fortifying treatment. Pain relievers are prescribed to relieve pain, for example, Ibuprofen or Nurofen. Very often adenomyosis is accompanied by anemia, therefore it is advisable to undergo a course of iron treatment. To maintain the body, gynecologists recommend taking vitamins. Some women need sedative (soothing) medications.
Treatment with folk remedies
Along with medication (with the permission of a doctor), folk remedies can be used to treat adenomyosis. There are many herbal collections that need to be taken not only for medical purposes, but also for general strengthening of the body, enhancing immunity. It is important to remember that any non-traditional treatment should be discussed with the attending physician.
Everybody knows about the healing properties of blue clay for a long time. But very few people know that it is widely used to treat adenomyosis. The method of application is quite simple. Blue clay must be mixed with water and mixed until a homogeneous mass is obtained. The resulting mixture should be held in a water bath for about 6 minutes, but no more. Then the blue clay is laid out on the cellophane with an even layer of thickness not more than two centimeters. This compress should be placed on the lower abdomen and left for two hours. The course of treatment is five to seven full-fledged procedures.
An effective but less pleasant way to cure adenomyosis is hirudotherapy. Principle of treatment: leeches choose particularly active points for suction, as a result of which blood circulation and lymph flow in the small pelvis considerably improves. In addition, substances that enter the blood of a woman during a bite of a leech have antiseptic properties that help to remove the inflammatory process in the uterus and prevent the development of adenomyosis.
Very widely used in gynecology are various herbs. With the help of herbal infusions and broths, the cycle is normalized, the level of hormones is corrected, and the metabolism is regulated and accelerated. Use of herbs for the treatment of adenomyosis is necessary with the permission of the attending physician and only under his vigilant control. During herbal treatment, hormone therapy is prohibited.
Recipes of broths and infusions:
- Casting plantain (one spoon) must be crushed, and then pour steep boiling water. Infuse this broth for at least two hours. Method of reception: Divide the broth for 4 doses. The first - necessarily on an empty stomach, and the rest - during the day, the reception of the broth is not necessarily associated with food intake.
- Stop menstruation, remove inflammation in the uterus, accelerate the metabolism will help decoction of nettle. Preparation of broth: a glass of boiling water should be poured over two tablespoons of nettle. Let it brew and cool. Method of reception: to divide the contents of the glass into four or five receptions, to use during the day.
- Medicinal properties have fresh juice of beetroot. Method of reception: take every morning before eating a hundred grams of fresh juice.
- To strengthen the myometrium should be treated with broth from a shepherd's bag. Preparation: one tablespoon pour a glass (one) of steep boiling water. Infuse one hour. Method of taking: take at least four times a day for one full table spoon. It is important - for half an hour before a meal.
- The bark of Kalina is another unique remedy for the fight against adenomyosis. Preparation: the bass of the viburnum (one tablespoon) is poured also with one glass of boiling water, it is obligatory to insist for about an hour. Способ приема: только три раза в день по две столовые ложки, с приемом пищи связывать не обязательно.
Отвары лечебных трав для борьбы с аденомиозом можно но использовать для спринцевания. Пример наиболее эффективного рецепта: кора дуба, омела, эвкалипт, пион, тысячелистник и календула берут в одинаковых порциях, затем смесь заливают крутым кипятком и обязательно настаивают один час. Можно ежедневно использовать для спринцевания.
Лечение травами таит в себе множество нюансов, которые следует знать в обязательном порядке. Кроме правильной дозы и способа приготовления, важно знать когда и какие травы принимаются для лечения аденомиоза. При использовании в лечебных целях некоторых сборов трав необходимо учитывать этап (фазу) менструального цикла, так как одни важно принимать во время менструации, а другие – только за несколько дней до нее.
Сбор перед менструацией:
- Почки тополя
- Почки березы
- Аир и пижма
- Ягоды можжевельника
Приготовление: смесь из вышеперечисленных ингредиентов (одна чайная ложка) заваривается одним стаканом кипятка. Настаивать необходимо не меньше одного часа. Способ приема: по четверть стакана три-четыре раза в день, желательно после еды. Во время лечения данным сбором целесообразно ежедневно два раза в сутки принимать 35-40 капель настойки пиона. Курс лечения – от трех до пяти менструальных циклов.
Сбор во время менструации:
- Корень солодки
- Шишки клевера
- Кипрей и анис
- Листья эвкалипта
- Ягоды смородины
Приготовление: смесь (одна чайная ложка) заливают одним стаканом кипятка, настаивают. Способ приема: по четверть стакана три раза в сутки. Наряду с приемом сбора важно употреблять ежедневно 30-35 капель элеутерококка. Курс лечения – от трех до пяти менструальных циклов.
Естественно, необходимо понимать, что полное излечения от генитального внутреннего эндометриоза возможно только при первой и второй степенях. На более поздних стадиях прием отваров и настоек из лечебных трав могут только приостановить прогрессирование болезни, а не вылечить. Каждый организм по-разному реагирует на лечение, то есть некоторых женщин народные средства навсегда избавляют от недуга, а другим приносят временное облегчение.
Первый и самый важный способ профилактики аденомиоза – регулярное посещение женского доктора (один раз в шесть месяцев). Ведь, чем раньше будет диагностировано наличие заболевания, тем легче его лечить. Не стоит тянуть и ждать, что само пройдет, чем быстрее будет выставлен диагноз, тем быстрее наступит выздоровление. Важно помнить, что любое неприятное и болезненное ощущение внизу живота – это повод срочно нанести визит гинекологу, для установления причин.
Gynecologists believe that stress and constant fatigue strongly affect women's health and, undoubtedly, can lead to the development of adenomyosis. To prevent the onset of the disease, a woman needs to: rest more, take relaxing baths, visit a massage, often stay in a calm and cozy environment. Procedures aimed at relieving muscle tension are another way of preventing adenomyosis.
A gynecologist, if deemed necessary, can prescribe the necessary medications and physiotherapy procedures. Women after thirty should avoid sunbathing in unlimited quantities, and it is better to minimize ultraviolet radiation to a minimum.
Adenomyosis and infertility
Specialists in the field of gynecology have proved that adenomyosis is a frequent cause of infertility. There are five main factors that can lead to infertility in this disease. Quite often there are cases when several factors are combined.
- According to many gynecologists, the main cause of infertility in genital internal endometriosis are pathological disorders in the hormonal sphere.
- Adhesive processes in the fallopian tubes or a decrease in their motor capacity. As a result of this pathology, the egg can not move up the uterine tube into the uterine cavity.
- An autoimmune reaction of the body, which leads to a decrease in the activity of the spermatozoon or the difficult fixation of a fertilized egg in the endometrium.
- Premature termination of pregnancy, mainly in the early stages, as a result of increased muscle tone of the uterus.
- The logical factor. With adenomyosis, most women experience severe pain, discomfort and discomfort during intercourse, and therefore cease to have a regular sex life.
To say unequivocally, that adenomyosis is a verdict, it is impossible. If infertility developed less than three years ago, then it is easier to restore the ability to conceive, than in more neglected cases. Timely, comprehensive and correct treatment significantly increases the chance of becoming pregnant and safely enduring the child. Naturally, adenomyosis is the cause of infertility, but there is also a cure for this ailment.
Adenomyosis and pregnancy
It is impossible to say unequivocally that it is impossible to get pregnant with adenomyosis. After all, the disease as can be the cause of infertility, and no. Naturally, quite often this disease is the main reason for the lack of children in a woman. Sometimes even prolonged conservative or surgical treatment does not lead to the onset of a long-awaited pregnancy.
But it is important to note that adenomyosis is not a sentence. A sufficiently large number of women with this disease in the anamnesis still could feel all the joy of motherhood. Pregnancy can proceed without any complications and features, and children are born absolutely healthy. If there are problems with the conception of the child or his bearing, then timely and adequate treatment is needed.
The chance to become pregnant and safely endure a child is even among women who are prone to surgical treatment. According to statistics, 40-60% of these women could conceive and give birth to themselves. Of course, pregnant women with adenomyosis are constantly under special control by the women's consultation in order to provide timely assistance or take any measures to preserve the pregnancy.
Scientists have proved that pregnancy has a beneficial effect on the course and nature of the disease. At its core, pregnancy is a physiological menopause, which is so necessary with such a diagnosis. Excess endometrial cells are no longer torn away, and therefore, its growth is significantly reduced. In addition, in gynecology there are many examples where a woman completely recovered after pregnancy.
Prognosis for adenomyosis
It is important to note that adenomyosis never takes the malignant course of the disease, that is, it does not degenerate into cancer. According to statistics, about 20% of women report relapse. After five years, as a rule, the disease resumes in 75 percent of women.
The risk of relapse is significantly lower with mixed treatment. For example, laparoscopy and long-term use of hormonal drugs. The risk is lower, but relapse is inevitable. Women in premenopausal and directly in menopause are more likely never to face a diagnosis of adenomyosis. This feature is due to the physiological decline of all functions of the ovaries.