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Adenomyosis

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A benign disease in which the inner layer of the uterus (endometrium) grows into the thickness of the uterus itself is called adenomyosis. In gynecology, there is another, more complex, definition of this disease: adenomyosis is an internal genital endometriosis. We can say that this disease is not an independent phenomenon, that is, it is a certain form of endometriosis.

The main feature of adenomyosis is that the endometrium grows only in the myometrium (middle layer of the uterus) and does not extend beyond its limits, that is, it does not infect nearby organs. It should be noted that in case of endomitriosis, endometrial cells, on the contrary, do not have a certain localization. Independent foci of the disease can occur on any organ: whether it be the liver, intestines or external genital organs.

Sprouted cells of endometrial tissue in the uterus (myometrium), still continues to perform its main functions associated with the menstrual cycle. As a rule, it contributes to the development of a local inflammatory process, and frequent relapses cause degenerative changes in the myometrium. Naturally, over time, adenomyosis leads to pathological disorders of the uterus as a whole.



Causes of adenomyosis

The mechanism of development of adenomyosis, one can say, is quite simple. Under the influence of certain factors, the endometrium begins to gradually grow into the muscle tissue of the uterus, while not losing its main functions. As expected, in the middle of the menstrual cycle, endometriotic cells increase in size for the possible fixation of a fertilized egg. The same thing happens with endometrium, overgrown in the myometrium.

If the pregnancy does not occur, the excessive endometrium leaves the uterus in the form of menstruation. But in the uterine muscle tissue there is no way out for enlarged endometrial cells, so the uterine organ cannot get rid of unnecessary “ballast”. As a result, the so-called “minor hemorrhage” occurs in the myometrium, which leads to the development of the inflammatory process.

In gynecology, the specific reasons leading to the development of adenomyosis in women have not yet been established. However, there are a number of factors that can contribute to the germination of the endometrium in the thickness of the uterus, as well as its further growth. According to statistics, women with a history of surgery on the uterus or abortion are more likely to develop this disease. Women who have crossed the 35-year-old age line are also at risk.

Some scientists tend to believe that adenomyosis has a genetic predisposition. But there is no absolute guarantee that a woman whose mother has been sick with adenomyosis, must definitely get the same disease. 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 agrees on one thing: stress, heavy physical exertion, a very active lifestyle, constant tension - these are the main factors contributing to the “origin” of adenomyosis. It should be noted that a sedentary lifestyle can also affect the development of this disease. In the organs of the small pelvis energy and blood stagnate, which leads to a thickening of the endometriotic tissue, and then to adenomyosis.

Women who have any problems or malfunctions in the endocrine system should carefully monitor their health. Diseases of the pituitary gland, thyroid gland, adrenal glands and female genital glands, as a rule, negatively affect the hormonal background of the 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 ultraviolet radiation. These observations do not apply to young girls, because only after 30 years susceptibility to ultraviolet radiation increases. Mud baths, so modern and popular among women, are another factor in the development of adenomyosis.

Symptoms of adenomyosis

The main feature of adenomyosis is asymptomatic. As a rule, women do not notice any signs of illness for a long time. The only thing that can push a woman into thinking about the development of the disease is:

  • profuse menstruation
  • unusually prolonged menstrual bleeding
  • menstruation with large blood clots

As a result of abundant blood loss in the majority of diseased women, a decrease in hemoglobin is observed, which leads to anemia of iron deficiency.

Against the background of developed anemia, other signs of “disorder” in the body appear in women. Pale skin, there is a weakness and drowsiness. As a rule, working capacity decreases, and at the slightest physical exertion dyspnea appears. Most women complain of constant dizziness, and sometimes short-term syncope.

Not unimportant symptom of adenomyosis can be considered painful sensations during intimacy. Women particularly acute increase in pain for several days before or after menstruation. Unpleasant and painful sensations have a clear localization - this is the area of ​​the isthmus of the uterus.

Spotting is another characteristic sign of genital internal endometriosis. Many women suffering from this disease, notice the appearance of smearing brown discharge a few days (from three to five) before the onset of menstruation. After the end of menstrual bleeding, spotting is retained for some time (about three days). Quite often, along with the discharge, aching pains appear in the area of ​​the uterus affected by the pathological process.

A characteristic sign of adenomyosis can be safely considered - pronounced pain syndrome. Strong painful feelings in the lower abdomen begin a few days before the menstrual bleeding, continue for the entire menstruation, and persist after their completion for one or two days. As a rule, bleeding and pain syndrome - this is a whole, that is, there are discharge, respectively, pain.

The pain has a clear localization, so it is enough just to determine the specific location of the pathological process. If the uterus isthmus is affected, the pain radiates to the vagina or rectum. With the location of the pathological endometrium in the corner of the uterus, pain gives to the groin area, respectively, the affected side. On palpation - pain of the whole body of the uterus.

You should know that the bright clinical picture of adenomyosis depends directly 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 grade 1-2 can only be determined by chance. The situation with a nodal view is slightly better - the more nodes, the brighter the clinical picture, and, accordingly, it is easier to establish an accurate diagnosis.

Types of adenomyosis

In gynecological practice, there are three main types of genital internal endometriosis:

  • diffuse
  • nodal
  • mixed or combined (diffuse nodular)

The latter form of adenomyosis is much more common than the previous two separately.

Diffuse adenomyosis is characterized by endometrial growth in the uterus, forming deep foci with pathological endometriotic tissue. Depth of penetration is different. In gynecology, there are cases when the diffuse form of this disease led to the formation of fistulas.

In nodular adenomyosis, pseudo-endometry cells invade myometrium and form endometrioid passages, in which they then successfully grow. It is worth noting that pseudo-endometrium is endowed with the same hormonal functions as the real endometrium. During menstruation, new endometriotic cells are also rejected, but there is no way out. This is how nodes appear.

Multiple nodes are filled with brown liquid or blood that appears as a result of the functional activity of pseudo-endometry, that is, during menstruation. Outside the nodes are covered with dense connective tissue forming the capsule.

Mixed or combined adenomyosis includes signs of diffuse and nodular. This type is found in women more often.

Degrees of adenomyosis

The degree of adenomyosis directly depends on the depth of penetration of the endometrium into the uterus.

First degree For the first degree of adenomyosis, germination of the endometrium to the upper layer of the myometrium is characteristic. In other words: the mucous layer does not affect the muscle tissue of the uterus, but only forms insignificant cavities in it. When examining any changes in the structure and relief of the uterus are not observed.

The second degree of adenomyosis is characterized by endometrial germination to the middle of the muscular layer. Myometrium thickens, becomes uneven, and the uterine cavity loses its former elasticity. With this degree of disease, a woman may already have the first problems with conceiving or carrying a fetus.

The third degree of adenomy. Pathological process affects the myometrium to the serous layer. Significantly changes the structure and surface of the body of the uterus. During the examination, certain areas enlarged in volume are visible, which do not have clear boundaries and contours. The walls of the uterus significantly thicken.

Fourth degree Adenomyosis of this degree is exposed if there is endometrial germination beyond the body of the uterus. For example, in the abdominal cavity, ovaries, fallopian tubes, bladder. If the pathological process struck the cervix, then the diagnosis is cervical adenomyosis, if the ovaries are ovarian adenomyosis.

The first degree and the second do not require surgical intervention, which cannot be said about the third and fourth. The last two - are difficult to conservative treatment, often adopted two methods in the complex.

Diagnosis of adenomyosis

To diagnose adenomyosis in the early stages is quite difficult. To identify it, a woman needs to undergo a thorough and thorough 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 evaluated. A lot of important to determine the presence of formations, the state of the ovaries and fallopian tubes. In adenomyosis, the uterus increases in size and takes on a spherical shape.
  • Mandatory collection of smears for vaginal purity and cytological analysis
  • Examination of the cervix with a colposcope. Under the microscope, you can see even single germinated cells of the endometrium. Indeed, germination of the pathological process on the cervix is ​​characteristic of grade 4 adenomyosis.
  • Ultrasound of the pelvic organs. Transvaginal echography is most commonly used. In gynecological practice, several echogenic signs of adenomyosis are distinguished: serration of the basal layer of the endometrium, asymmetric consolidation of the uterine walls, increased echogenicity in the affected areas and the rounded shape of the uterus.
  • Hysteroscopy. A visual inspection of the inner surface of the uterus shows endometriotic passages. The even pale pink color of the uterine mucosa is disturbed by dark brown inclusions, from which blood is periodically released.
  • A comprehensive clinical study of all organ systems: respiratory, urogenital, cardiovascular and digestive.

Only due to such a deep comprehensive examination can adenomyosis be diagnosed at an early stage, and at later stages it is possible to correctly determine the extent of damage by the pathological process and its severity.

Drug treatment of adenomyosis

There are two ways to treat genital internal endometriosis: conservative and surgical treatment. Naturally, the method of treatment depends on the degree of adenomyosis. As a rule, the first and second degrees, less often the third, are amenable to conservative treatment, and the fourth is treated only promptly.

First of all, women are prescribed hormonal drugs that artificially create menopause (cessation of menstruation for a certain period). The duration of treatment is from two to four months. At the end of the treatment course, hormone therapy must be continued.

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

Electrocoagulation is another common treatment for adenomyosis. With this method, the affected areas of the uterus are eliminated.

The radical treatment method includes two main ways:

  • Laparoscopy is the most benign. The reproductive organ is not completely removed, but only the affected areas are excised.
  • Complete removal of the uterus (hysterectomy), sometimes with appendages.

For the prevention of recurrence of adenomyosis, women can be given hormonal contraceptives, and at 1-2 degrees - as a method of treatment. Many gynecologists recommend special intrauterine devices that reduce pain and normalize menstrual bleeding.

In addition to specific therapy, a fortifying treatment is also necessary. Pain relievers are prescribed to relieve pain, for example, Ibuprofen or Nurofen. Very often, adenomyosis is accompanied by anemia, so it is advisable to undergo a course of treatment with iron. For the maintenance of the body, gynecologists recommend taking vitamins. Some women need sedative (sedative) medications.

Treatment of folk remedies

Along with drug treatment (with the permission of the doctor) you can use folk remedies for the treatment of adenomyosis. There are many herbal preparations that must be taken not only for therapeutic purposes, but also for general strengthening of the body, improving immunity. It is important to remember that any unconventional treatment should be negotiated with your doctor.

Everyone has long known about the healing properties of blue clay. But few people know that it is widely used for the treatment of adenomyosis. The method of application is quite simple. Blue clay should be mixed with water and stirred until a homogeneous mass. 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 in an even layer no more than two centimeters thick. Such a compress should be put on the lower abdomen and left for two hours. The course of treatment is five to seven full procedures.

An effective, but less pleasant way to cure adenomyosis is hirudotherapy. The principle of treatment: leeches choose particularly active points for suction, as a result of which the blood circulation and lymph flow in the small pelvis are significantly improved. In addition, substances that enter a woman’s blood during a leech bite have antiseptic properties that help relieve the inflammatory process in the uterus and prevent the development of adenomyosis.

Various medical herbs are widely used in gynecology. With the help of herbal infusions and decoctions, they normalize the cycle, correct hormone levels, regulate and speed up the metabolism. It is necessary to use herbs for the treatment of adenomyosis with the permission of the attending physician and only under his watchful control. During herbal therapy, drug hormone therapy is prohibited.

Recipes decoctions and infusions:

  • Molding the plantain (one spoon) must be chopped, and then pour boiling water. Insist this decoction for at least two hours. Method of administration: Divide the decoction into 4 doses. The first - necessarily on an empty stomach, and the rest - during the day, the intake of broth is not necessarily associated with food intake.
  • Stop menstrual bleeding, relieve inflammation in the uterus, speed up the metabolism will help decoction of nettle. Cooking broth: you need a glass of boiling water pour two tablespoons of nettle. Let it infuse and cool. Method of administration: divide the contents of the glass into four or five receptions, use during the day.
  • The medicinal properties of fresh beetroot juice. Reception method: to accept every morning before meal on one hundred grams of fresh juice.
  • To strengthen the myometrium should undergo treatment decoction of shepherd's purse. Preparation: one tablespoon pour a glass (one) of boiling water. Insist one hour. Method of administration: take at least four times a day, one full tablespoon. Important - half an hour before meals.
  • Viburnum bark is another unique remedy for adenomyosis. Preparation: bark of viburnum (one tablespoon) is also poured with one glass of boiling water, be sure to insist 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
  • Подорожник
  • 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.

Профилактика аденомиоза

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.

Гинекологи считают, что стресс и постоянное переутомление сильно отражаются на женском здоровье и, несомненно, могут приводить к развитию аденомиоза. Для профилактики возникновения заболевания женщине необходимо: больше отдыхать, принимать расслабляющие ванны, посещать массаж, чаще находиться в спокойной и уютной обстановке. Процедуры, направленные на снятие напряжения мышц, — еще один способ профилактики аденомиоза.

Врач-гинеколог, если посчитает необходимостью, может назначить нужные лекарственные препараты и физиопроцедуры. Женщинам после тридцать стоит исключить прием солнечных ванн в неограниченном количестве, а лучше – сократить до минимума ультрафиолетовое излучение.

Бережное отношение к своему здоровью – главный способ профилактики не только аденомиоза, но и других не менее опасных заболеваний.

Аденомиоз и бесплодие

Специалистами в области гинекологии доказано, что аденомиоз — частая причина бесплодия. Существует пять основных факторов, которые могут приводить к бесплодию при данном заболевании. Достаточно часто встречаются случаи, когда несколько факторов сочетаются.

  • По мнению многих специалистов-гинекологов, главной причиной бесплодия при генитальном внутреннем эндометриозе являются патологические нарушения в гормональной сфере.
  • Adhesions in the fallopian tubes or a decrease in their motor ability. As a result of this pathology, the egg can not move through the fallopian tube into the uterine cavity.
  • Autoimmune reaction of the body, which leads to a decrease in the activity of the sperm or difficult fixation of a fertilized egg in the endometrium.
  • Premature termination of pregnancy, mainly in the early stages, as a result of increased tone of the muscle layer of the uterus.
  • Logical factor With adenomyosis, most women experience severe pain, discomfort and discomfort during sexual intercourse, and therefore cease to have a regular sex life.

It is impossible to say unequivocally that adenomyosis is a sentence. If infertility developed less than three years ago, then it is easier to restore the ability to conceive than in more advanced cases. Timely, comprehensive and proper treatment significantly increases the chance of getting pregnant and safely carrying the child. Naturally, adenomyosis is the cause of infertility, but there is also a cure for this ailment.

Adenomyosis and pregnancy

It is unequivocal to say that it is impossible to get pregnant with adenomyosis - it is impossible. After all, the disease as may 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 a long 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. Quite a large number of women with this disease in history all the same were able to feel all the joy of motherhood. Pregnancy can proceed without any complications and peculiarities, and babies are born completely healthy. If there are problems with conceiving a child or carrying it, timely and adequate treatment is necessary.

Even women who are subject to surgical treatment have a chance to get pregnant and safely carry the child. According to statistics, 40-60% of these women were able to conceive and give birth normally. Of course, pregnant women with adenomyosis are constantly under special control from the women's consultation in order to help or take any measures to save the pregnancy in time.

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 for such a diagnosis. Excessive endometrial cells are no longer rejected, and therefore its growth is significantly reduced. In addition, there are many examples in gynecology when a woman recovered completely after pregnancy.

It is important to know that adenomyosis does not in any way affect the normal development of the fetus.

Prognosis for adenomyosis

It is important to note that adenomyosis never takes a malignant course of the disease, that is, does not degenerate into cancer. According to statistics, about 20% of women report relapses. After five years, as a rule, the disease recurs in 75 percent of women.

The risk of recurrence is significantly lower with mixed treatment. For example, laparoscopy and long-term hormone therapy. Although the risk is lower, relapses are inevitable. Women in premenopause and directly in menopause are more likely to never again face the diagnosis of adenomyosis. This feature is caused by the physiological extinction of all ovarian functions.


    | January 17, 2014 | | 21,998 | Uncategorized
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    • | Anonymous | September 17, 2015

      5 of 5

    • | Nastya | 1 November 2015

      I was diagnosed with adenomyosis and I cannot get pregnant.

    • | Anonymous | 2 November 2015

      I, too, was diagnosed with adenomyosis, only by ultrasound and PCA for hormones. G. said nothing without laparoscopy. I did not want to be cut and interfered there. I traced O by tests Ovuplan began to believe and pray. And I started taking Duphaston from 16 and was prescribed for 25, but I was afraid if I get pregnant immediately will have a miscarriage and decided to drink before the start of menstruation. After 4 days of delay, the test showed showed // Girls believe pray and act!

    • | ANASTASIA | November 9, 2015

      Girls, I have stage 2 adenomyosis, she got pregnant !!!!! The main thing is to be calm! Peace and peace of mind are very important for conception! I could not get pregnant 5 years ...

    Leave your feedback


    Iris Revoltar: Hello i am 39 yrs old and 5 weeks pregnant to my second child.. i am suffering from bleeding.. what am going to do.. medicines has not gud effect

    Reygene Kay: I'm just diagnosed with this. Heart breaking cause I thought it was all just regular cramps. Ladies, let's all take care! <3

    June H: Stop waging war on women by encouraging cutting them up. A basic med student can tell you that many of the symptoms are treatable with change in diet and exercise. Making women feel like they need to take hormones or have surgery is IRRESPONSIBLE!

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