Adenomyosis of the uterus: symptoms, causes and treatment, photo
What is it - adenomyosis is an endometriosis disease in which uterine lesions are observed.
In turn, endometriosis is a pathological process in which the tissue of the inner layer of the uterus extends beyond its limits( most often in the myometrium - the muscular layer of the uterus).
The disease is most often found in active modern women, often leading to a significant decrease in the quality of life, including disability.
The incidence of this pathology is approximately 10% of all gynecological problems.
Adenomyosis can be classified according to various principles. So, from the point of view of the prevalence of the process, the
To date, there is no unified etiological concept for the development of uterine adenomyosis. It is customary to single out several theories, each of which has both pluses and minuses.
These etiological theories include the following:
In some patients, adenomyosis of the uterus can last for a long time without symptoms and become an accidental finding during the examination. However, in the overwhelming majority of cases, characteristic features appear.
The main ones are:
Adenomyosis is a diagnosis of an exception. Therefore, there are certain difficulties in diagnosing this pathology. The first step is to issue a preliminary diagnosis based on the clinical picture.
In the attention of the doctor must take the presence of painful menstruation. This symptom is found in almost all women with adenomyosis. The severity of this symptom increases with the passage of time, as pathological changes in the organs of the reproductive system progress.
The second step in the diagnosis is the confirmation or deletion of the diagnosis that was made in the preliminary stage. For this purpose, additional methods of investigation are shown.
These include:
Treatment of adenomyosis of the uterus is associated with certain difficulties, which are associated with the uncertainty of the etiology and pathogenesis of the disease. The main place in the treatment is hormonal therapy.
However, in addition to this, other drugs are also prescribed:
The main groups of hormonal drugs used for adenomyosis are:
The absence of timely treatment of adenomyosis can lead to the development of certain complications.
These include the following:
In conclusion, it should be noted that adenomyosis - a common disease of modern women that affects the uterus. Bright clinical manifestations of this disease process negatively affect the quality of life for patients.
therefore requires timely diagnosis and treatment based on the latest achievements of modern medicine.
In turn, endometriosis is a pathological process in which the tissue of the inner layer of the uterus extends beyond its limits( most often in the myometrium - the muscular layer of the uterus).
The disease is most often found in active modern women, often leading to a significant decrease in the quality of life, including disability.
The incidence of this pathology is approximately 10% of all gynecological problems.
Classification of
Adenomyosis can be classified according to various principles. So, from the point of view of the prevalence of the process, the
- diffuse process
- focal
- is nodulous.
- 1) In the first stage, endometriotic growths reach the myometrium of
- 2) In the second stage, sprouting to the middle of the myometrium of
- is observed 3) In the third stage, the pathological process reaches the peritoneum that covers the uterus
- 4) In the fourth stage,the process involves the peritoneum.
Causes of adenomyosis
To date, there is no unified etiological concept for the development of uterine adenomyosis. It is customary to single out several theories, each of which has both pluses and minuses.
These etiological theories include the following:
- 1) Weighed genetic inheritance. It is proved that in families where the mother or grandmother suffered endometriosis, the risk of its development is higher.
- 2) The casting of menstrual blood, which contains endometrial cells. They can be implanted in atypical places for them.
- 3) Increased estrogen content in the body of a woman or hypersensitivity of receptors to these hormones. Hyperestrogenemia may be relative to the background of reduction of gestagens and absolute in connection with their enhanced synthesis. This explains the development of adenomyosis in women of reproductive age and its absence in women of menopausal age.
- 4) Disrupted immunity, which allows endometrial cells to survive in conditions unusual for them. This creates conditions for the implantation of cells of the inner layer of the uterus beyond its limits.
- 5) Metaplasia processes, which consist in the transformation of one type of tissue into another. This means that certain smooth muscle cells of myometrium can be transformed into endometrial structures under the influence of various factors.
- the presence of abortions in the history of
- operations on female reproductive organs
- excess body weight( currently fatty tissue is considered as endocrineorgan that is synthesized and sex hormones)
- introduction of intrauterine contraceptives and their wearing
- decreased liver function
- inflammatory disease byorgans in women, etc.
Symptoms of adenomyosis of the uterus
In some patients, adenomyosis of the uterus can last for a long time without symptoms and become an accidental finding during the examination. However, in the overwhelming majority of cases, characteristic features appear.
The main ones are:
- 1) Algodismenorea is the main clinical manifestation of adenomyosis. Its essence lies in painful menstruation. It is characteristic that in the initial stages of pain appear only on the first day, and with the progression of the disease - throughout the entire period. This is accompanied by exhaustion of the nervous system, which causes the second symptom of the disease - irritability, nervousness, depressive mood, imbalance, etc.
- 2) Infertility - the inability to conceive in the conduct of regular sexual activity throughout the year, while methods of contraception should not be used. Infertility develops as a result of several pathogenetic factors, namely because of the adhesion process, disorders in the immune system, anovulation and imbalance of prostaglandins.
- 3) Violation of the ovarian-menstrual cycle( anovulation), leading to the development of profuse menstruation. In some women, anovulation can be accompanied by uterine bleeding, which leads to the development of anemia. The latter is manifested by weakness, shortness of breath, hair loss, pallor and dryness of the skin, palpitations, weakness, headache, etc.
- 4) Miscarriage of pregnancy( spontaneous miscarriage) in the event of its onset, which is associated with hormonal disorders.
Diagnosis of adenomyosis
Adenomyosis is a diagnosis of an exception. Therefore, there are certain difficulties in diagnosing this pathology. The first step is to issue a preliminary diagnosis based on the clinical picture.
In the attention of the doctor must take the presence of painful menstruation. This symptom is found in almost all women with adenomyosis. The severity of this symptom increases with the passage of time, as pathological changes in the organs of the reproductive system progress.
The second step in the diagnosis is the confirmation or deletion of the diagnosis that was made in the preliminary stage. For this purpose, additional methods of investigation are shown.
These include:
- 1) Ultrasonic examination of pelvic organs. To identify the characteristic ultrasound criteria of adenomyosis, the study should be conducted on the eve of menstruation, comparing the results with those obtained on the 5th-7th day of the menstrual cycle. Thus, it is necessary to conduct dynamic ultrasound.
- 2) Hysteroscopy - visualization of the uterine cavity with the help of endoscopic technique. Adenomyosis is characterized by the presence of a picture of "honeycombs".The study should be combined with curettage of the uterine cavity. This scraping is subjected to a histological examination.
- 3) X-ray examination of the uterus and appendages - metrosalpingography.
- 4) Determination of blood level of CA-125, which increases with adenomyosis. It should be noted that the method is not very sensitive, since the level of this biochemical marker also increases in ovarian cancer.
Treatment of adenomyosis
Treatment of adenomyosis of the uterus is associated with certain difficulties, which are associated with the uncertainty of the etiology and pathogenesis of the disease. The main place in the treatment is hormonal therapy.
However, in addition to this, other drugs are also prescribed:
- immunomodulators
- vitamin preparations
- non-steroidal anti-inflammatory drugs that normalize the balance of prostaglandins and effectively stop the pain syndrome.
The main groups of hormonal drugs used for adenomyosis are:
- gestagens are the drugs of choice for women who want to realize the reproductive function of
- combined oral contraceptives
- antiestrogens
- analogues of gonadoliberin
- antigonadotropins.
Complications of
The absence of timely treatment of adenomyosis can lead to the development of certain complications.
These include the following:
- infertility, having a comprehensive
- Development Mechanism uterine bleeding with subsequent development of hemorrhagic anemia
- adhesive disease pelvic
- psycho-emotional disorders
-
- neurological disorders malignant transformation of adenomyosis.
In conclusion, it should be noted that adenomyosis - a common disease of modern women that affects the uterus. Bright clinical manifestations of this disease process negatively affect the quality of life for patients.
therefore requires timely diagnosis and treatment based on the latest achievements of modern medicine.