Fibroids and adenomyosis of the uterus are among the most frequent pathologies gynecologists diagnose.
In some cases, these two illnesses can occur simultaneously, which leads to various dangerous changes in a woman’s body.
Both illnesses adversely affect the functionality of the reproductive organ, and in order to realize the seriousness of such a combination, it is necessary to begin by analyzing each of these diseases separately.
In fact, this is one of the manifestations of endometriosis, in which the inner layer of the reproductive organ becomes inflamed.
What is adenomyosis?
Normally, most of the endometrium is rejected every month and is displayed with menstruation, but with adenomyosis, the endometrium is not only not rejected in the right quantity, but also grows pathologically and also grows into the uterine muscle.
As a result, the uterine walls thicken, leading to deformation of the organ. A healthy uterus resembles a pear in shape; the uterus affected by adenomyosis has a spherical shape.
Without adequate treatment endometrial cells can affect not only the reproductive organs of a woman, but all others that are in the pelvic region.
This phenomenon worsens the work of all systems and negatively affects the health of a woman.
What is fibroids?
Myoma - is a benign neoplasm that grows on the walls of the genital organ or in its cavity.
Myomatous formation grows slowly, but with its increase, the reproductive organ also increases greatly.
This tumor can put pressure on other organs of the reproductive system, impairing their blood circulation.
Myomatous formation often becomes the cause of infertility, since a large fibroid can block the fallopian tubes, preventing sperm from penetrating inside.
The reasons for the combination of pathologies
These diseases are often diagnosed at the same time, since the mechanism of their occurrence is similar.
Provocative factors for the formation of both pathologies are considered:
- hormonal changes in the body, in which there is an increase in estrogen, these can be pathological hormonal disruptions, as well as restructuring during pregnancy,
- chorionic infectious processes,
- advanced gynecological pathologies,
- long and uncontrolled hormonal drugs,
- frequent stress
- violation of metabolic processes,
- irregular sex life.
Often these illnesses provoke weight lifting, overweight, surgery in the reproductive system, as well as genetic predisposition.
Symptoms of the disease
Signs of adenomyosis and uterine fibroids, occurring simultaneously, are somewhat different from the symptoms of these diseases, occurring separately.
Read about symptoms of adenomyosis here.
Since the lesion is related to the reproductive organ, the main symptoms of these ailments are pain in the uterus, and interruptions in the menstrual cycle.
So, the joint disease of fibroids and adenomyosis provokes the following clinical picture:
- pain of varying intensity, which can radiate to the lumbar and sacrum,
- failure in the monthly cycle,
- copious menstruation,
- intermenstrual spotting or bleeding,
- spontaneous abortion.
Such a clinical picture is observed when one or both of the illnesses progress for a long time and are in an advanced stage.
The initial stages of ailments may not have any impact on the quality of life of the woman, and not manifest clinically.
Types of fibroids in combination with adenomyosis
Myomatous formations that can occur on the background of adenomyosis are classified as follows.:
- Intermuscular fibroids Such a neoplasm is located in the thickness of the muscle layer, and makes up 60% of all cases of this pathology.
- Submucous. Growing towards the endometrium.
- Subserous. Partially and completely under the outer shell of the reproductive organ.
- Retroperitoneal. Myomatous node grows from the cervix of the genital organ or the lower parts of the uterus, that is, where the peritoneum is absent.
- Stitching. Located between the leaves of the uterine ligaments.
In addition, fibroids are classified by cell composition.:
- Simple. Cell division in the neoplasm is absent.
- Profiling. Has a large number of muscle cells, but also has a benign character.
- Predsarcoma. Multiple foci in which mitosis occurs, heterogeneous cell nuclei, that is, begins the malignant process.
What is the danger?
Both illnesses themselves are quite dangerous for women's health, and combinations of such pathologies can lead to the following complications.:
- infertility - the nodes prevent sperm from moving towards the egg cell,
- spontaneous abortions - the presence of pathological processes during gestation of the baby, which provoke miscarriages,
- development of ectopic pregnancy
- abnormal fetal development,
- strong, life threatening bleeding women,
- the transformation of benign pathology into malignant.
To diagnose the presence of myomatous nodes on the background of adenomyosis, the following diagnostic measures are necessary.:
- Gynecological examination, during which it is possible to note an increase in the size of the genital organ, changing its shape and other parameters of pathologies.
- Ultrasound. Myoma on ultrasound is seen as a circular formation with hypoechoic signs, and in adenomyosis, the structure of the myometrium is heterogeneous. In addition, there is an increase in the size of the reproductive organ and other signs of pathologies.
- Hysteroscopy. This study is indicated for suspected submucous myomas. During the inspection is determined by the state of the mucous layer of the uterus. The main symptom of adenomyosis is the presence of endometrial foci.
- MRI This research method allows to detect even small myomatous nodes and tiny foci of adenomyosis.
- Laboratory research. Assigned to tumor marker CA-125, blood test and other tests.
In medical practice, myoma in combination with adenomyosis is treated with the following drugs.:
- Gonadoliberin antagonists, which cause artificial menopause, which leads to a decrease in pathology almost twice.
- Oral contraceptives are used only in the early stages of ailments.
- Progesterone preparations. They stop the progression of the disease, and significantly reduce the size of the tumor formation.
- Sedative preparations.
The choice of drugs, their dosage and duration of treatment should be determined only by a competent specialist.
Self-medication in this case can lead to undesirable consequences..
It is also necessary to remember that conservative treatment cannot completely rid itself of pathologies, it only partially reduces the size of fibroids, and prevents the development of adenomyosis.
Surgery to eliminate the pathology can be carried out with the help of complete or partial removal of the affected organ.
The following indications are available for surgery:
- knots more than 10 mm,
- Myoma corresponds to the 12th week of pregnancy
- the neoplasm is growing fast
- the patient complains of severe pain and bleeding,
- anemic syndrome,
- transformation of a neoplasm into a malignant one
- necrotic changes in the tissues of the reproductive organ,
- submucous myoma is combined with adenomyosis.
The intervention of which plan would be more appropriate in a particular case, the doctor decides on an individual basis, based on the size of the nodes, their location, number, general condition of the woman, her age and the desire to preserve reproductive function.
I must say that with the onset of menopause pathology can resolve.
This is possible with the restructuring of the hormonal background of a woman, during which the secretion of estrogen, the female sex hormones, decreases.
Myomatous formation will increase until the ovaries produce sex hormones.
As for preventive measures in relation to the development of fibroids and adenomyosis, they consist in visiting the gynecologist once a year, even in the absence of clinical signs of pathologies.
In addition, any woman should understand that the unauthorized self-administration of oral contraceptives and other hormonal drugs can lead to an imbalance of hormones, which will give impetus to the development of various pathologies, including fibroids and adenomyosis..
Conclusion and conclusions
Uterine fibroids and adenomyosis in combination with each other is a dangerous combination that requires the timely detection of pathologies using modern diagnostic methods.
Only if you have a complete picture of the disease in your hands, the doctor can create the optimal treatment for pathologies.
Therefore, a woman should clearly understand how serious her condition is, and not delay the visit to the doctor.
General information about diseases
Myoma is a benign tumor of the muscle layer of the uterus. Other names for pathology are leiomyoma, fibromyoma, fibroma. The tumor is hormone-dependent, is detected in women of reproductive age and grows up to menopause. In menopause, fibroids are capable of independent regression, but this does not always happen. Without treatment, the neoplasm can grow to gigantic proportions, leading to dysfunction of the pelvic organs and other serious disorders.
Adenomyosis is a special case of endometriosis. By this term is meant the growth of the endometrium (the mucous layer of the uterus) beyond it. Pathology has no tendency to self-resolution in menopause and is one of the leading causes of infertility.
- Uterine fibroids are detected mainly in women older than 35 years. The incidence rate is 30%,
- The share of adenomyosis accounts for 10-40%. This variation is due to the fact that the disease is asymptomatic for a long time and is detected by chance. Adenomyosis occurs at any age, including in young women,
- Simultaneously, uterine fibroids and endometriosis are detected mainly at the age of about 35 years (28-40 years),
- With infertility, endometriosis of any location occurs in 30% of cases.
The combination of fibroids and endometriosis occurs, as a rule, in women aged 28 to 40 years.
Causes of development and risk factors for pathology
Uterine fibroids are not accidentally detected on the background of adenomyosis. These diseases have similar causes of development. And although the exact mechanisms of the formation of pathological foci in the uterus are unknown, the following factors are implied:
- Hormonal imbalance. Traditionally, in the development of fibroids and adenomyosis, estrogen plays a key role. The excess of this hormone provokes the proliferation of tissues, which leads to the appearance of the rudiments of fibroids and foci of endometriosis in the uterus. The increase in the level of progesterone, another female hormone,
- Refusal to have children according to the biological role of a woman. Repeated cycles of ovulation and monthly menstrual flow trigger cell proliferation processes and disrupt the mechanisms of apoptosis (programmed death). This theory largely explains the development of leiomyoma, but is of much less importance in the pathogenesis of adenomyosis,
- Immune theory is based on the failure of natural defense mechanisms. The exact chain of violations was not identified.
In the development of endometriosis of the ovaries, fallopian tubes and peritoneum, menstrual blood reflux is of great importance. It is believed that the injection of blood into the tubes and further into the abdominal cavity provokes the growth of foci (heterotopies). This theory does not explain the occurrence of adenomatous structural changes in which pathological foci are detected in the muscle and serous layer of the uterus.
One of the reasons for the development of endometriosis is menstrual reflux.
There are several risk factors that contribute to the simultaneous development of fibroids and adenomyosis:
- Heredity. The particular importance of genetic predisposition is given in the development of endometriosis,
- Refusal of the birth of children
- Late realization of reproductive function (birth of the first child over the age of 30),
- Transferred spontaneous miscarriages and abortions, difficult childbirth, diagnostic and therapeutic interventions in the uterus,
- Endocrine diseases: thyroid disease, diabetes, obesity,
- Inflammatory processes in the pelvic organs,
- Irrational hormonal drugs.
Abuse of hormonal drugs may contribute to the formation of fibroids and the development of adenomyosis.
Do not confuse adenomyosis and adenomyoma. In the latter case, we are talking about uterine myoma, in the structure of which many glandular cells are detected. The causes of adenomyomatosis are not studied. It is assumed that adenomyoma occurs in violation of fetal development and is often combined with other malformations of the urogenital system.
The clinical picture: how to distinguish myoma from adenomyosis?
Internal uterine endometriosis and leiomyoma have similar symptoms:
- For a long time they are asymptomatic and come to light accidentally during a routine examination by a gynecologist,
- Accompanied by violations of the menstrual cycle of the type of polymenorrhea. Menstruation becomes long and abundant. Adenomyosis is characterized by pain during menstruation. With fibroids, the pain does not occur immediately, but only when the tumor grows into the deeper layers of the muscle layer or with multiple nodes,
- Uterine acyclic bleeding.
Uterine bleeding can be a sign of both endometriosis of the uterus and leiomyoma.
At the initial stages with minimal clinical manifestations, it is quite difficult to distinguish one pathology from another. With a combination of fibroids and adenomyosis, the symptoms will overlap, complicating the diagnosis.
Distinctive signs of adenomyosis:
- Severe premenstrual syndrome: discomfort in the lower abdomen, engorgement of the mammary glands, emotional instability,
- The appearance of bloody discharge for 1-3 days before the onset of menstruation and for several days after it,
- Pain during menstruation. Localization of pain will depend on the location of the hearth. With the defeat of the uterus body, discomfort occurs in the lower abdomen. The formation of the lesion in the corners of the uterus gives pain in the groin, in the isthmus - gives in the perineum. The pain occurs a few days before menstruation and persists for 2-3 days after the end of the discharge,
- Dyspareunia - pain during intercourse,
- Uterine bleeding occurs predominantly in the middle of the cycle.
Adenomyosis is often accompanied by pain during intimacy.
In endometriosis, pathological lesions are detected outside the uterine mucous layer. This means that all the monthly changes characteristic of endometria will also occur in heterotopies, which explains the clinical picture of the disease.
Distinctive signs of fibroids:
- Littering before and after menstruation is not characteristic,
- Abundant periods often pass into uterine bleeding,
- There may be bloody discharge in the middle of the cycle,
- There is chronic pain syndrome, including outside of menstruation,
- Large nodes lead to dysfunction of the bladder and rectum.
Symptoms of fibroids are determined by its localization. With a single nodular subserous tumor, symptoms of dysfunction of the pelvic organs come to the fore. Submucous fibroids in the uterine cavity gives a clinical picture similar to adenomyosis.
To understand the pathological processes taking place, it is necessary to know the classification of diseases.
There are four stages in the development of adenomyosis (according to L. V. Adamyan and V. I. Kulakov):
- Stage I - the process is localized in the uterine lining,
- Stage II - foci of endometriosis are detected in the muscle layer,
- Stage III - heterotopies capture the entire myometrium up to the serosa,
- Stage IV - the pathological process moves to neighboring organs (pelvic peritoneum, etc.).
The severity of symptoms depends on the stage of the disease. The larger the area of the lesion, the worse the prognosis.
The form of adenomyosis is divided into three groups:
- Nodal - foci of endometriosis form nodes similar to myoma. This form of pathology is the most difficult for differential diagnosis,
- Focal - separate parts of endometriosis are formed in the thickness of the uterus,
- Diffuse - there is a massive spread of heterotopies.
The percentage of different forms of adenomyosis.
In the development of stage fibroids are not isolated. The disease is classified according to the size of the tumor:
- Small size of fibroids - up to 2.5 cm
- Medium tumor - from 2.5 to 6 cm,
- Big fibroids - from 6 cm.
In the diagnosis of fibroids, uterine enlargement also matters. The size of the reproductive organ is estimated in weeks of pregnancy.
According to the localization of myoma nodes, subserous tumors (located in the abdominal cavity), interstitial (intermuscular) and submucous (growing in the uterus) are isolated.
Reproductive function: possible problems and their solutions
Infertility is a frequent companion of endometriosis. In the development of infertility, there are several factors:
- Hormonal disorders that occur under the influence of overgrown foci. Infertility is associated with anovulation, when the maturation of the egg does not occur,
- Adhesions in the fallopian tubes often occur on the background of endometriosis, and the egg can not meet with the sperm.
Endometriosis is often complicated by adhesions, which can lead to infertility.
With myoma infertility is much less common and is usually observed with submucous nodes. A tumor located in the uterus, acts as a foreign body - a spiral, and prevents sperm from penetrating to the egg. A certain role is given to hormonal imbalance.
Myoma and adenomyosis can be combined with other diseases of the reproductive organs: cysts and ovarian tumors, polyps and endometrial hyperplasia. Often, chronic endometritis becomes a provoking factor in the development of pathology. All these conditions make the course of the disease worse and reduce the chances of having a baby.
The probability of infertility increases with a long course of the disease: 3 years for adenomyosis and 5 years for uterine fibroids.
The successful conception of myoma or adenomyosis does not guarantee that the embryo will take root and develop normally. Both pathologies threaten miscarriage - a condition in which a spontaneous miscarriage occurs repeatedly. The causes of this complication are known:
- The formed embryo does not find a place for implantation and dies,
- Fetal egg is attached in the wrong part of the uterus and soon exfoliates from the uterine wall,
- Myomatous nodes and foci of adenomyosis prevent the development of the placenta and nutrition of the fetus, which leads to its death and miscarriage.
Tumors in the uterus and adenomyosis can threaten abortion, because they affect the nutrition of the embryo.
Pregnancy on the background of fibroids or adenomyosis is possible. The prognosis depends on the stage of the disease, the age of the woman and other factors. In combined pathology, pregnancy is accompanied by the development of complications and often ends in preterm birth. To save the child, you must follow the recommendations:
- To register for pregnancy and regularly visit a doctor,
- Complete all necessary examinations, including ultrasound screenings. Assess the state of endometrium, identify foci of endometriosis and myomatous nodes,
- Control the growth of fibroids and heterotopias during pregnancy.
With the threat of termination of pregnancy is preserving therapy. Used tocolytics, means to improve blood flow in the uterus, hemostatic drugs. With the development of complications from fibroids (tumor necrosis, torsion of the legs), its removal is indicated. Surgical treatment of adenomyosis during pregnancy is not carried out.
Diseases of the uterus lead to the development of bleeding during pregnancy and childbirth. Gynecologists strongly recommend testing and treatment before conceiving a child. Such tactics will avoid complications and increase the chances of a favorable outcome of pregnancy.
With the development of obstruction of the fallopian tubes against the background of fibroids or endometriosis in vitro fertilization is possible.
The method of IVF (in vitro fertilization) is used in cases when due to various pathologies the patency of the fallopian tubes is impaired and it is no longer possible to restore it.
Other dangerous complications
The main negative consequences of uterine fibroids in combination with adenomyosis are heavy menstruation, leading to anemia. Anemia can be suspected when severe weakness and pallor of the skin appears. There are complaints of tinnitus, headaches, dizziness. Diagnosis helps complete blood count. Iron preparations are prescribed for the treatment of anemia, but this is only a temporary measure. To normalize the condition, it is necessary to reduce the amount of monthly blood loss, conservatively or surgically.
Bleeding caused by diseases of the uterus, can be very heavy and pose a threat to the life of a woman.
A small fibroid does not deform the stacks of the organ and is not determined by bimanual examination. Large subserous and interstitial nodes make the uterus lumpy. During the examination, the doctor draws attention not only to the size and contour of the uterus, but also its soreness, dislocation and other parameters.
With adenomyosis, the uterus is enlarged in size, its surface remains even. Other specific signs are not detected.
During a gynecological examination, the specialist draws attention to the condition of the uterus in order to make a primary diagnosis.
With ultrasound myoma is seen as a rounded hypoechoic formation located in the bottom, body or cervix. The doctor assesses the size of myoma nodes, the number and location. With the help of Doppler blood flow is determined in the vessels that feed the tumor of the uterus.
In adenomyosis, myometrium becomes inhomogeneous. The signs of the disease include:
- Increasing the size of the uterus,
- Diffuse myometrial changes of the type of adenomyosis. The appearance in the muscle layer zones of increased echogenicity and anechoic inclusions with a diameter of 5 mm,
- With focal adenomyosis, heterotopies of up to 15 mm are detected.
Differential diagnosis of uterine fibroids is carried out with a nodular form of adenomyosis. For the latter is characterized by the appearance of anechoic lesions in sizes up to 5-6 mm. The centers are round or oval, with clear contours. Unlike adenomyosis, myomatous nodes have a capsule visible with good resolution on ultrasound.
The echographic signs of adenomyosis allow us to distinguish it from fibroids and other pathologies of the uterus, but they do not always make it possible to set an exact diagnosis. To determine the tactics of treatment may require additional methods.
An endoscopic examination of the uterus is performed if a submucous myoma is suspected. During the inspection, the size and location of the site is estimated, and the state of the mucous membrane is determined. When education sizes up to 5 cm may be their one-time removal through the vagina.
In adenomyosis, the hysteroscopic picture is different. The main symptom of pathology is the detection of endometriotic foci in the form of bluish-purple points on the pink mucosa.
If during the hysteroscopy procedure bluish-purple foci are visible on the uterine mucosa, then this is a sure sign of adenomyosis.
Laboratory research methods
The increase in CA-125 level indirectly indicates myoma and adenomyosis. Protein concentration is also increased in malignant tumors of the uterus and appendages. Endometriosis is favored by the simultaneous increase in the placental protein PP-14.
The test for tumor marker CA-125 may be prescribed for suspected malignancy of the tumor.
With the combination of fibroids and adenomyosis, priority is given to such drugs:
- Gonadotropin-releasing hormone agonists. Depot forms are applied (one injection per 28 days). The course of therapy is 3-6 months. Against the background of agonists, reversible amenorrhea develops. Menstruation stops, tissue proliferation slows. Foci of adenomyosis and myomatous nodes are reduced in size. Acceptance of agonists is carried out under the guise of estrogen to reduce the unpleasant symptoms of drug menopause,
- Estrogen-progestin drugs. Under the influence of combined oral contraceptives, the production of gonadotropic hormones is suppressed, proliferation of uterine tissues, growth of endometrioid and myomatous foci are reduced. With prolonged use marked sclerosis adenomatous moves. The course of treatment is at least 6 months,
- Modulators of progesterone receptors (Esmia). Inhibit the growth of fibroids, inhibit the activity of the endometrium and eliminate the foci of adenomyosis. Apply a course for 3 months.
Progesterone receptor modulator preparations (for example, Esmia) have a positive effect in the treatment of myomatous nodes and adenomyosis.
Progesterone preparations (Duphaston, Norkolut, Utrozhestan) are not used for the combination of fibroids and adenomyosis. There is evidence that gestagens provoke the growth of myomatous nodes.
Folk remedies in the treatment of comorbidity are ineffective. Herbal preparations, homeopathy, hirudotherapy, self-hypnosis sessions and conspiracies can only be used as ancillary measures and not to the detriment of the gynecologist's recommendations.
Of interest is the use of Mirena intrauterine device. According to the reviews of doctors, the Navy has established itself as a good means of helping to slow down the growth of myoma nodes and prevent the growth of foci of adenomyosis. The spiral is put for a period of 5 years. In addition to the therapeutic effect, Mirena provides reliable protection against unwanted pregnancy.
The hormonal intrauterine device Mirena can be used in the treatment of certain types of myomas and prevents the development of adenomyosis.
- Uterine fibroids are more than 3 cm in diameter,
- Adenomyosis of the III-IV degree,
- Combination with endometrial hyperplasia,
- The lack of effect of hormone therapy.
Before surgery, medications can be prescribed to reduce the size of the lesion.
Surgical treatment of combined pathology is a difficult task. The best option for uterine fibroids is uterine artery embolization. The method allows you to get rid of the tumor, but is not effective against adenomyosis. For this reason, doctors often resort to sequential treatment of fibroids, and then engage in adenomyosis (after uterine artery embolization or removal of the node).
Organ-sparing surgical treatment for advanced endometriosis has not been developed. When detecting adenomyosis of grade III-IV in combination with multiple myoma, a radical operation is shown - removal of the uterus.
Summing up, it is worth noting: the difference between fibroids and adenomyosis is not the causes and symptoms, but the approaches to therapy. And if effective organ-preserving techniques have been developed for the treatment of fibroids, then there is only one tactic for endometriosis: either hormone therapy or uterus removal. To avoid the sad outcome is possible only with timely treatment to a doctor. At the slightest suspicion of pathology need to be examined by a gynecologist. The earlier the disease is found, the easier it is to cope with the problem by conservative methods and to avoid radical surgery.
Despite the fact that these two diseases have a different nature of development, they still have a lot in common, since in both cases the development of volumetric formations occurs.
Of course, the intensity and nature of the signs of uterine fibroids in combination with adenomyosis can be different in different cases, since so many factors affect the clinical picture of the disease. But if we talk about the main signs of combining these pathologies, then these include:
- pain during intercourse,
- increased organ size even without menstruation,
- excessive bleeding during menstruation, bloody discharge between the menstruation,
- pain in the abdomen,
- menstrual disorders,
- severe pain during menstruation.
These are the main symptoms of such pathologies, but in addition, multiple uterine fibroids in combination with adenomyosis may be accompanied by more general symptoms, such as nausea, dizziness, weakness, pale skin, shortness of breath and not only. As already noted, if one does not respond to signs of such a pathology in a timely manner, then it can lead to infertility, which is why it is very important to see specialists as soon as possible when symptoms appear.
Why pathologies can develop
Uterine fibroids on the background of adenomyosis often develops on the background of hormonal imbalance, but in addition, there are many other reasons that can provoke both of these ailments. It is the fact that these two pathologies have many of the same causes, and contributes to the fact that cases of the combination of two ailments are not uncommon now. So, the main reasons for the development of myomatous and adenomyotic seals include:
- A large number of abortions performed.
- Chronic infectious diseases.
- Hereditary predisposition
- Frequent hormonal disruptions.
- Unfavorable environmental situation.
- Dysfunction of the immune system.
- Ignoring gynecological diseases.
As already noted, if you do not respond in a timely manner to the echo signs of adenomyosis in combination with uterine myoma, then such illnesses can lead to very serious consequences. Often, women with such a diagnosis may experience disorders such as miscarriages, abortions, and even sterility. That is, these diseases need to be treated as quickly as possible, especially if the woman is planning a future pregnancy.
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Features of the treatment of ailments
Diagnostic measures and the appointment of appropriate treatment
Treatment of uterine fibroids in combination with adenomyosis can be carried out in two ways, namely, medication, as well as surgically. Drug therapy will be appropriate if the tumors do not grow quickly and do not cause anxiety to the patient. In addition, conservative therapies are used for women of mature age, as in this case it is sufficient to simply slow down the growth of compaction before menopause. Conservative treatment of the disease is primarily in the use of hormonal drugs, especially effective are considered drugs based on progesterone.
If the size of the seals exceeds 1 centimeter, then in this case the treatment of uterine fibroids with adenomyosis will be performed surgically. In the event of the need for surgery, it should be carried out immediately, since the larger the tumor grows, the harder it will be to remove it. The type of surgery is determined individually, taking into account both the characteristics of the disease and the condition of the patient.
But before undergoing a course of treatment, each patient with such a diagnosis must undergo a full examination. Such diseases are diagnosed with the help of hardware examination, namely with the use of ultrasound diagnostics. If, based on the results of the ultrasound study, it was not possible to determine all the features of the diseases, then the patient can be given hysteroscopy, as it allows for a more detailed study of all the details of the ailment.
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Uterine fibroids, despite its widespread use among modern women, have not yet been sufficiently studied. Only one thing can be said for sure, it is a hormone-dependent pathology. This is confirmed by its full regression at the onset of menopause and partial regression during pregnancy. Myoma is a benign tumor, while in any form it remains monocolonal - that is, it grows from a single mutated cell. So with multiple myoma, each of the myoma nodes is a separate formation that grew out of a single cell.
According to the location of myoma nodes it is classified:
- Subserous - localized on the outer walls of the uterus and grows into the abdominal cavity.
- Intramural - the most common form of fibroids. Myomatous nodes are located inside the muscle layer of the uterus.
- Submucous - nodes are formed in the submucosal layer of the uterus.
- Interstitial - nodes located deep in the muscle layer of the uterus.
- Cervical fibroids - the location of the cervical muscle.
According to the size, fibroids are divided:
- Small - clinically insignificant education size of 15-20 mm.
- Multiple small - multiple myoma nodes, no larger than 20 mm.
- Medium - single formations of no more than 40mm.
- Multiple fibroids with the presence of a dominant node. Multiple nodes are found in the body of the uterus, the largest one is dominant no more than 60 mm.
Another common pathology among women of childbearing age. Basically, the diagnosis of adenomyosis is made to women aged 25-45 years. As well as fibroids, adenomyosis is a hormone-dependent pathology that regresses with the onset of menopause and during the period of childbearing. Adenomyosis is an internal form of endometriosis, with this pathology endometrium - the mucous inner layer of the uterus grows into the muscles of the uterus - myometrium.
The form of adenomyosis is divided into:
- Focal form - endometrial tissue is embedded in the uterus muscle, forming foci.
- Diffuse - the endometrium, penetrating without forming foci in the muscles of the uterus. Often there is a combination of focal and diffuse forms of adenomyosis,
- Nodular - the endometrium in the uterine cavity forms nodes similar to myomatous. Distinguish adenomy nodes from myomatous by the presence of a capsule, with adenomyosis it is absent.
The depth of damage to the body of the uterus adenomyosis is usually divided:
- Adenomyosis of the first degree - affected no more than 1/3 myometry.
- Adenomyosis of the second degree - the endometrium grows to the middle of the muscular layer of the uterus.
- Adenomyosis of the third degree - complete destruction of the entire layer of the uterus to the serous membrane.
- Fourth degree adenomyosis of the uterus - the endometrium begins to be introduced outside the uterus - into the pelvic organs.
Leiomyoma and adenomyosis diagnosis features
Determining the correct form and stage of adenomyosis and uterine fibroids are crucial.Due to the fact that the symptoms of these two pathologies are very similar, and it is not always possible to make an accurate diagnosis with a two-handed examination, if you suspect a combination of these two diseases, you must use all modern diagnostic methods.
- Ultrasound signs of adenomyosis in combination with myoma may not always give a clear picture. The uterine uterine myoma combined with diffuse adenomyosis may not give a clear picture, especially if adenomyosis is in its initial stage. Depending on the stage and place of localization, echoal signs of uterine adenomyosis may not be sufficiently pronounced, the accuracy of the diagnosis made during ultrasound examination may be 55-95%, depending on the form and stage of both pathologies. However, there are situations when an experienced doctor cannot distinguish myoma from nodular adenomyosis with an ultrasound scan. In addition, there are cases when the endometrium grows into existing tumors.
- MRI Is the most informative method for the determination of uterine adenomyosis and fibroids, by determining the internal structure of the formation of multiple uterine fibroids in combination with adenomyosis can be determined, but only in the case of the nodal form of the latter.
- Laparoscopic examination can be used to clarify the diagnosis or in cases where its formulation is difficult.
- Biopsy. It is mainly used when there is a suspicion that uterine body fibroid is present in combination with adenomyosis, however, it is impossible to confirm adenomyosis by other methods.
Myoma in combination with adenomyosis - treatment
How to cure myoma in combination with adenomyosis, this question has only one honest answer - no way. The fact is that to get rid of these diseases can only be one cardinal way - the removal of the uterus. However, it should be understood that by themselves both of these conditions cannot affect the quality of life of a woman and her childbearing functions, if diagnosed and kept under control in a timely manner. In addition, since both of these conditions depend on the level of hormones in a woman’s body, with the onset of menopause, adenomyosis and fibroids actively regress. Possible partial regression and stabilization during pregnancy. In addition, only actively progressing conditions require immediate intervention. If fibroids and adenomyosis are at the initial stage, then they do not show themselves and the woman for many years may be unaware of their presence. So, speaking of the treatment of uterine leiomyoma and adenomyosis, we mean a situation when either one of the pathologies got out of control and began to actively develop, or when a woman went to a doctor at a late stage.
Myoma and adenomyosis hormone therapy
As mentioned above, both of these diseases are hormone-dependent, and what is remarkable, both of these conditions are treated and stabilized by the same drugs. Gonadoliberin agonists are widely used to treat various forms of fibroids and adenomyosis. Taking this drug injects a woman into artificial menopause, during which adenomyosis and fibroids begin to regress. The drug is taken up to six months, then the result is stabilized by oral contraceptives. Oral contraceptives are also widely used for the treatment of fibroids with adenomyosis, but only in the early stages.
Multiple uterine fibroids in combination with adenomyosis and EMA
According to the practice of domestic physicians and in particular doctors of the European Clinic, when embolizing the uterine arteries in women with multiple myomas against the background of a diffuse form of adenomyosis gave a positive result. This method, despite the fact that data on its effectiveness in relation to adenomyosis is still insufficient, is an alternative to the removal of the uterus. And in some cases it is not only justified, but also leads to a significant improvement.
Myoma with adenomyosis treatment of folk remedies
Since these two pathologies are hormone-dependent, treatment with folk remedies cannot get rid of the disease. The only effect of taking herbs can be a reduction of some symptoms. I can’t affect the growth or regression of tumors. Believing in advertising of such miraculous means, patients can lose precious time - when it was possible to cope with tumors using medical methods.
Why fibroids are formed
- Disturbed balance of sex hormones,
- Constant stress
- Chronic infectious diseases
- Endocrine diseases
- Impaired metabolism
- Hereditary predisposition
If a woman already had fibroids, then further development can be provoked by certain factors: there was no pregnancy until 30 years, all kinds of inflammatory processes in the genital area, prolonged use of contraceptives, visits to tanning studios.
In most cases, the tumor begins to grow in size after about 30 years. Depending on the location and size will depend on the symptoms. If you suspect the presence of fibroids, then you should look at certain symptoms.
Symptoms of fibroids
- Abundant and strong periods,
- Uterine bleeding,
- Private urination and constipation
- Aching pain in the abdomen,
- Headaches and heartaches.
Uterine fibroids symptoms
The disease in the first stages usually proceeds without symptoms. If the myoma of the uterus is small, then even considering its presence, it is possible to conceive and bear a child without any complications. If the tumor is of considerable size, which does not allow sperm to pass through the fallopian tubes, then there can be no conception of speech, therefore, pregnancy will have to be forgotten. In the case when the growth of the tumor began during pregnancy, this will seriously hinder the development of the fetus, and may also cause a miscarriage. Often, rapidly progressive fibroids lead to miscarriage, even at the latest dates. The doctor must prescribe medicines that during pregnancy will reduce the tone of the uterus. This approach allows us to extend the pregnancy for as long as possible. Large fibroids do not allow the fetus to pass through the birth canal, so a cesarean section is performed.
Adenomyosis is a type of endometriosis. The disease is characterized by inflammation of the inner layer of the uterus. The uterus on the inside has a mucous membrane that expands during the menstrual cycle, awaiting a fertilized egg. If a woman does not become pregnant at this time, then the upper layer begins to reject, which is why menstruation occurs. After that, the endometrium is still contained in the uterus, which gradually begins to expand during the next menstrual cycle.
The uterus and endometrium are separated by a thin layer. If the endometrium expands into the body cavity of the uterus, slightly thickening during the menstrual cycle, this is considered normal. If adenomyosis occurs, the endometrium will partially break through the dividing tissue and grow into the muscle tissue of the body cell. Because of what the walls of the uterus will begin to thicken, forming a kind of restriction on the development of the neoplasm. Due to this, in the course of the disease, an increase in the uterus itself is observed, which begins to resemble a ball.
The process of formation of endometrium foci in the thickness of the uterus is called focal adenomyosis. When introducing endometrium into the uterus wall and the absence of a lesion, it is necessary to speak of diffuse adenomyosis. It may also be the case that focal and diffuse adenomas form together.
It is worth noting a very important fact that the nodes of adenomyosis are in many respects similar to uterine myomas. As a rule, a myoma tumor consists of connective and muscle tissue, and the adenomyotic node consists of glandular components and connective tissue. In such cases, it is customary to talk about nodal adenomyosis.
Principles of treatment of the combined disease
If the doctor detected a myoma with adenomyosis in time and in time, then the probability that the growth of cells will stop and the uterus will remain in its original form is quite high. Treatment in this case will occur in the traditional way without the use of any dangerous drugs and drugs. In cases where the disease becomes neglected, the main method of treatment is the removal of the uterus.
Therefore, if a woman is in childbearing age, then she needs to visit a gynecologist as often as possible for a routine examination. Prevention of this type of formation is the most effective way to treat such diseases.
Drug and surgical treatment
Treatment of uterine fibroids
Treatment of a combined disease involves the use of one of two methods: medication and surgery. Drug treatment is a reception of certain drugs, prescribed by a doctor, who are responsible for stopping the development of tumor growth. As a rule, hormonal preparations are used, which by their action can halt the development of myomas and adenomyosis. Most often, one can observe the administration of GnRH agonists, which cause false menopause. Such drugs can reduce myoma in size. This treatment is not recommended for young women.
Conservative treatment in this case has some limitations. The cure of fibroids is impossible with the help of drugs, however, with their help, the necessary state of the tumor is maintained until menopause. Conservative treatment can last for a very long time.
Most of all drug treatment is suitable for women in the age (usually it is after 45-50 years old), as well as for those who have already had menopause. For young women, such therapy is prescribed only when it is necessary to delay the surgical treatment according to certain medical parameters or it is contraindicated.
Surgical treatment is indicated in cases in which a fibroid with a diameter of more than 10 mm in combination with adenomyosis was found in a woman in reproductive age. Surgical treatment is necessary here.
It is recommended to perform the operation as quickly as possible. Several points can be distinguished, if one of them is detected, surgical intervention is indicated:
- Solitary fibroids of significant size
- The rapid growth and development of the tumor,
- Serious pain, preventing a woman to work and rest,
- Permanent uterine bleeding,
- Decreased hemoglobin
- Detection of the transformation of a benign tumor into a malignant,
- Detection of foci of tumor necrosis during ultrasound,
- Submucous fibroids in combination with adenomyosis, which was revealed during diagnostic hysteroscopy.
The operation can be performed in different ways, therefore, in the presence of a combined disease, the specific features of the development of the disease are taken into account.
The importance of making an accurate diagnosis
With the help of ultrasound, even an experienced specialist can hardly distinguish myoma from nodular adenomyosis. In addition, it is impossible not to note the fact that often the endometrium grows into existing tumors.
In this regard, it is extremely important to quickly and quickly detect and determine what emerged in the uterine cavity, and then make the correct diagnosis. Even taking into account the fact that similar agents are used in the treatment of fibroids and adenomyosis, it is required to work out the correct treatment tactics, which will depend on the individual characteristics. The prognosis of this disease is quite favorable. With surgical intervention, women are completely cured, after which they can have quite high chances of successfully carrying a child. However, one should not hope for a positive outcome in the case of a neglected form of the disease, because in such cases the problem is solved radically - by removing the uterus.
The concept of myoma node
Uterine fibroids is a benign tumor that forms from the muscles of the uterus wall. Myomatous nodes can be single or multiple. Their weight varies from a couple of grams to several kilograms.
In some cases, a uterus tumor appears suddenly, accompanied by severe symptoms, while in others it begins gradually and without manifestations. Sometimes, due to the fact that gynecologists make different diagnoses, myomatous nodes are not immediately detected.
The average age of women who have myoma nodes is 35-45 years.
A characteristic feature of fibroids - its growth until menopause, and then self-resorption.
However, one should not wait for a spontaneous recovery from the disease, because myomatous nodes can cause such problems as:
- preterm labor,
- urination disorders
- constipation, etc.
What is characterized by adenomy growth?
Adenomyosis (a subtype of endometriosis) is characterized by an inflammatory process of the intrauterine layer. During a normal menstrual cycle during menstruation, the upper uterine layer is rejected and leaves with blood, if, of course, fertilization has not taken place. Part of the endometrium remains in the uterus and grows in the subsequent menstrual period.
In adenomyosis, part of the endometrium begins to grow into the uterine muscle tissue. When this occurs, a thickening of the walls of the uterus in order to protect against neoplasms. The course of the disease is characterized by spherical swelling of the uterus.
Adenomyosis is similar to myomatous nodes. The first benign neoplasm is formed from muscle and connective tissue, and the second is from connective material and glandular elements. In such situations, a diagnosis of “nodular adenomyosis” is made.
Causes of fibroids in combination with uterine adenomyosis
Patients who turn to specialists with the manifestation of anxiety symptoms, in more than 80% of cases, adenomyotic changes of the myometrium in combination with myomatous nodes in the uterus are diagnosed. Together, these diseases are detected for the reason that they have similar mechanisms of occurrence.
There are several reasons that may affect the joint development of these pathologies:
- hormonal disorders in the body,
- chronic infectious diseases
- weakening of the immune system
- frequent surgical abortions,
- the presence of neglected pathologies,
- long uncontrolled intake of oral contraceptives,
- installation of intrauterine device,
- external environmental impacts
- rare sex.
The possible consequences of the integrated development of these pathologies are infertility and miscarriages. There are often cases when there is a sudden spontaneous abortion in case of myoma on the background of adenomyosis.
Symptoms that manifest themselves with simultaneous adenomyosis with uterine myoma, are several:
- changes in the duration of the menstrual cycle,
- pelvic pains beginning before menstruation and continuing during them and a few more days after,
- the manifestation of bloody dark discharge before menstruation and in the days of its completion.
- pain during sexual intercourse (not always).
Pain when the disease is usually aggravated before the onset of menstruation. When running pathology, they persist after the end of the month.
Conducting an ultrasound to diagnose myoma nodes in combination with adenomyosis does not lead to an objective result, because the uterus is enlarged, and the overall picture is complicated by multiple nodal neoplasms.
The diagnosis is made on the basis of a complex of examinations:
- hysteroscopic and other.
Ultrasound scanning is considered the most complete method. Sonography is performed within 24-25 days of the menstrual cycle. This time is considered the most favorable for determining the degree of pathology.
When performing an echography on a combination of adenomyosis of hyperplasia and submucous fibroids, the following reasons are indicated:
- an increase in the uterus to the size of a 6-week pregnancy
- globular uterus,
- different thickness of the walls of the uterus,
- multiple cysts.
The risk of multiple forms of the disease in women 25-45 years. Symptoms of the pathology:
From the reproductive system
- copious menstrual flow
- increase in the size of the uterus,
- painful intercourse,
- intermenstrual discharge.
General condition of the body:
- shortness of breath
- bouts of nausea and pain.
The effect in the treatment of pathology is given by surgical methods. In the case when the patient turned to the doctor in time, and the disease was diagnosed at the initial stage, there is every chance of preserving the uterus. When the process of neoplasm development is in neglect, the only effective way to cure is removal of the uterine body.
There is a practice of hormone therapy, however, it can only be used at an early stage. One of the drugs used in the treatment, Duphaston, is an analogue of progesterone and suppresses endometriosis (progesterone deficiency).
Such an approach to the treatment of pathology can affect the reduction of the tumor. However, there is no guarantee that the result will be consolidated, as the experts prohibit taking hormones for a long time.
When uterine leiomyoma in combination with adenomyosis is already sufficiently developed, treatment with hormonal drugs is ineffective, it only inhibits tumor growth.
The reason for the surgical intervention is the presence of myoma nodes with a diameter of more than 1 cm in the woman, along with adenomyosis. The choice of the method of operation depends on the nature of the pathology, the characteristics of the patient’s body and other factors.
Показания к хирургическому вмешательству:
- rapid tumor progression and myoma growth,
- necrotic myoma centers,
- suspected malignant tumor,
- red blood cell deficiency and anemia,
For the treatment of the disease are used and such techniques as:
- medication treatment,
- hormonal drugs with progesterone (for example, the antiestrogen drug Klostilbegit affects ovulation),
- therapy aimed at improving immunity,
- taking sedatives
- ozone and ultraviolet radiation,
- surgery and other methods.
Myomatous nodes and adenomyosis are characterized by benignity. However, the proliferation of adenomyosis neoplasms into the tissues and their distribution throughout the body is possible.
Adenomyosis is resistant to external influences, which makes it look like a malignant tumor. In the fight against adenomy growths, experts prescribe a course of injections with the introduction of the drug Depo Provera.
If you go to a doctor in time, you can stop the growth of tumors, as well as keep the original size of the uterus.
Treatment of uterine fibroids in combination with adenomyosis
Adenomyosis and uterine myoma gynecological diagnoses, leading among the diseases of women of childbearing age. They are hormone-dependent, the etiology is not fully understood. Often there is uterine fibroids in combination with adenomyosis. Both diseases occurring simultaneously aggravate the situation. These are two different pathologies, but have similar causes, an asymptomatic course in the early stages. They are difficult to differentiate, but it is necessary to conduct an effective treatment.
Adenomyosis is difficult to distinguish from uterine fibroids.
Adenomyosis is the internal endometriosis of the uterus. Pathological germination of the endometrium in the thickness of the muscle layer, myometrium. Depending on germination in the muscle, nodular, diffuse and mixed forms are distinguished. The nodal form forms foci in the thickness of the muscle layer, diffuse scattered throughout the body of the uterus. Endometriotic nodes during menstruation during menstruation, filling the cavity with blood or brown liquid. The contents of the nodes - glandular epithelium. In response to penetration, the muscular layer thickens in these places and, with massive lesions, the uterus takes a spherical shape. The treatment is medication, surgical and complex.
All fibroids are divided into diffuse and nodular. The former are quite rare, so when diagnosing uterine fibroids, doctors most often have in mind precisely the nodular form. Very often, the nodal form of the disease is combined with such pathologies of the reproductive system as endometriosis and adenomyosis, therefore, several diseases are usually treated at once. These diseases are dangerous because if they are not started in time to heal, they can cause infertility.
Depending on the location of the tumor, the uterus uterus myoma is subdivided into the following main forms.
- Subserous form is located under the serous membrane of the uterus, often on the leg and looks on the ultrasound like a small mushroom. It is dangerous that with the twisting of this leg tissue necrosis appears, and this condition is very dangerous for the body. If the subserous nodular myoma reaches a large size, it has a squeezing effect on the organs adjacent to the uterus. This leads to disruption of the functioning of these same organs. For example, difficulty urinating.
- Submucous nodular myoma is located under the mucous membrane, therefore, it is almost always the cause of uterine bleeding. Most blood loss, if not treated, leads to anemia and the accompanying symptoms. At the same time the woman looks tired and faded.
- The intramural nodular form of uterine fibroids is located in the muscle layer and occurs most frequently. A tumor can grow both inside the organ and outwards and on ultrasound looks like a thickening in the wall of the uterus. The main symptoms of this form of the disease are disruptions in the menstrual cycle, pain, increased blood loss.
The uterus myoma can be multiple. At the same time several tumors of different size and location are detected. The most common treatment for multiple nodular myomas is more difficult, but easier to detect.
The exact cause of the appearance of uterine nodular fibroids in combination with adenomyosis or endometriosis was not found. However, it is definitely known that several factors contribute to the emergence of this form of the disease. The main considered 2 theories of the appearance of the disease.
The first theory says that even during intrauterine development, a so-called defective cell appears in the woman's body.
With a combination of several concomitant factors, this cell begins to divide and thus the growth and development of the tumor occurs.
Imbalances of sex hormones, stress, some diseases of the female reproductive system, such as adenomyosis or endometriosis, as well as a combination of some other factors can be provoking factors.
The second theory also says that there is such a defective cell in the body, but it does not appear in the prenatal period of development, but at the onset of the menstrual cycle. Part of the muscle cells of the uterus, which were supposed to prepare the organ for the attachment of a fertilized egg, do not die after the pregnancy has not occurred, and leave the body along with menstruation.
They remain for the next cycle, but they are already pathological. Some of them may later die, and some - turn into the nodular form of uterine fibroids. If there are several, then multiple nodes may appear.
Also factors contributing individually or in combination to provoke the appearance of fibroids together with adenomyosis and endometriosis are:
- inflammatory processes in the reproductive system,
- abortion and other interventions in the integrity of the uterus,
- uterine injury,
- overweight and related diseases
- endocrine disruption.
The nodular form of uterine fibroids in combination with endometriosis and adenomyosis, or without them, can develop asymptomatically for a long time. And to begin to manifest itself only reaching large sizes or in a multiple form. Symptoms may vary depending on the type of site, but the following are considered major.
- Various violations of the menstrual cycle, most often an increase in the duration of discharge and their abundance.
- Bleeding in the middle of the cycle.
- Pains that intensify during the premenstrual period.
- When the nodes are large, there may be irregularities in the work of organs adjacent to the uterus. For example, problems with urination or defecation.
- If the node grows in the uterus, then there are problems with the conception of a child.
- There may be pain during sex.
With multiple nodes of different shapes, the symptoms may be slightly blurred.
Not long ago, the diagnosis of uterine myoma was a verdict, because it was thought to be dangerous because it was a precancerous condition. Therefore, almost all tumors, and especially large sizes were treated either by removing the node or by removing the uterus. The latter was common if nodular myoma was diagnosed in combination with diseases such as endometriosis and adenomyosis. Modern medicine offers several methods of treatment that preserve the reproductive function of women.
The choice of treatment for a disease will depend on how large the node is, how dangerous the fibroid is, whether it is multiple, how old the patient is, whether adenomyosis or endometriosis is present in combination with the myoma and other factors.
This type of treatment of the uterus myoma nodular form is recommended for tumors of small size, possibly with multiple nodules. It is also possible to treat a tumor that has appeared in combination with adenomyosis or endometriosis. The main readings are two groups of drugs - hormonal contraceptives and gonadotropin-releasing hormone agonists. However, none of the groups of drugs eliminates the main cause of the nodular form of fibroids. They only reduce symptoms or suspend the growth of the tumor. However, after cessation of medication, everything can return.
It should also be remembered that the treatment of this disease with hormonal drugs can provoke the appearance of various side effects, the most famous of which is weight gain.
Sometimes medication is prescribed to reduce the site of large size and prepare for further surgical treatment.
Uterine artery embolization
This method of treatment has proven itself with the uterine fibroids nodular form. It is effective even for multiple nodes and tumors of large sizes. Its essence lies in the fact that there is an obstruction of the arteries supplying the myoma node. To do this, use special microscopic particles - emboli. The method is considered safe for the reproductive system, since the tumor feeds through a separate artery, so there are no violations in the functioning of the uterus.
After cessation of nutrition, the myoma node begins to decrease in size. Moreover, this process is irreversible, in contrast to medical treatment. As the size of the tumor decreases, symptoms begin to disappear. The menstrual cycle returns to normal, and the pain disappears.
Another advantage of this method of treatment is the simplicity and speed of the manipulations. The whole operation takes no more than an hour, and for rehabilitation it takes a day. In the future, you need only periodic visits to the gynecologist to monitor the condition of the body.
In case of uterus nodular myoma, treatment is often prescribed, in which the tumor is removed during surgery. Myomectomy is most commonly used - that is, the removal of the node while maintaining the uterus itself. The most benign method of surgical treatment is laparoscopy, in which the node is removed without abdominal surgery. The doctor only makes punctures through which he gets access to the tumor. Often, this method is assigned if the tumor is located outside the uterus or has the shape of a node located on the pedicle.
Surgical treatment may also occur with the aid of a hysteroscope apparatus. Most often it is prescribed for intramural or submucous nodules, which are located near the inner lining of an organ.
A hysteroscope is inserted into the cavity of the reproductive organ, and the surgeon controls all his actions with the help of a monitor.
The most radical surgical treatment is the removal of the uterus or hysterectomy. It is prescribed for very large nodes, with a combination of the disease with advanced forms of endometriosis and adenomyosis, with a sharp growth of the tumor, when it becomes dangerous for the body. However, now doctors try not to treat pathology with this method and do everything to preserve reproductive function.
This method of treating a disease is based on the effect of ultrasound waves on the body of a tumor. When this node is heated and destroyed. There are limitations to the use of this method of treatment. For example, it is poorly suited for large tumors.
Many older women do not understand: uterine fibroids, the nodal form of the disease - what is it? How it looks and how dangerous it is for the body. And if already diagnosed: nodular myoma in combination with endometriosis or adenomyosis, it becomes even worse. And therefore, after making such a diagnosis, they are very afraid of modern methods of treatment. But do folk treatment methods help with the nodal form of pathology?
One of the popular herbs in traditional medicine that has been used to treat tumors is calendula. A tampon is impregnated with its decoction and inserted into the vagina. Moreover, the disease should be treated with cooled liquid, three times a day for 2 hours. Also, decoction or infusion of calendula can be used for douching. To do this, it must be mixed with water in a ratio of 1 to 10.
You can treat the nodular form of fibroids with aloe juice in combination with honey and propolis. This combination of ingredients has many positive properties and has a good effect on a woman’s immune system.
Such a treatment of fibroids may appoint a doctor who believes that if the site is not large, then you can apply such techniques. However, popular treatment can only reduce symptoms. It can be used only in combination with other methods by which you will treat your disease.
The nodular form of fibroids, even in combination with endometriosis or adenomyosis, is not a sentence. Timely diagnosis and adequate treatment will help you to simply cope with this disease and live a full life in the future.
Etiological factors of uterine fibroids and adenomyosis:
- Inflammatory and infectious diseases, especially of sexually transmitted diseases, which are not subject to timely treatment,
- Violations of the hormonal status of women due to the multitude of pathological conditions localized at different levels of the female reproductive system, starting from the brain (hypothalamus and pituitary, ending with target organs for female hormones).
- Immunosuppressive states of various etiologies that provoke prolonged inflammatory processes in the pelvic organs, especially in the reproductive organs.
- Carrying out intrauterine manipulations, such as abortions performed by both curettage and vacuum aspiration. In particular, the negative impact on the occurrence of the considered pathological processes of abortion, performed in late periods.
- Frequent endometritis, salpingitis, ophritis, and combinations thereof.
- Viral etiology of both myoma formations and endometrial growths is also distinguished.
- Impact of negative environmental factors,
- Being under constant stress also affects a decrease in the overall immune status, hormonal levels, which leads to the above pathological processes.
- Also, no one excludes genetic predisposition in the occurrence of such nosological forms. That is, the presence in the genotype of genes responsible for the development of such pathological processes.
- The effects of ultraviolet radiation on the body,
- Unfinished reproductive function - the absence of pregnancy and childbirth up to 30 years are also provocateurs in the occurrence of fibroids and adenomyosis.
Clinical symptoms of such a frequent and such dangerous combination:
- The most frequent and pathognomonic symptom for these processes is a violation of the ovarian-menstrual cycle, which can manifest itself as an irregularity of the latter, and in a sufficiently large amount of menstrual blood loss,
- Abundant menstruation leads to a decrease in hemoglobin level and the occurrence of anemia of varying severity,
- The second symptom, which in 98% of cases accompanies these two nosological forms is pain syndrome. Pain gives both fibroids, squeezing adjacent organs, and adenomyosis, which is the same endometrial tissue, which also bleeds during menstruation and leads to quite intense pain.
- Before menstruation, spotting from the genital tract of dark brown color occurs, otherwise they are called "chocolate".
- Dyspareunia - painful sexual intercourse, which gives a lot of discomfort for both women and men,
- Large nodular uterus myoma in combination with adenomyosis can cause squeezing of myomatous formations of the abdominal cavity and small pelvis and lead to constipation, dysuric phenomena, and intestinal obstruction clinic.
Multiple uterine fibroids in combination with adenomyosis: treatment
Adenomyosis in combination with uterine myoma treatment should receive complex: hormones using drugs that reduce the effect of estrogens on pathological structures, and if necessary, surgical treatment, such as embolization of uterine arteries for adenomyosis, and other techniques that reduce the manifestation of such a nosological form.
All women who have learned about the existence of such a combined problem in them are asked by the same question “how to treat multiple uterine myoma with adenomyosis?”.
As with any diagnosis, the prescription of any kind of therapy is necessary.
If myoma adenomyosis, or rather its foci, are of insignificant size, the myoma presses on neighboring organs, these pathological conditions are not manifested by severe clinical symptoms. That obstetrician-gynecologists can choose for such a woman conservative therapy. In most cases, it will be based on the use of a number of progestin drugs. Either it will be combined oral contraceptives with gestagenic preparations contained in it, or progesterone drugs such as utrogestan, duphaston. also used drugs from groups of gonadotropin releasing hormone agonist groups. However, the appointment of such a group of drugs should be done very carefully in the reproductive age of a woman, as they create hormones in the body, similar to the menopause period, which will bring a lot of unwanted moments to a young woman.
Гомеопатическая терапия при таких серьезных диагнозах не используется. Since its effectiveness is extremely low and loss of time for this treatment is not justified. A specific diet for uterine myoma with adenomyosis will not be superfluous, but it will also not be of decisive importance in this process.
Surgical treatment depends on the size of myoma education. So the size of adenomyosis. If myomatous nodes exceed the size of 12 weeks, and adenomyosis - more than 1 centimeter, then surgical methods of correction of these conditions are applied.
Combination of adenomyosis and fibroids
Having a causal similarity, asymptomatic in the early period, these two pathologies often occur together. Even according to the results of an ultrasound, it is difficult to distinguish myoma from adenomyotic focus. Both diseases affect the muscle layer of the uterus - myometrium. There are cases of germination of endometriotic tissue in myoma. Common causes of education:
- inflammatory processes of internal genital organs,
- gynecological surgery,
- hormonal dysfunction
- endocrine diseases
- menstrual irregularities.
In addition to common causes, both pathologies in the initial stages are asymptomatic. Detected by chance on inspection, or if there are complaints in a later period. The symptoms of each disease are similar, when they occur together, the symptoms may increase. Due to hormone dependence, these problems regress after menopause. In accordance with the size, localization of nodes, stage of the disease, signs appear:
- longer periods, menorrhagia,
- bleeding between cycles
- pain in the abdomen, during sexual contact, examination,
- infertility, spontaneous miscarriages,
- enlarged uterus,
- frequent urination and constipation,
- reduced immunity
Uterus adenomyosis is its internal endometriosis.
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VrachLady / Uterine fibroids / Treatment of uterine fibroids in combination with adenomyosis
Unfortunately, the ecological situation in modern cities and large cities in our time leaves much to be desired. Therefore, cases of "female" diseases have become more frequent. Such diseases include adenomyosis (most often the nodular form) and fibroids. often combined with each other. This frequency of diagnosing a combination of the two diseases is explained by hormonal disorders, which are a complication of both ailments. Both adenomyosis and uterine fibroids lead to diffuse changes in the organ cavity.
In order to understand what caused the combination of these two ailments, you first need to touch them separately.
Fibroids are rarely malignant, although a large formation can narrow the uterine cavity and lead to a false pregnancy or infertility.
Myoma (leiomyoma) of the uterus is called a benign tumor that appears in its myometrium (muscle layer). It occurs by dividing the muscle and connective cells that form myomatous nodules or tumors.
This disease is diagnosed in women from 35 to 50 years old, but in recent years the disease has become “younger”: young 25-year-old girls who have difficulties with conception because of myomatous nodes in the uterus turn to doctors.
There are several classifications of leiomyoma:
- Sumculosa - located inside the uterus, often grows on a thin stalk,
- Subserous - grows on the outer surface of an organ, often touches adjacent organs in the abdominal cavity,
- A cervical fibroid is located in the cervix,
- Interstitial localized in the middle layer of the myometrium.
By the number of tumors:
When diagnosing myoma nodes, doctors correlate the degree of their development with the size of the uterus during pregnancy in weeks.
There are many cases where, with the onset of menopause, myomatous nodes in women dissolve and disappear by themselves, which is due to a drastic decrease in the number of female sex hormones in the body.
Physicians consider the reasons for the appearance of leiomyomas:
- Hormonal disruptions
- Depression, stressful situations,
- Endocrine diseases,
- Infectious diseases of the chronic course,
- Impaired metabolism
- Hereditary factor
- Regular frequent visits to the solarium,
- Late age of birth of the firstborn, childlessness,
- Inflammation of the female genitourinary system,
- Use OK for years.
In the early stages, the fibroid practically does not make itself felt and manifests itself only after it reaches a certain diameter.
Symptoms indicating a possible development of leiomyoma are considered:
- Menstrual pain in the lower abdomen and lumbar back (intense and moderate strength),
- Large volumes of menstrual blood,
- Frequent urination,
- Chronic constipation
- Pain in the head, heart.
Fibroids can cause infertility (the node prevents the passage of eggs and spermatozoa to the internal genitals) or chronic miscarriage (changes in the tumor that occur in the process of fetal development, provoke miscarriages).
Large fibroids often become an indication for delivery by cesarean section.
Adenomyosis is an unusual proliferation of the endometrium, in which its cells germinate deep into the muscular uterine layer. In fact, adenomyosis is one of the varieties of endometriosis.
Endometrium is called the inner layer of the uterus, which grows throughout the entire menstrual cycle, waiting for a fertilized egg to attach to it. And when this does not happen, the body rejects the main part of the endometrium, which leaves the uterus in the form of bleeding.
Anatomically, the myometrium and endometrium are separated by a thin layer. Growth of the mucous membrane inside the uterus is considered normal, but if the endometrium begins to pierce the septum and grow into the myometrium, adenomyosis is diagnosed against the background of such changes.
In medicine, there are several varieties of adenomyosis:
- Focal - when the disease affects the myometrium with the formation of the focus,
- Diffuse - localization in myometrium, without foci,
- Nodular - foci of adenomyosis consist of glandular and connective tissue (the structure is very similar to a myomatous tumor),
- The combination of focal and diffuse forms.
Doctors so far have not identified the true cause of the rupture of barrier tissue between the myometrium and the endometrium.
However, it is believed that there are some adverse factors:
- Multiple abortions,
- Caesarean delivery,
- Surgery on the uterus,
- Natural multiple childbirth,
- Inflammatory diseases of the body.
Adenomyosis occurs in women after 25-30 years, however, there are known cases of diagnosing the disease in girls 13-16 years old. This is due to the insufficient opening of the neck at the beginning of regular menstruation and with the individual characteristics of the development of the female reproductive system (anomalies of intrauterine endometrial development).
Symptoms of adenomyosis are similar to signs of myoma development:
- Irregular, painful, heavy menstruation,
- Brown discharge from the genital tract during ovulation,
- Lower abdominal pain, distension of the uterus,
- Pain during sex.
Adenomyosis in itself does not cause infertility, but the fact that its combinations with myomas or endometriosis are often found can be an obstacle to motherhood.
The combination of uterine fibroids and adenomyosis
The nature of both ailments is the same, so the combination of adenomyosis with myomatous nodes in the uterus is not uncommon.
The causes of this phenomenon may be:
- Chronic infections (hepatitis),
- Hormonal disorders in the female body,
- Unfinished "female" ailments,
- Disruptions in the immune system,
- Multiple abortions,
- Poor environmental conditions
- Hereditary factor
- The use of intrauterine devices,
- Long reception ok,
- Irregular sex life, its absence.
A combination of adenomyosis and myomatous nodes is diagnosed most often in women between 25 and 45 years of age, and the following complications can occur against these two ailments:
- Miscarriage of pregnancy (sometimes in the later periods),
Symptoms of the fact that in addition to myoma women developed adenomyosis, are considered:
- Enlarged uterus (abdominal distention),
- Pain (pulling, intense during menstruation),
- Pain during sex
- Isolation of blood from the genital tract between menstruation,
- Heavy menstrual bleeding,
- General condition of weakness
- Pale skin,
- Bouts of nausea.
Treatment of a combination of two diseases
It is possible to cure diseases completely only in the early stages. If a woman came to the doctor immediately after the appearance of alarming symptoms - the chances of preserving the uterus and the ability to have babies in the future are quite high.
If the tissue of the fibroids has grown to a significant size, only surgical intervention can help. That is why for all women of reproductive age it is obligatory to visit the gynecologist twice a year (prevention is better than treatment).
The combination of diseases is treated in a complex:
- Drug treatment:
- Hormonal agents to slow the growth of nodular tissue. The use of these drugs is shown more to older women, or young to improve the condition of the uterus before surgery. Progesterone derivatives (GnRH agonists) are mainly used - these drugs reduce tumors several times,
- Soothing preparations (Valerian extract, Motherwort, Novopassit),
- Physiotherapy treatment:
- Ozone therapy,
- Plasma exchange
- UVCA (blood irradiation with ultraviolet rays),
- VLOK (laser blood treatment).
- Surgical intervention in the combination of adenomyosis and fibroids is mandatory if at least one node with a diameter of more than 10 mm is diagnosed. In addition, the indications for surgery on the uterus are:
- Myoma, the size of which corresponds to 12 weeks of pregnancy
- The rapid rate of growth of tumors
- Intense persistent pain in the lower abdomen,
- Regular bleeding from the genital tract (not menstruation),
- Low hemoglobin level
- The incipient degeneration of the tumor,
- Necrosis of the uterus,
- Adenomyosis, combined with one or more succinosis myomas,
- Endometritis, overgrown to such limits that it began to touch the bladder and rectum.
Depending on the following factors and their combinations, a woman will be prescribed a complete or partial removal of the uterus, or the removal of tumors with organ preservation:
- Node sizes
- Their localization
- The number of tumors
- The prevalence of adenomyosis (can go to the ovaries, rectum or walls of the bladder), its appearance and progress,
- The general condition of the patient
- Other diseases she has.
The effectiveness of treatment in general depends on the correct diagnosis (nodular adenomyosis and myomatous formations are similar in appearance and symptomatology).
Features of diseases
Many are interested in what is uterine fibroids. This is a disease, with the development of which occurs benign formation in the muscle tissue of the myometrium. In adenomyosis, pathological germination of the tissue layers that line the uterus develops. Most often develops nodular myoma and adenomyosis. The disease is formed in the muscle tissue of the uterus. Myoma is formed from muscle fibers, and adenomyosis - from the endometrium. Uterine fibroids in combination with adenomyosis is a dangerous phenomenon that requires immediate treatment.
As medical practice shows, adenomyosis and fibroids are diagnosed in every tenth woman. Diseases are dangerous because they are able to develop and move into more complex forms. For this reason, it is necessary to consult a doctor in a timely manner, undergo a comprehensive medical research, since adenomyosis can spread to other organs, as a result of which their proper functioning is impaired. As a result, overall health is deteriorating. With the running form of the disease, the treatment is carried out comprehensively in the hospital.
Adenomyosis disrupts the lung due to the fact that the pleura is filled with blood. With the development of adenomyosis and fibroids, there are strong pain sensations that interfere with maintaining a full and active lifestyle. Due to the progression of these diseases, complications can occur, which often lead to premature birth or infertility. Despite the fact that these tumors are benign, they are very dangerous because they can develop into a malignant neoplasm. It is important to complete a full medical examination in time and begin a complex therapy, since uterine fibroids in combination with adenomyosis can be fatal.
What are the reasons for the disease?
There are a number of reasons that may cause adenomyosis in combination with myoma. The main causes of the disease include:
- sexually transmitted disease of chronic form
- hormonal disorder,
- irregular menstruation,
- weakened immunity
- the presence of an inflammatory, infectious or viral disease,
- a large number of abortions
- chronic gynecological disease
- bad environmental situation
- genetic factor
- systematic stress
- impaired metabolism
- Unhealthy Lifestyle.
Uterine fibroids in combination with adenomyosis appear equally often in both older women and young girls. In adolescence, adenomyosis occurs due to insufficient disclosure of the cervix during menstruation. In rare cases, the disease develops without any reason.
When does a disease progress faster?
In case of myoma with adenomyosis, tumors grow faster if:
- there is a strong inflammation in the pelvic organs,
- woman stays in the sun for a long time.
In addition, the long-term use of oral contraceptives aggravates the clinical picture.
Adenomyosis of the uterus and fibroids have the same signs of the development of the disease. In rare cases, at the initial stage of development, the pathology proceeds without symptoms. In diffuse adenomyosis, there are often no complaints from the patient. Adenomyosis most often diagnoses a doctor with a random gynecological examination. For this reason, gynecologists recommend visiting a doctor even if no symptoms of the disease are observed and the woman has an excellent state of health. Contact a doctor should be at least once every six months.
When fibroids occur, symptoms are often absent at the initial stage of the onset of the disease. When the size of the tumor is insignificant, the person does not feel discomfort and pain in the genital area.
Main symptoms of female genital mutilation
There are a number of symptoms that most often occur with the development of diseases in women. Among the main signs of fibroids and adenomyosis are:
- the presence of brown secretions
- systematic and aching pain in the lower abdomen,
- unbearable abdominal pain during menstruation,
- soreness during sexual intercourse,
- long and copious menstruation,
- feeling of weakness and exhaustion
- frequent urination,
- violation of the gastrointestinal tract,
- frequent headaches
- pain in the heart,
- having trouble breathing.
When one of the symptoms appears, it is important to immediately complete a full medical examination, to pass all the necessary tests, since this is not a normal condition of the body. At different stages of development of the disease, the symptoms may vary. It is important to diagnose the disease in a timely manner, since with the running form of the disease there are often negative consequences. Removal of the uterus in myoma (patient reviews confirm this) occurs quite often due to the fact that the tumor has grown too much or turned into a malignant form.
It is very important to carry out a diagnosis in a timely manner, since at the initial stage of the appearance of the disease, treatment is carried out much faster and more efficiently, there is no need to carry out surgical intervention. From the effectiveness of treatment depends on the ability to conceive a child in the future.
First of all, the doctor performs a gynecological examination. During the examination of the patient, the doctor takes a smear for bacterial culture. In addition, colposcopy is performed. It is equally important to examine the respiratory organs, the cardiovascular system and the work of the gastrointestinal tract. If it is not timely to make a diagnosis, then there may be consequences - removal of the uterus in case of myoma Reviews of doctors confirm the fact that, when the disease is neglected, drug therapy is ineffective.
Medicines should be prescribed exclusively by a doctor, based on the patient’s general state of health. In the presence of other serious diseases should be especially careful approach to the selection of certain drugs. A prerequisite is an ultrasound of the pelvic organs. In the process of diagnosing fibroids and adenomyosis, hysteroscopy and laparoscopy are performed. The form of adenomyosis is determined strictly by the doctor after a thorough examination of the patient.
Treatment of a tumor that has appeared in the uterus is carried out using a surgical or medical method. It all depends on the stage of the disease. First of all, the doctor must assess the degree of damage to the female organs.Drug treatment is applied by a specialist if the tumors are small, they do not cause severe discomfort to the woman. In this case, with the help of drugs there is an opportunity to stop the growth of the tumor.
After the onset of menopause, the tumor no longer develops, it resolves. When treating uterine fibroids in combination with adenomyosis, a specialist often prescribes the drug that contains progesterone. Due to the fact that therapy introduces the body into a state of menopause, it is not recommended to take the drug for a long time. In the course of therapy, physiotherapy is also applied, which includes mud therapy. Therapy is carried out using a laser or ultraviolet ray.
As medical practice shows, in the presence of adenomyosis, homeopathic medicines are not prescribed, since they are not effective in the treatment of serious diseases. At the initial stage of the development of the disease, doctors treat uterine fibroids without surgery. Reviews of patients indicate that the main thing is to seek help from a specialist in a timely manner, not to delay treatment.
Traditional methods of treatment are used only if the disease is at an early stage of development. Self-medication is prohibited. Many herbs have hormones in their composition, so it is important not to use decoctions without the recommendation of a specialist, as this can greatly harm and aggravate the situation. If the neoplasm is larger than 1.5 cm, then surgery is indispensable. Do not be afraid of the operation, because over time the problem will only worsen. Treatment without surgery is not carried out if:
- unbearable pain in the pelvic organs,
- heavy bleeding,
- the presence of malignant fibroids.
The type of surgery for the treatment of tumors is determined by the strictly treating physician. If there are no complications of the disease, then the uterine fibroids will most likely be treated without surgery. Reviews of doctors suggest that most often it is necessary to intervene if the tumor has greatly increased. It all depends on the state of health of the patient and the overall clinical picture. It is important to take into account the individual characteristics of the patient.
Common Disease Therapies
Therapy for uterine fibroids with signs of adenomyosis often includes embolization of the uterine artery, removal of the uterus, or removal of the adenomyosis node. Removal of the uterus is performed if the disease is too advanced. Much depends on how badly the organ is affected. That is why it is so important to carry out treatment at the initial stage of the development of the disease.
Prevention of female diseases
Any disease is easier to prevent than to cure. To minimize the risk of developing diseases, it is important to consider all the recommendations of the doctor. Experts recommend:
- Regularly examined by a gynecologist.
- It is important to find a doctor who can be trusted and tell about all their unpleasant feelings. Symptoms of the disease often manifest themselves in the form of aching pain in the lower abdomen or peculiar discharge. In order to solve some problems of the intimate sphere, it is important to regularly undergo an examination by a gynecologist, to control the acidity of the vagina. This indicator can be determined independently with the use of test strips on the level of acidity, which are sold in any pharmacy.
- If there are problems with the level of acidity, you should immediately consult a doctor and undergo a full medical examination.
Uterine fibroids with adenomyosis - what is it? Many people are interested in this question, but not everyone knows that this disease is too dangerous, it is characterized by the appearance of tumors in the uterus, therefore they do not rush to see a doctor if signs of illness appear. You should know that in case of disorders related to the intestinal microflora, problems with the level of acidity of the vagina often develop. If you have problems with digestion, it is important to immediately carry out treatment.
You must comply with proper nutrition and take a prebiotic prescribed by a doctor. A healthy lifestyle, moderate physical activity and regular examination by a gynecologist are the best prevention of any gynecological disease.
Traditional methods of treatment have a positive impact on the work of the whole body only if you strictly follow the recommendations of the attending physician. For the treatment of female diseases most often used:
You can prepare the tincture, both from one herb, and from a complex of plants. It all depends on the recommendations of the doctor and the form of the disease. It is necessary to combine herbs especially carefully, since some plants have undesirable side effects when interacting.
Experts say that sage is the most effective folk remedy that is used in the development of endometriosis and the nodular form of uterine adenomyosis. The grass has a positive effect on the process of conceiving a baby and cures infertility. To prepare a healing drink, you need to add 1.5 tsp to half a liter of boiling water. plants. After that, the drug should be infused for an hour. Before use, strain and drink a tablespoon for a week. Doctors do not recommend self-medicating and drinking hormone pills for adenomyosis without a prescription.
Adenomyosis and its characteristics
This is a type of endometriosis, which is characterized by inflammation and abnormal growth of the endometrium in the uterus. In a normally functioning female body, if pregnancy does not occur, part of the mucous membrane of the reproductive organ is rejected with menstrual bleeding, and the remaining inner layer grows for the next cycle. If conception has occurred, the fetus is attached to it.
Between the uterus and its mucous membrane passes a thin layer. During the formation of adenomyosis, the endometrium penetrates through the barrier and grows into the muscle of the female genital organ. With the development of the disease, its walls thicken, and it becomes much larger.
Depending on the form of pathology adenomyosis happens:
- Focal: the shell of the female reproductive organ is attacked by an ailment with the formation of a lesion.
- Diffuse Endometrium grows into the inner tissue of the uterine wall without clearly defined areas of damage. He can get to the outer shell of the genital and go beyond it.
- Nodal. In the walls of the uterus are embedded nodes resembling capsules of blood. This is the most severe form of internal endometriosis. New growths do not allow the fetus to implant in the mucous membrane of the reproductive organ or lead to miscarriage.
Affected areas close to critical days begin to bleed, this often provokes inflammation.
Symptoms and diagnosis
Uterine myoma and adenomyosis at the beginning of development is extremely difficult to recognize on your own. Symptoms of a combination of these diseases are manifested:
- painful sensations in the lower abdomen during sex,
- violation of the menstrual cycle,
- a significant increase in the volume of blood rejected during menstruation,
- brown secretions in any period of the month
- fatigue, frequent ailments, bouts of nausea, pale skin,
- migraines and heart pain,
- frequent constipation and urge to urinate,
- pain syndrome of varying intensity in the pelvic region, which begins a few days before the critical days and lasts some time after they end,
- thickening of the walls and swelling of the uterus,
Monthly with myoma become painful, abundant and long, so we recommend reading additional information on this topic.
When the disease is detected at the initial stage, it can be eliminated with the help of drugs. But if the disease is started, then the only way out of the situation is sometimes the removal of the affected organ, without which the woman can no longer have children.
To make such a diagnosis, it is necessary to conduct a comprehensive examination, which should include an ultrasound scan. But due to a strong increase in the affected organ and a large number of neoplasms in the form of nodes, ultrasound is not effective enough. Therefore, echography is used as an additional diagnostic method. It shows a more complete and qualitative picture of the disease. In some cases, to be sure of the diagnosis, the doctor sends a woman:
- on MRI,
- multispiral computed tomography,
- definition of tumor markers,
- color dopplerography.
The use of modern technology will allow more accurate diagnosis and start early treatment, which will help to quickly get rid of the disease.
Disease treatment methods
If the disease is detected at an early stage of development, then there is a chance to be cured with the help of tablets. For this, Duphaston and more powerful agents that can lead to a false menopause are effectively used. That is, the menstrual cycle is lost, and then completely disappear monthly.
The use of such drugs can reduce the size of a benign tumor by half in a short time. Nevertheless, such therapy takes a lot of time. This treatment has features, it is not suitable for everyone. Therefore, there are cases when it is necessary to resort to surgical removal of the pathology, and sometimes the entire affected organ.
After removal of the reproductive organ, surgical menopause occurs, therefore we recommend reading additional information on this issue.
Prognosis of the disease
Often, after the appearance of fibroids with adenomyosis, a woman may be unaware of their presence for a long time, since they are asymptomatic at the stage of generation. This indicates the good quality of formations that are not life threatening.
With timely treatment to the doctor and timely treatment, the woman has a great chance to get rid of the pathology and restore the original appearance of the endometrium of the uterus. Therefore, it is very important to go to the gynecologist as a preventive measure, even if nothing is bothering you, at least once a year.
After surgery to remove the pathology, women are fully restored, they can conceive and safely give birth to the desired baby. Therefore, after the rehabilitation period, it is allowed to plan the pregnancy.
But after menopause, neoplasms and adenomyosis independently decrease in size and disappear altogether.
The success of therapy depends on:
- on the accuracy of the diagnosis,
- timely visit a doctor,
- the experience of a gynecologist
- woman's desire to recover.