The female body regularly undergoes cyclical changes. So, one calendar month can be divided into several different periods. Recently, hormonal diseases (endometritis, endometriosis, adenomyosis, etc.) have become increasingly common. Every year this or that pathology affects millions of women around the world. In this article, the story goes about what is adenomyosis and endometriosis. What is the difference between these pathologies? You will find the answer to this question below. It is also worth mentioning which treatment is prescribed for such a disease as adenomyosis (the symptoms and causes of adenomyosis will also be described below), how it differs from the correction of endometriosis.
Since the woman's body is regularly subjected to a change of hormonal levels, sometimes failures occur. This most often occurs after childbirth, abortion and diagnostic curettage. Also, hormones can "misbehave" during menopause and before menopause.
The most common and insidious hormonal diseases are endometriosis and adenomyosis. The difference between them is significant. However, many women confuse these pathologies. It is worth noting that adenomyosis is sometimes called internal endometriosis. Let's try to figure out what the pathology data is similar to and how different it is.
What is the difference between endometriosis and adenomyosis? This pathology occurs as follows. Due to the high production of estrogens or androgens, the mucous layer of the uterus expands to the peritoneal region. Also, a disease can occur due to the fact that menstrual blood is thrown through the fallopian tubes into the percutaneous space.
All this leads to the fact that the endometrium begins to function on the ovaries, body of the uterus, intestines and other nearby organs. Being subjected to cyclic changes, this substance can menstruate, as well as the internal cavity of the reproductive organ.
Symptoms of endometriosis
There are several stages of the disease. Depending on the lesion and the site of the lesion, a woman may have absolutely no complaints even at the very last stage of the disease. That is why pathology is considered very dangerous and insidious. So, with endometriosis, the symptoms are as follows:
- pain in the abdomen during menstruation and a few days before it,
- violation of the chair (with intestinal lesions),
- irregular cycle with breakthrough bleeding,
- long periods, which take on a black tint at the end,
- prolonged inability to conceive a child.
Adenomyosis and endometriosis: what is the difference? Many doctors say that endometriosis can be internal. In this case, it is called "adenomyosis." The disease develops as follows. Due to the imbalance of estrogen and progesterone in the body, an excess of the first substances can be observed. As a result, the inner surface of the uterus grows abundantly. In the absence of timely and correct treatment, the endometrium is embedded in the muscular layer of the reproductive organ. Endometriosis of the uterus - adenomyosis. Many women think so. In some ways they are right. However, each pathology has its own name and it will be more correct to use it.
Symptoms of adenomyosis
This pathology most often begins to manifest itself in the very early stages. The symptoms of the disease may be as follows:
- pain in the lower part of the peritoneum during menstruation and without it,
- lack of pregnancy for a long time
- spotting in the middle of the female cycle
- prolonged menstruation and a short non-structural period.
What are the similarities between endometriosis and adenomyosis?
- Both diseases are hormonal. The main reason for their appearance is a high level of estrogen.
- Both pathologies can lead to infertility and menstrual disorders.
- The treatment of the initial stages of the disease is quite effective with the help of potent hormonal drugs.
- Relapse can occur in both cases, even after the disease has completely cured.
So, now you know what adenomyosis and endometriosis are (what is the difference between them). Remember that self-diagnosis is almost impossible to make. As you can see, even doctors are not always able to accurately recognize the disease. If you suspect pathology is better to contact a specialist and undergo a diagnosis. Only in this case can you receive a qualified and correct appointment and overcome the disease. Be always healthy!
Adenomyosis and endometriosis: what is the difference between concepts?
Hyperplastic diseases are often found in the practice of gynecologists. The proliferation of uterine tissue and appendages can occur at any age. All hyperplastic processes are considered potentially dangerous for the female body. They can lead to infertility, tumor development, etc. A similar group of pathologies include adenomyosis and endometriosis. The differences between these diseases are not pronounced.
Endometriosis is a pathological condition in which normal endometrial cells intensively divide and spread throughout the body. They can appear in any organ, but are most often found in the pelvic cavity.
Adenomyosis is considered a similar disease. With this pathology, proliferation and distribution of the tissue of the muscular layer of the uterus also occurs. Therefore, patients often ask the question: adenomyosis and endometriosis - what is the difference? The difference between the two diseases lies in the localization of hyperplastic processes. Adenomyosis is characterized by the germination of endometrioid tissue in the body. As a result, the uterus increases in size.
Causes of endometriosis and adenomyosis
What causes adenomyosis and endometriosis, what is the difference between etiological factors? Although the pathologies are somewhat different from each other, both arise due to hyperplasia. Endometrial proliferation does not occur by itself. This process is associated with hormonal changes that occur constantly in the female body. Etiological factors of endometriosis and adenomyosis can be:
- Pathological conditions in the hypothalamus or pituitary gland. Hormonal status changes with the occurrence of benign tumors, head injuries.
- Diseases of the female genital glands - the ovaries. As in the brain, there may be hormone-producing tumors.
- Pathology of the thyroid gland.
In diseases of all these organs, the hormonal status of the patient changes. Most often, endometrial tissue hyperplasia occurs with elevated estrogen levels.
Endocrine disorders occur in women at risk. The factors for the development of hyperestrogene include:
- Frequent pregnancy and childbirth.
- Abortion history in the patient.
- Lack of pregnancies for life.
- Severe obesity. In adipocytes, the formation of female sex hormones.
- Installing the intrauterine device for a long time.
- Chronic inflammatory and venereal diseases.
Differences in the mechanism of development of pathological processes
Adenomyosis and endometriosis: what is the difference in the mechanism of action? The basis of both diseases is tissue proliferation. As you know, this process is observed in normal women of childbearing age. With a normal menstrual cycle, the thickening of the endometrial wall due to enhanced cell growth occurs every month.
However, in adenomyosis, the process is more pronounced. In addition, areas of hyperplasia do not disappear during the progesterone phase of the cycle. As a result, the uterine wall is constantly thickened and has a soft texture. Before menstruation, it reaches its maximum size, since during this period the production of estrogen increases.
The mechanism for the development of endometriosis is the same as in adenomyosis. The difference is that the overgrown foci of tissue of the muscular layer of the uterus are located outside the organ. They can be in the field of appendages, a cavity of a small basin, on ovaries, a peritoneum. In rare cases, endometriotic foci are located in the cavity of the internal organs: lungs, intestines, joints, nasal cavities, etc. All of them are amenable to hormonal regulation. That is, the activity of pathologically overgrown cells depends on the production of estrogen.
Clinical picture with endometriosis
The symptoms of endometriosis can be varied. First of all, it depends on the location of the hyperplastic process. Often the pathology proceeds without severe symptoms, since the endometrial foci are localized in the pelvis, intestine or appendages. During menstruation, the tissue lining the uterine cavity is rejected. As a result, bleeding occurs, which is observed every month. The fact is that, regardless of the location of the endometrial foci, during menstruation, they are all active. Therefore, spotting may appear in the most unexpected places. If there is hyperplasia in the pelvic cavity (Douglas space, peritoneal pockets), then the clinical manifestations of the disease may not be observed.
In addition to bleeding, symptoms of endometriosis include: abdominal pain, anemia, dysmenorrhea - menstrual disorders. Sometimes the only sign of illness is the absence of pregnancy with non-compliance with contraceptive measures.
What are the symptoms of adenomyosis?
Adenomyosis and endometriosis - what is the difference in the clinical picture? Although the pathologies have the same developmental mechanism, the symptoms may differ. Unlike endometriosis, a pathological focus for adenomyosis cannot be common. Therefore, bleeding from other organs and cavities will not be observed. Adenomyosis is the proliferation of endometrial tissue in uterine tissue. Therefore, the main symptom of the disease is pain in the lower abdomen. Unpleasant sensations arise due to stretching of the ligaments of the uterus and increasing its size. Also characteristic symptom of adenomyosis is dysmenorrhea. The menstrual cycle is often shortened, and the period of blood flow is lengthened. During intercourse, there is pain due to an increase in the walls of the uterus. The intensity of menstrual bleeding increases. As a result, an anemic syndrome may develop.
Diagnosis of adenomyosis and endometriosis
To distinguish endometriosis from adenomyosis, several diagnostic procedures should be performed. In addition to the gynecological examination, instrumental methods of examination are required. It is possible to suspect adenomyosis according to clinical data: pain during intercourse and menstruation, profuse bleeding. On palpation of the uterus is marked increase. Thickening of the walls and foci of hyperplasia are diagnosed using ultrasound of the pelvic organs.
It is more difficult to identify endometriosis, since its localization is unknown. In addition, the pathology often has no symptoms. Most often, the disease is diagnosed during examination of a woman about the inability to conceive a child. Endometriotic foci can be located in the uterus (in adenomyosis - in the thickness of the organ wall) and prevent the attachment of the ovum. Hyperplasia is detected by ultrasound, hysteroscopy, laparotomy. Bleeding of unknown etiology can also be triggered by endometriosis. In this case, it is necessary to examine the entire body.
Adenomyosis and endometriosis: the difference in the treatment of diseases
Hyperplastic diseases are considered dangerous as they lead to serious consequences. Therefore, treatment is required for both processes. Help with pathologies adenomyosis and endometriosis - what's the difference? The treatment of both diseases can be conservative and surgical. Most often, drug therapy is carried out in cases of small foci of proliferation in women of fertile age. Since endometriosis and adenomyosis are considered hormonal pathologies, drugs from the COC group are prescribed. They contain estrogen and progesterone in the quantities necessary for a normal menstrual cycle. The combined oral contraceptives include medicines "Yarin", "Jess", "Janine", etc.
Surgical treatment is necessary in the absence of the effect of conservative therapy, as well as during menopause. For surgical interventions include:
- Laparoscopic removal of an endometrioid focus or adenomyosis zone.
- Hysterectomy. With oncological history and heavy bleeding, the uterus is removed.
What is the prognosis for endometriosis?
Some women are interested in the question: adenomyosis and endometriosis - which is worse? In both cases, changes in the hormonal background are observed in the female body. Therefore, each of these pathologies is dangerous. Often the prognosis for endometriosis is favorable. However, the disease may recur in the presence of endocrine disorders.
According to statistics, one of the ten diseases identified by the gynecologist is the result of endometrial germination deep into the muscle layer of the uterus or any other organ. Such pathologies are called adenomyosis and endometriosis. Are there differences between them and how is the treatment carried out?
Let's first understand the meanings of these words and the nature of the disease.
This is one of the most common female diseases.
Adenomyosis is a disease of the uterus caused by the penetration of endometrial muscle tissue. This penetration not only leads to an increase in the volume of the uterus, but also to severe bleeding, which causes severe pain both during menstruation and outside.
There are three main forms of the disease:
It is noteworthy that in one patient two or even three forms of manifestation of the disease can be observed simultaneously. Diffuse form is expressed by the defeat of large parts of the uterus. Focal, on the contrary, captures small areas and practically does not cause inconvenience. The nodal manifestation of adenomyosis is very similar to myoma in its structure, small nodes are formed.
There are four stages of the disease.
- The first is surface penetration of the endometrium.
- The second one is that the endometrium is deep enough, but the damage is not local. Damage to the thickness of the muscle layer of the uterus does not exceed 50%.
- The third is a deep penetration of the endometrium by more than 50%.
- The fourth - complete damage, when the endometrium is located at the entire depth of the layer.
Adenomyosis belongs to the category of chronic diseases and requires high-quality therapeutic measures. It is very important to detect pathology in the early stages of development - this will greatly facilitate treatment and also help to avoid serious manifestations of the disease.
To date, it is still not known what could be the cause of the disease. However, a clear relationship was found between endometrial germination and the number of female hormones - their number is overestimated. Hereditary predisposition is seen in almost every case.
The impetus for the development of pathology can be:
- physical and mental stress
- nervous breakdowns.
At the initial stages of adenomyosis can occur completely without a trace. Clear signs of the disease are extremely rare, and in most cases they are not there at all.
What are the signs of adenomyosis?
- Lower abdominal pain. Especially vividly manifested during menstruation, physical activity and sexual intercourse.
- Profuse bleeding during menstruation.
- The presence of blood clots.
- Lightening is observed before and after the cycle.
- Enlarged uterus.
- Due to severe bleeding in patients anemia is observed, and this in turn causes weakness, dizziness, fatigue.
- There is a logical system of disruption of the entire body, which degrades the quality of life and opportunities for women.
Similarities and differences
Two pathologies have a similar nature - in both cases they are caused by the spread and germination of the endometrium outside its normal location. Many symptoms have something in common, and it is possible to establish the disease only after a long and careful analysis of the situation.
But there are some special manifestations. Endometriosis can cause female problems, infertility. Endometriosis is a more complex disease, it is much more difficult to treat, and the list of symptoms is much broader. For example, there are cases of the development of this disease even in the lungs, causing them to bleed during menstruation. Endometriosis can occur even in men, but is very rare.
Due to its nature, the disease spreads to many internal organs. The attending physician can not immediately determine the cause of inflammation, and the disease continues to progress. Therefore, it is much more difficult to diagnose.
What does the treatment look like?
Так как точная причина заболеваний остается неизвестной, то в большинстве случаев врач стремится избавить пациента от симптомов и повлиять на интенсивность менструации. Сделать это можно многими методами, но задача доктора заключается в подборе идеального варианта.
- Acceptance of painkillers before and during the cycle will relieve pain.
- Contraceptives reduce the intensity of menstruation and reduce inflammation.
- Hormonal drugs are used to create the necessary balance. They are the main treatment.
- Anti-inflammatory substances are prescribed to reduce inflammation.
In some severe cases, it is impossible to do without surgery, but they are being avoided. The complexity of the procedure depends on the extent of the spread and the woman’s desire to have a child in the future. Cauterization of damaged areas is carried out, and then a full or partial removal of the ovaries, removal of the uterus can be carried out. The efficiency of operations is very high, but the consequences for the body are very heavy.
Another solution could be a spiral. However, its action cannot be described as treatment - after its removal, the disease can return.
Treatment of diseases is possible only with the implementation of complex effects.
About the occurrence of anemia has already been said, but is it the most dangerous? Not. A number of consequences are irreversible changes. Violation of the reproductive function can be a real grief for the family who wants to have a child. Similar effects occur without any symptoms of the disease. If you cannot get pregnant for a long time, the doctor will look for signs of endometriosis and adenomyosis.
Myoma and endometriosis are closely related. The same applies to adenomyosis. Myoma and endometriosis have many similar symptoms, but often these two diseases develop at the same time, while one of them can cause the other over time. Nevertheless, the connection is not reliably confirmed due to problems with determining the causes of the occurrence of ailments. It is likely that fibroids and endometriosis simply create each other favorable conditions for development. The fact of the appearance of a tumor and growth during hormonal disorders and weakening of the immunity remains obvious.
If the treatment does not bring results, then sooner or later the removal of the uterus and ovaries will be recommended, which in itself is a heavy blow to the body.
Based on these physicians, women of middle and old age are more likely to suffer from such diseases. Ecological problems, bad habits, the rejection of a healthy lifestyle and a balanced diet rejuvenate every year these pathologies. Both of them are dangerous to health and can cause a strong deterioration of the woman’s well-being and worldview, depriving her of the opportunity to achieve the goal of having a baby. By the way, the birth of a child under the age of 30-35 is one of the best preventive drugs.
To get timely treatment, it is not enough just to monitor your health, you also need to undergo regular check-ups at the gynecologist and pass the necessary tests. There is nothing better than timely detection and treatment.
What is adenomyosis?
This pathology affects the muscular layer of the reproductive organ.
The cause of its occurrence is a hormonal disorder. When the concentration of estrogen increases in a woman's body, the endometrium begins to grow actively, penetrating into the muscle layer of the uterus. In this case, the uterus increases in size and deforms.
Adenomyosis can be observed in the following forms:
In focal form, certain parts of the muscle layer are affected, and a bright clinical picture, as a rule, is not observed. In the diffuse form, the lesions are larger, which entails severe pain. With a nodular form, small nodules form in the muscle layer, and with mixed adenomyosis, signs of all previous forms of the disease can be observed simultaneously.
The stages of adenomyosis are as follows:
- the first stage - the germination in the muscle layer is negligible,
- the second stage is characterized by deeper germination, but only half of the muscle layer is affected. At the same time, the uterus begins to increase somewhat,
- third stage - more than half of muscle fibers are affected,
- fourth stage - The endometrium grows through the muscular layer of the uterus, and can affect nearby organs that are not in the reproductive system.
The initial stages of the disease may be asymptomatic, but with the progression of the disease clinical picture getting brighter. If the bleeding is very severe, the patient may suffer from anemic syndrome, which manifests itself in general weakness, dizziness, fainting, and so on.
What is endometriosis?
This pathology is manifested in the presence of endometrioid cells in uncharacteristic places of localization. Cells can be observed both inside the genital organ, and on other tissues and organs.
Depending on the location of enometrioid foci, the ailment is classified as follows:
- genital - the pathological process takes place in the genitals,
- extragenital - organs that are located in close proximity to the uterus are involved in the pathological process,
- combined - combines the features of both previous forms.
Endometriosis can occur in 4 stages:
- first stage - there are a small number of pathological foci that do not have a significant effect on the woman’s body,
- second stage - there is a spread of pathology in the deep layers of organs,
- third stage - various organ damage is observed - cysts, tumors, inflammatory processes,
- fourth stage - tissue damage contributes to the formation of benign or malignant pathologies.
- bleeding of the uterus or another affected organ,
- inflammatory processes that occur on the affected organ,
- temperature rise,
- pain during urination and sexual contact,
- pain in the localization of the pathological focus,
- failures in the menstrual cycle
What is the difference between these two such pathologies?
The main difference between them in the localization of hyperplastic processes.
With regard to the mechanism of development of pathology, I must say, at the heart of these ailments lies tissue proliferation.
Such a process in women of childbearing age is considered the norm. During normal operation of the reproductive system, the endometrium becomes thickened during the menstrual cycle. It is necessary to attach the ovum to the walls of the uterus.
But with adenomyosis, this process is more pronounced than necessary. In addition, if fertilization does not occur, the endometrium is normally rejected and removed by the body. In adenomyosis, it penetrates into the inner layers of the uterus and grows into them.
In endometriosis, almost the same thing happens, with only one difference - the pathological foci germinate outside the genital organs.
Do pathologies occur together?
Quite often, adenomyosis is combined with ovarian endometriosis.
Most scientists believe that the cause of the proliferation of endometrioid tissue on the ovaries is due to the fact that menstrual blood, which contains living endometrial cells, is thrown through the fallopian tubes into the ovary.
When endometriosis joins adenomyosis, the clinical picture of the disease is supplemented by a group of additional symptoms:
- pain that is permanent. It is localized in the lower abdomen, and can also be given to the sacrum, rectum and lower back,
- premenstrual syndrome is more pronounced,
- disruption of the bladder and intestines,
- possible appearance of cystic neoplasm in the ovary.
What is the difference of symptoms?
Typical symptoms of adenomyosis:
- pain that occurs a few days before menstruation and continues for several days after it ends,
- spotting vaginal discharge before and after menstruation,
- failures of the menstrual cycle
- changing the shape and size of the uterus,
- discomfort during intercourse,
- deterioration of the general condition of the patient.
Clinical picture of endometriosis:
- pains, most often of a permanent nature,
- intermenstrual bleeding,
- the presence of blood after sexual intercourse,
- problems with urination and defecation,
- with the defeat of the lungs, hemoptysis is observed during menstruation, pain, shortness of breath
- posthemorrhagic anemia.
Causes of disease
Modern science has not yet figured out the exact cause of these ailments, but is aware of the provoking factors that may contribute to their appearance:
- disruptions in immunity
- damage to the layer of connective tissue that lies between the endometrium and myometrium,
- hormonal disorders,
- too early or too late sexual debut
- too early or too late formation of the menstrual cycle,
- poor environmental conditions
- excess weight,
- too active physical activity or not active lifestyle,
- prolonged stress
- endocrine pathology.
Diagnosis of adenomyosis is based on the following measures:
- history taking,
- gynecological examination,
- laboratory tests for anemia,
- blood test for hormones.
- colposcopy, which will reveal the form of pathology and the place of its localization,
- CT, MRI, ultrasound - allows you to assess the relationship of pathology with other organs, as well as to accurately beat the nature and extent of pathology,
- laparoscopy is the most accurate and informative research method,
Since both diseases are hormone-dependent, both adenomyosis and endometriosis can occur on their own during menopause.
In some cases, the pathological processes stop and the foci of disease decrease during pregnancy.
But such phenomena are not always observed, and most often pathologies require careful treatment.
As such, there are no differences in the treatment of adenomyosis and endometriosis, since in both cases hormonal preparations are used. Specific drugs are selected individually and depend on the stage of the disease, as well as the severity of the clinical picture.
In addition to hormonal drugs, the doctor may also prescribe as an additional symptomatic treatment:
- homeopathic remedies (for example, Remens),
- folk remedies.
In both cases, anti-inflammatory drugs, immunomodulators, and vitamins are often prescribed.
If a conservative tactic does not lead to a positive dynamic, surgical treatment is prescribed.
There is a significant difference:
- with endometriosis there is the possibility of local removal of the pathologically overgrown layer, and only radical and complicated cases are resorted to radical methods,
- With adenomyosis, it is more and more difficult - pathological foci grow into the depths of tissues, and there is no way to remove them locally. Therefore, the affected organ is most often removed completely.
Conclusion and conclusions
If adenomyosis and endometriosis are diagnosed at early stages and have not yet led to significant or irreversible consequences for the female body, then preventive measures will be sufficient to prevent complications and symptomatic treatment.
In this case, a woman can lead a normal life and preserve reproductive function.
If the disease is diagnosed late, you may need to remove organs of reproduction, and subsequently the woman will have to take hormonal drugs for life.
Considering that adenomyosis and endometriosis at the initial stages of development are not always expressed by clinical manifestations, it is necessary to regularly receive routine gynecological examinations. This is the only way to identify pathology in the early stages.
After treating adenomyosis or endometriosis, a woman should also be regularly examined by a gynecologist to prevent the recurrence of the disease.
What is the difference between endometriosis and adenomyosis? These diseases do not have any fundamental differences. Mostly, they are denoted by different terms due to differences in the localization of the affected areas. Endometriosis is a process in which healthy and functioning endometrial cells begin to actively grow. At the same time, the endometrial tissue even goes where it should not be - both to neighboring organs and inland to other tissue layers of the organ.
Endometriosis can develop on any organ of the reproductive system on which there is an endometrium. These are the fallopian tubes, ovaries, external and internal surfaces of the uterus, etc. Moreover, it can spread to other organs - the bladder, intestines, and even the lungs, causing symptoms typical of endometriosis.
Adenomyosis is an endometriosis lesion of the internal genital organs. That is, if the foci of endometriosis do not expand beyond the interstitial part of the fallopian tubes, cervical canal and the body of the uterus, then we can say that it is adenomyosis or internal endometriosis.
Thus, we can conclude that, in essence, there are no differences between phenomena. Just adenomyosis is a particular case of endometriosis.
The similarity of these diseases lies in the fact that they are caused by the same reasons. They have, in fact, the same developmental mechanism and almost similar symptoms (with the exception that endometriosis can have more symptoms, including uncharacteristic ones). For this reason, disputes about whether it is advisable to separate adenomyosis and endometriosis separately from each other, are still ongoing.
Differences in symptoms
The clinical picture of adenomyosis is less diverse. It is characterized only by symptoms from the reproductive system. These are manifestations such as:
- Long periods that go for 5-7 days,
- Reducing the period between them
- Increased pain in the lower abdomen before and during menstruation, increased or the appearance of back pain in this period,
- Increased blood loss during menstruation,
- Acyclic bleedings.
Moreover, all the symptoms increases during menstruation.
In endometriosis, the symptoms depend on which organ or system it has struck. Since in most cases the reproductive system is involved in the process, the symptoms described above almost always occur. But there may be another:
- If the lungs are affected, hemoptysis during menstruation, pain in the lungs, swelling manifested in shortness of breath,
- If the intestine is affected, then there is pain during bowel movements, bleeding from the intestines before and during menstruation,
- If the bladder is affected, the pain in the lower abdomen is almost always present, especially during physical exertion, urination, blood may be expelled from the bladder on the eve of menstruation, as well as increased urination,
- If the vagina or cervix is affected, then discomfort during intercourse may be present.
Thus, we can conclude that the difference in adenomyosis from endometriosis in symptoms is minimal and consists only in the fact that it is more diverse in the second disease. But such localization of lesions are quite rare, and therefore the symptoms for doctors is not the most typical.
Statistics for this disease is not too optimistic. According to various sources, from 30 to 50% of all gynecologist patients suffer from endometriosis. At the same time, 35-40% of them are asymptomatic and are detected by chance. Such a lesion can be localized at various sites, both external and internal genital organs. Such a wide distribution is due to the fact that this disease is almost impossible to cure completely. Usually, you can only talk about improving the state and the overall reduction in the severity of symptoms.
Moreover, adenomyosis accounts for most of these cases. Since 25-40% of patients affected precisely the internal reproductive organs.
What is the difference in the treatment of these diseases? It is minimal, since in both cases it is aimed at suppressing the active proliferation of the endometrium, no matter whether it is in the uterus or on the lungs. This tissue is hormone-dependent, because treatment is carried out by hormonal drugs and is aimed at reducing the production of estrogen, which stimulates the growth of the endometrium. More information about this can be found in the articles "Treatment of adenomyosis" and "Treatment of endometriosis."
What it is
Is endometriosis and adenomyosis the same or not?Pathological endometrium most often grows into the muscle layer of the uterus (myometrium), more rarely, lesions are detected in the tubes, on the ovaries, pelvic organs that are not directly connected with the reproductive system.
Cases of the formation of endometrial foci in the lungs and even the eyes are described.
The clinical symptoms of both diseases are associated with the presence of pathological foci of the endometrium, but the external manifestations and possible complications of the pathology depend on the localization of the lesion.
Lots of endometrial tissue function in the same way as normal endometrium.
In the first half of the menstrual cycle, when the endometrium prepares for possible implantation of the embryo, the pathological tissue also grows.
If fertilization has not occurred, the upper layer of the endometrium is rejected, and menstruation begins. Tissue fragments along with blood are removed from the uterus.
At the same time, pathological formations begin to bleed. If there is an exit, blood is poured from the lesion, normal menstruation is accompanied by additional bleeding of atypical localization.
If the focus of pathology is closed, internal accumulations of blood, the so-called "chocolate" cysts.
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When endometrial tissue grows into the muscle layer of the uterus, the organ increases in volume. Abundant and painful menstruation indirectly indicate the presence of pathological formations. Pain and spotting dark discharge may occur outside of menstruation..
As adenomyosis, the lesions of the body and the isthmus of the uterus, as well as the areas of the fallopian tubes adjacent to it, are classified.
When diffuse form the lesion captures significant areas of the endometrium. Focal education relatively small, often almost do not bother the patient. Nodal lesions outwardly resemble fibroids.
There are four stages in the course of the disease.that differ in the severity of the lesion:
- Single surface formations.
- Single or few neoplasms affecting the myometrium by no more than half the thickness.
- Multiple germination of endometrioid tissue by more than half the thickness of the myometrium.
- Multiple germination through myometrium, extending to the nearest organs.
Adenomyosis - whether to treat, “Popular Doctor”:
Different forms of endometriotic disease always accompanied by hormonal disorders, which is displayed on the menstrual cycle. The cycle is either noticeably shortened, or, on the contrary, menstruation delays occur.
Abnormal endometrium rejection accompanied by pain, bleeding becomes more abundant and prolonged.
Some patients have intermenstrual bleeding, spotting dark a few days before or a few days after menstruation.
Possible pain during intercourse, defecation or urination. Some patients have fever, nausea or vomiting during menstruation.
Major difference clinical manifestations associated with the localization of pain and bleeding. With adenomyosis, the uterus is painful, in cases of spreading the pathological process to neighboring organs, the pain becomes diffuse.
Other forms of endometrial disease manifest morbidity in the area of localization of the lesion of pathology.
If fragments of the endometrial tissue can be expelled, periodic hemorrhages and bleeding are observed in the corresponding area. Soreness and bleeding naturally associated with cyclical changes in hormonal levels.
In advanced and severe cases of adenomyosis and endometriosis manifestations of anemia join the main gynecological symptoms. Both pathologies often cause secondary infertility.
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If you suspect endometriotic disease other than the standard gynecological examination transvaginal transducer ultrasound is performed, abdominal ultrasound ultrasound, if necessary.
Additionally, the patient can be assigned to:
- CT or MRI,
- blood test for specific tumor markers CA-125 and SA-199.
If lesions are found on the body of the uterus, in the adjacent parts of the tubes or isthmus, adenomyosis is diagnosed.
When identifying areas of endometrioid tissue in other organs endometriosis is diagnosed.
Since the nature of both pathologies is the same, treatment is performed by similar methods.: conservative, surgical or combination.
Tactics of treatment is selected individually, taking into account the localization of the pathology, the severity of the lesions, the age of the patient and her plans for future motherhood.
The main role in the medical treatment of endometriotic pathologies belongs to hormonal drugs. Additionally, the patient may be prescribed anti-inflammatory, analgesic, immunomodulatory drugs.
Surgical treatment of endometriosis and adenomyosis can be performed laparoscopically. Removal of cysts and other endometrioid tumors, dissection of adhesions.
In severe lesions, the volume of surgical intervention can vary up to complete removal of the uterus in the last stages of adenomyosis.
It is impossible to say which disease is worse. Each individual clinical case and its outcome is very individual.
It is important to remember that a responsible attitude to their own health is one of the key conditions for its preservation. With timely diagnosis and appropriate treatment disease development may stop.
What are the similarities in diseases?
Pathologies have the following similar characteristics:
- the cause of development is the intensive production of estrogen,
- endometrial growth occurs,
- hormone preparations are used at the initial stage of treatment,
- there is a failure of the menstrual cycle,
- in the absence of proper treatment, pathologies become chronic and often recur.
At the same time, adenomyosis is diagnosed by means of histological examination. In the case of endometriosis, this method is ineffective.
Forms of adenomyosis
According to the type of endometrial formations in the affected organ, focal, nodular and diffuse forms of adenomyosis are distinguished.
Focal neoplasms have a relatively small size and often do not cause discomfort. In the case of the development of a diffuse form, significant areas of the uterine layer are affected. When nodular education visually similar to myomas.
Pathology proceeds in several stages, differing in severity:
- single formations on the surface of the endometrium,
- lesions that extend to myometrium, but not more than half its depth,
- numerous germination of endometrial cells in the myometrium,
- defeat of the entire thickness of the myometrium and adjacent organs.
Diagnosis of Endometriosis
To diagnose endometriosis is quite difficult. This is due to the fact that the place of localization of endometriosis is initially unknown. At an early stage of development of the disease, the clinical picture is erased. Often it is found during the examination of women who seek medical help because of problems with conception. The main diagnostic methods for endometriosis are ultrasound, hysteroscopy and laparotomy.
What is the prognosis for adenomyosis?
As a rule, after excision of the affected area of the endometrium, the reproductive function is fully restored. The forecast is favorable. Irreversible effects are possible only with untimely initiated therapy, when large parts of the reproductive organ are affected. In this case, resorted to the removal of the uterus.
Can I get pregnant with endometriosis and adenomyosis
Endometriosis and adenomyosis often cause infertility. In case of adenomyosis, conception is possible, but due to frequent uterine contraction there is a high risk of miscarriage or childbirth ahead of time.
Pregnancy with the development of adenomyosis and endometriosis becomes impossible due to damage to the internal organs of the urogenital system. Often, this is marked obstruction of the fallopian tubes and the beginning of the adhesions. Such changes lead to the fact that the ovum is not able to penetrate into the cavity of the reproductive organ.
One of the main symptoms of endometriosis is considered a violation of the menstrual cycle, caused by changes in hormonal levels. As a result, ovulation may be absent, and fertilization becomes impossible.
The reason for the development of both endometriosis and adenomyosis lies in hormonal imbalance and excessive growth of the endometrium. The difference of these pathologies lies in the site of localization of the lesion. Both diseases can lead to infertility and need timely treatment.
Symptoms of the disease
The symptomatology of both diseases is very similar, so the exact nature of the disease can be accurately determined only by a diagnostic method. The main symptoms often include the same thing:
- failure of the menstrual cycle
- the selection of brown during and after menstruation,
- acute pain in the first days of the menstrual cycle,
- abnormal bloating.
As the disease progresses, I can observe the following symptoms:
- discomfort and pain during intercourse,
- painful urination,
- constant alternation of diarrhea and constipation, which cannot be eliminated by a medication method,
- constant state of fatigue.
What happens in adenomyosis?
As usual, almost everything is already said in the very name of the diagnosis: “adeno” means the glandular tissue, which is the endometrium, or the inner lining of the uterus, and the ending indicates the growth of this tissue. Normally, the endometrium grows after menstruation only into the uterine cavity. But in adenomyosis, it undergoes hyperplasia, that is, an increase in the number of epithelial cells. As a result, the endometrium begins to grow “in the other direction,” that is, not into the lumen of the uterus, but towards the muscle layers. As a result, it sprouts that very demarcating membrane, as a result of which a knot is formed, which is located deep in the muscle layer.
The fact is that the muscle is not passive in relation to the growth of the endometrium. Since local pressure is applied to it in the area of the endometrium, which has broken through the barrier and grows, the muscle responds to this pressure. And the reaction of the muscle can be only one: it is contraction and compaction. Therefore, its local spasm occurs, and an adenomyotic node is formed.
Adenomyosis can have both focal and diffuse growth. Sometimes a type of focal growth is nodular growth. If the growth is nodular, then it is very difficult to distinguish it from uterine fibroids, since the node with myoma and with adenomyosis looks almost the same.
Endometriosis, in fact, is the same process that occurs with adenomyosis, only on a large scale. Endometrium is a tissue that has hormonal “responsiveness”. Now imagine what will arise if the pressure in the uterus increases, for example, due to inflammation of the vagina and swelling of its walls. As a result, during menstruation, a channel may open poorly, and instead of leaving the body, exfoliated endometrial fragments come back to the uterus, enter the mouths of the tubes, leave them and end up in the abdominal cavity. Here, endometrial fragments attach to the peritoneum, separate themselves and begin to "live" in a strange place.
Endometriosis can affect the genitals, if it occurs in the genital form. But there is also an extragenital form in which the endometrium is localized, for example, in the abdominal cavity or in organs that are not at all connected with the uterus. In some cases, endometriosis can cause pulmonary hemorrhage or hemoptysis during menstruation.
Therefore, from a purely practical point of view of a gynecologist, adenomyosis and endometriosis is one and the same process. Adenomyosis is the “internal form” of endometriosis that does not leave the muscle layer of the uterus. On the other hand, endometriosis can also be considered an extended form of adenomyosis, in which the endometrium has spread far beyond the uterus and even the female reproductive system.
Differences in histology (cell composition), in the features of biochemistry and metabolism of ectopic foci in this and other process does not exist. But speaking from a “technical” point of view, the treatment of endometriosis will always be more difficult and lengthy than the treatment of adenomyosis.
There is some difference in the clinical manifestations. Endometriosis can occur hidden and not be felt, in the case of adenomyosis, the clinic will be more pronounced. But in both cases, this process of pathological proliferation of the epithelium can lead to impaired fertility and even infertility. These processes manifest as follows:
- with endometriosis, most often during menstruation there is pain in the lower abdomen,
- for adenomyosis more characteristic is the irradiation of these pains in the lower back and the sacrum,
- menstruation lasts longer than usual
- with adenomyosis of the cervix uterus appears.
Most importantly, with the increased growth of the endometrium in other organs, when it is rejected, blood will be generated, which cannot be removed from the body. Therefore, there are processes such as its organization, with the formation of adhesions and scars. Therefore, with the slightest changes in the ovarian-menstrual cycle, it is necessary to see a gynecologist and undergo an ultrasound examination (ultrasound), from which the diagnosis of these diseases begins.
A brief excursion into the anatomy and physiology of the reproductive system
Tell, what is the difference between adenomyosis and endometriosis, it will be difficult, not stopping at the structure of the organs of the female reproductive system. Its main part are the ovaries. There is maturation of the egg, the formation of the corpus luteum and the production of estrogen and progesterone. The change of these processes determines the woman's menstrual cycle.
The ovaries are connected to the uterus by the fallopian tubes. On them the egg prepared for fertilization falls. Their walls are composed of smooth muscle tissue, and the inside is lined with epithelium. In the structure of the uterus emit such structures:
- mucous basal and functional endometria, which undergoes certain changes during the calendar cycle under the influence of sex hormones. If pregnancy has not occurred, he is rejected during menstruation,
- muscle membrane, myometrium, consisting of three cross-layered layers of smooth muscles. Their functioning ensures the reduction of the body during menstruation,
- outer perimetry of loose connective tissue.
With the vagina the uterus is connected with the cervix. It is lined with mucous epithelium, where numerous glands are located. The central regulation of the secretion of female sex hormones is carried out in the pituitary gland. Also a certain amount of estrogen is secreted by the adrenal glands.
Mechanism of development of the disease
What is the difference between adenomyosis and endometriosis? Both pathologies are characterized by the proliferation of a functional endometrium outside the mucous membrane. However, in adenomyosis, this process is limited to the walls of the uterus, and endometriosis is characterized by damage to the ovaries, vagina and fallopian tubes (genital form). Then the bloodstream and lymph disease spread to the organs of the small pelvis (kidneys, ureters, navel), lungs, intestines, pleural cavity and brain (extragenital endometriosis).
According to medical statistics, the disease is common in women of reproductive age (from 20 to 40 years). It is in third place after fibroids and inflammation of the reproductive organs. Genital form is found in 94% of cases. The mechanism of development of endometriosis or adenomyosis is not fully established. There are several theories explaining the pathological hyperplasia of the uterine mucosa:
- Implant mechanism. Transfer of endometrial cells to various organs and tissues occurs with blood or lymph flow.
- Disorders in the intrauterine formation at the initial stages of pregnancy. Embryo development begins with a few cells. It is believed that endometrial particles can sometimes be fixed in other places.
- Mechanical injury of the mucous layer during surgery or during childbirth.
- Metaplasia, replacement of one type of epithelial tissue, for example, in the ureters, kidneys, etc., with endometrium.
Even using the most modern methods of examination, it is impossible to establish exactly how endometriosis and adenomyosis of the uterus began. However, for practicing gynecologists it does not matter. Treatment of diseases occurs according to the same scheme. And it does not depend on pathogenesis.
Even with the listed physiological abnormalities in the development of the reproductive system, adenomyosis and endometriosis may not disturb a woman. Most often, the “trigger” of the onset of the pathological process is hormonal imbalance. In the majority of patients with endometriosis, elevated estrogen levels were detected during the examinations. Other causes of disease are:
- surgical procedures (late abortion, diagnostic procedures, medical curettage), resulting in damage to the uterine wall,
- disorders of the immune system,
- complicated labor in which endometrial cells enter the vagina,
- genetic predisposition
- infections of the genital organs, including venereal,
- heavy exercise
- nerve strain.
Also, adenomyosis and endometriosis cause diseases of the hypothalamic-pituitary system.The pathological process may be the result of frequent medical abortions, uncontrolled intake of oral contraceptives. They must be selected by a gynecologist on the basis of the tests performed. A frequent cause of adenomyosis is also myoma.