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Adenomyosis of the uterus - the reasons for the appearance in women, the form and extent, just about difficult

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Many gynecological diseases are asymptomatic, and women seek help when they can not conceive or bear a child, there are pronounced irregularities in the menstrual cycle.

It is important to treat some pathologies even before severe symptoms appear. One of these diseases is uterine adenomyosis. What is it, how to diagnose and cure this disease in women, everyone should know.

What is uterine adenomyosis

Uterine adenomyosis is a form of endometriosis. With this type of pathology, there is not only an increase in the volume of the growing monthly endometrium. These tissues become able to grow deep into the muscle layer of the organ, causing more serious damage.

Internal endometriosis is a diagnosis requiring immediate treatment. Its main feature is the local formation of foci of pathology - only inside the uterus.

Endometriosis can leave the reproductive system and be located in other internal organs. Endometrial cells are able to survive on the tissues of the bladder, intestines, ovaries. This pathology leads to unpleasant consequences. If you do not conduct proper treatment, infertility occurs.

Adenomyosis is a disease that depends on the level of hormones in a woman’s blood. Nevertheless, ultrasound allows to assess the state of the endometrium, the size of the uterus, to determine what is happening with the mucous membrane and what form it is.

The echographic signs and characteristics of the disease are well pronounced, so an experienced doctor will immediately notice them and explain the differences in adenomyosis and endometriosis of the uterus.

Varieties

Internal adenomyosis can occur in different forms. It differs in the degree of distribution, the depth of germination and the structure of tumors. Endometrial tissues can reach the myometrium, and can be located only on the surface layer.

Causes of adenomyosis are common to all forms. Most often, doctors distinguish the following varieties:

  • diffuse,
  • nodal,
  • focal adenomyosis:
  • diffuse focal,
  • diffuse nodular.

It is worthwhile to examine in detail each form of uterine disease and understand how they differ.

Diffuse form of adenomyosis is a type of pathology in which extensive lesions occur inside the uterine mucosa. They have no clear boundaries, the depth of germination is different. In severe cases, tissue penetrate into adjacent organs, fistulous passages can form.

The disease often does not show any symptoms. During examination, the doctor may see signs of adenomyosis on ultrasound. In the running forms, women feel pain in the abdomen, severe discomfort during menstruation, notice the presence of bleeding from the day before menstruation and some time after.

The nodal form is a type of disease when a capsule with connective tissue and blood forms around the overgrown epithelium particles. The echo signs of internal endometriosis of this species remotely resemble the picture observed in uterine myoma.

This form of the disease rarely develops as an independent disease. The risk of pathology increases against the background of endocrine disorders or serious problems of the sexual sphere.

The following pathologies can provoke nodular adenomyosis:

  • metaplasia,
  • ovarian dysfunction,
  • cirrhosis of the liver,
  • stomach ulcer,
  • oncology of the thyroid gland.

Suspect the development of the disease women can by violation of the menstrual cycle. They have plentiful monthly periods, they become longer. Concerned about pain and discomfort.

Focal adenomyosis is a type of pathology that occurs most often and is easier to treat than others. Signs of internal endometriosis are usually not noticeable; a doctor can see them during a gynecological examination with ultrasound.

The focal form is characterized by single formations in the tissues of the muscles of the uterus. Such zones may be several or one.

Often the disease is combined with other types of pathology.

Degree of development

The degree to which focal adenomyosis (or its other forms) manifests itself depends on the stage of development. Signs on ultrasound can usually be seen already in the early stages, when symptoms are completely absent.

Timely gynecological examinations will protect the uterus from the disease in its advanced form. Treatment of adenomyosis of the 1st degree is carried out much easier than when the pathology has been present for a long time.

There are 4 stages of the disease. Each is characterized by its own distinctive features and symptoms:

  1. When adenomyosis of the 1st degree affects the uterus muscle tissue. Endometrial cells germinate shallowly. The thickness of the pathological foci is no deeper than 1/3 of the total depth of the tissues of the organ. Endometriosis foci are usually located only inside the uterus, do not apply to neighboring organs and systems.
  2. With the 2nd degree of pathology, endometrial tissue germinates to the muscle layer. The examination will confirm that in the uterus, uneven compaction occurs, endometrial cells grow. The lesion area can reach half of the total thickness of the muscle layer.
  3. With grade 3 adenomyosis, more than half of the total thickness of the muscle layer of the uterus is involved in the pathological process. He is amazed almost completely. At this stage, endometrial cells still do not extend beyond the reproductive system. If you do not start adequate therapy, the process will spread to healthy organs.
  4. For the 4th degree of the development of the disease is characterized by excessive growth of the endometrial layer with its release beyond the reproductive system. The affected tissues enter the abdominal cavity, from where they are transferred to other organs and fixed on them.

Causes

Uterine adenomyosis is a hormone-dependent disease, therefore, hormone failure is considered the main cause of its occurrence.

Violation of the hormonal background can be caused not only by diseases of the sexual sphere. Problems with the thyroid gland, ovaries, and even disorders in the pituitary gland, the part of the brain that controls hormone levels, can alter the normal balance.

When adenomyosis of the uterus is not cured in time, the pathology of the organ neck can develop. The likelihood of such complications is higher if a woman uses tampons instead of sanitary pads.

Menstrual blood stasis, caused by anatomically irregular shape, bending, scarring or adhesive process, increases the risk of endometrial tissue entering the abdominal cavity. The output of these cells is carried out through the holes in the fallopian tubes. Tubal adenomyosis may develop.

Rarely the cause of the disease is a genetic predisposition. Some gene mutations also make a woman more prone to this pathology. It is noticed that several relatives can simultaneously suffer from this disease.

The following factors can provoke the development of adenomyosis:

  • inflammatory processes in the reproductive system,
  • transferred cesarean section
  • carrying out scraping,
  • natural childbirth,
  • miscarriages and abortions,
  • injuries of the uterus mucous membrane during the insertion of the intrauterine device,
  • cyst formation and tumor processes
  • hormonal disorders,
  • long-term use of oral contraceptives,
  • metabolic disorders
  • a dramatic change in body weight
  • early sexual debut and pregnancy
  • weak immunity,
  • life under constant stress
  • hard physical labor.

Adenomyosis is a female disease that can be triggered by many factors. The risk increases if the woman likes to sunbathe often, go to the solarium. Ultraviolet rays in large quantities violate the correct rate of formation of new cells in the body. And with focal endometriosis and adenomyosis, the problem begins with an overgrowth of endometrial cells.

Too often mud baths should not be taken. If such procedures are used for medicinal purposes, a medical examination must be conducted and a doctor’s prescription issued.

Often, adenomyosis occurs without symptoms. About a third of all the weaker women found out about their diagnosis quite by accident - during the next routine examination by a gynecologist. Nevertheless, an attentive woman will notice that there are some changes in her reproductive system - and you need to check your health.

Indirect signs are visible at the initial stage of pathology. With grade 2 symptoms may be more noticeable. Echographic signs are already visible at the beginning of the development of the disease.

The most prominent symptoms manifest themselves in advanced stages of pathology in women aged 35 to 50 years. After menopause, the disease does not develop.

A woman can suspect the development of adenomyosis if she pays attention to such signs and sensations as:

  • the pains
  • cycle violations
  • inability to get pregnant,
  • anemia,
  • intoxication.

Pain in adenomyosis is the first sign. Initially, discomfort occurs exclusively during sexual intercourse. At later stages of development, the appearance of unpleasant sensations is possible outside the menstruation, on any day of the cycle.

During the period of menstrual bleeding discomfort is most pronounced. Soreness is associated with inflammation that occurs inside the myometrium due to excessive separation of endometrial tissue. There is a squeezing of nerve endings, because of what sometimes even painkillers do not help.

The pain begins to appear a few days before the start of menstruation. With age, these symptomatic signs of adenomyosis only increase. The adhesions inside the uterus or fallopian tubes increases the intensity of the pathological symptoms.

Since adenomyosis is caused by hormonal disorders, against the background of pathology, the cycle may become irregular. The discharge of dark smearing mucus from the genital tract begins before the beginning of menstruation. The bleeding itself lasts longer than usual. May occur over a week. There are intermenstrual bleeding.

It sometimes happens that a woman is not disturbed by anything, however long attempts to conceive a child are unsuccessful. In this case, during the examination, it is likely that the doctor will diagnose adenomyosis.

Regular early failure can also be a symptom of uterine adenomyosis. If a woman manages to safely carry the child, against the background of this disease increases the risk of generic complications.

Anemia accompanies adenomyosis of the ovary and uterus due to the fact that a woman loses more blood than during menstruation without pathology. Common negative symptoms appear. There may be weakness, dizziness, fatigue, decreased ability to concentrate. In severe cases, shortness of breath, tachycardia, and tinnitus develop. The skin becomes paler than a healthy person.

Signs of intoxication appear only in those women whose endometrial cells have already formed pathological foci on other internal organs. Nausea, vomiting, fever, and fever are due to the rejection of cells in the blood stream during menstruation. This causes poisoning of the body and negative symptoms.

Diagnostics

Treatment of adenomyosis of the uterus is carried out only after a thorough medical examination. Diagnosis includes not only laboratory procedures, but also an examination, a study of the history and lifestyle of a woman.

Gynecological disease can be identified by doing a series of procedures. The survey is conducted using methods such as:

  • examination in the gynecological chair using special mirrors,
  • evaluation of the shape, size and mobility of the uterus using palpation,
  • complete blood count and hormone test,
  • Ultrasound,
  • GHA,
  • MRI,
  • hysteroscopy
  • biopsy.

Adenomyosis of the ovaries, body and cervix can be detected by ultrasound. Using ultrasound, it is realistic to estimate the exact size of the reproductive organ, to see focal lesions of the mucous membrane. Obvious echo signs help the doctor in making an accurate diagnosis, but you should always use several diagnostic methods. The procedure is completely safe, even for pregnant women.

Based on the results of the study, the doctor decides what other procedures are needed to confirm or exclude adenomyosis.

The GHA is a procedure in which a contrast agent is injected through the cervix into the organ cavity, and then the permeability of the reproductive system and tubes is determined. The method is used if you need to identify the cause of infertility. Helps eliminate endometriosis tubes and ovaries.

MRI allows you to see the manifestations of diffuse or nodular adenomyosis. It is possible to estimate the thickness of the walls of the organ and how severely they are affected by the pathology. Reliable, but expensive diagnostic method.

Hysteroscopic examination of adenomyosis allows the gynecologist to assess the condition of the uterine mucosa, to examine all foci using a special microscopic camera. It is possible to establish the shape and exact localization of the pathological foci.

A biopsy is performed if the malignant process inside the uterus is suspected. For the study, a piece of tissue is taken and their histological analysis is done.

Diagnosed adenomyosis can be cured. It is important to follow the recommendations of the doctor and start treatment immediately.

How to treat

Treatment of adenomyosis of the uterus is carried out after diagnosis. The doctor will evaluate the echo signs, symptoms and identified lesions in the body of the organ. Only a specialist can diagnose pathology. Relying only on their own feelings is dangerous.

Preparations for the treatment of adenomyosis are prescribed individually. The doctor takes into account the age and features of the pathology. Often the doctor prescribes hormonal contraceptive pills. Applied medical and surgical method of treatment.

Conservative

Uterus adenomyosis can be treated with medicines. Used drugs that slow the growth of abnormal endometrial cells.

Hormone therapy has contraindications. These drugs are not suitable for the treatment of diabetes, obesity, increased blood clotting.

The drug, which is based on progesterone –Dewaston - with adenomyosis, normalizes the frequency of menstruation, activates ovulation and promotes pregnancy.

Treatment of internal endometriosis may include the use of estradiols. If you take these drugs, the endometrium stops rising.

Medicines based on androgens and pituitary hormones can be used in treatment. To reduce negative symptoms, anti-inflammatory, analgesic and immunomodulating agents are used.

Only the doctor should evaluate the symptoms and treatment of adenomyosis, both in the focal form and in any other. Self-medication can greatly harm the female body.

Surgical

Treatment of adenomyosis is sometimes performed surgically. Uterus operations are performed in different ways: through an incision in the skin and in the wall of the organ, with the help of a laparoscope, through hysteroscopy, and even by complete removal.

Surgical intervention is used in cases where conservative treatment is already difficult, curing adenomyosis is not possible.

Treatment with hormones for adenomyosis after surgery is prescribed in most cases. This technique is used for both diffuse forms and for other types of pathology.

Folk treatment of adenomyosis can not completely save a woman from the pathology. You can only achieve a reduction in symptoms.

Treatment is used with a decoction of medicinal herbs: douching, ingestion, staging tampons, when the layer of gauze is soaked with medical composition.

Treatment of internal adenomyosis is carried out using a decoction of nettle, oak bark, calendula, eucalyptus, bergenia root.

Any methods of therapy, as well as folk remedies should be coordinated with your doctor.

Prevention

To protect yourself from endometriosis of the body of the uterus and the risk of subsequent development of oncology is possible in the following ways:

  • regularly visit a gynecologist,
  • routinely carry out an ultrasound scan,
  • lead an active life without overwork,
  • follow the rules of nutrition,
  • carefully follow the rules of intimate hygiene,
  • Do not ignore the disturbing symptoms.

If you carefully consider your own health and visit the doctor in time, you can protect yourself from a dangerous disease. Any illnesses can be successfully treated in the early stages.

What about uterine denomyosis?

Uterine adenomyosis is an abnormal growth of the endometrium in the body of the uterus. Until recently, in gynecology, adenomyosis was not recognized as a separate disease, it was considered as a type of genital endometriosis and was called genital endometriosis of the uterus or internal endometriosis. Recently, an opinion has emerged that adenomyosis is an independent disease.

Causes of adenomyosis

There are a sufficiently large number of theories trying to explain the emergence and mechanism of development of adenomyosis, but the causes of the disease in most cases remain difficult to explain.

There are the following assumptions about the occurrence of this female disease:

  • Hormonal changes are observed in some patients with adenomyosis: "insensitivity" to the action of progesterone, LYuF-syndrome and others. The thyroid gland, the ovaries affect the hormones of a woman, so any abnormalities in these organs can lead to disease, but the state of the hormonal background is not always an accurate indicator of the disease.
  • Immune balance disorder.
  • Pathology in the intercellular reactions of the body.
  • The most recognized implant theory, the main influencing factor in which is "retrograde menstruation" - this is when, for some reason, menstrual flow moves back through the fallopian tubes and into the peritoneum and into other organs - it does not fit adenomyosis, since it develops inside the body of the uterus, and not outside it.

These are theories that try to explain with scientific criteria what affects uterus adenomyosis, what is its root cause and impetus to its development, but there are obvious provocative factors that are observed in patients:

  • Genetic predisposition to genital tumor diseases.
  • Overweight, hypertension, gastrointestinal diseases, allergies, susceptibility to infectious diseases.
  • Frequent gynecological diseases (inflammatory, external endometriosis and others).
  • A history of periodic interventions on the uterus: curettage, abortion.
  • Ectopic pregnancy.
  • Hormonal medication, the use of intrauterine devices.
  • Other pathologies of the uterus (fibroids, cervical erosion).
  • Currently, poor ecology plays an inevitable role in the development of this disease. In developed countries with a large number of enterprises and highways, a high level of this disease is diagnosed.
  • Planning for a child at a later age or unwillingness to have children has led to the fact that young women are diagnosed with this disease more and more often.

Form of Disease

The following forms of adenomyosis are distinguished:

  • The diffuse form, in which endometrium is interspersed throughout the uterine muscular membrane, may occur in parallel with the nodular form (diffuse-nodular form).
  • Focal - small foci are located in different parts of the uterus.
  • Nodular form, in which endometriotic nodes filled with blood are formed in the uterine muscle layer.
  • Cystic - a rare and severe form of the disease, it is assumed that as a result of repeated hemorrhage cysts are formed.

And denomyosis 1 2 3 4 degrees

  • Stage I - the initial course of the pathological process is only in the thinnest layer of the myometrium (submucosa) of the uterus.
  • Stage II - the disease goes further into the myometrium, which consists of 3 layers, affecting it by 2/3.
  • Stage III - the pathological process spreads to the entire thickness of the myometrium, reaching the serous membrane, which borders the bladder.
  • Stage IV - the deepening of the pathological process, which, in addition to the uterus, is sent to its “nearest neighbors” and develops into external genital endometriosis.

With symptoms of adenomyosis

Symptoms of adenomyosis will not always manifest due to the fact that internal endometriosis may not be in active form and the appearance of symptoms and signs is a “symptom” no longer the initial stage of the disease, only the doctor can detect the first degree of this pathology.

The characteristic symptoms of adenomyosis:

  • The appearance of pain arising in the lower abdomen, in the perineum, which develops into chronic pelvic pain.
  • Uterine bleeding, before and after menstruation - a small amount of brown discharge is constantly observed in adenomyosis, the duration of which may be 7 days or more.
  • Violation of menstruation: an increase in duration, great pain and profusion.
  • Decreased hemoglobin.
  • Infertility.
  • Regardless of the menstrual cycle, pain can occur during intimate relationships.
  • The uterus can significantly increase in size before the onset of menstruation.

What are the features of adenomyosis in menopause

Previously it was thought that adenomyosis is a premenopausal disease, but at the moment the disease has become much younger. Currently, adolescent and young girls are diagnosed with internal endometriosis.

Adenomyosis can occur during menopause, but this rarely happens because the level of estrogens in menopause decreases and the growth of the inner lining of the uterus (endometrium) stops, respectively, endometriosis lesions do not grow and decrease.

But, despite the fact that menstruation is extremely important for the progression of the disease and now one of the ways of drug treatment of adenomyosis is the creation of an artificial menopause in a woman’s body (therefore many women hope that adenomyosis after menopause will not bother them anymore) the period of postmenopausal disease is even possible.

One of the possible causes of the occurrence of the disease at such a late age is hormone replacement therapy, estrogen intake increases the risk of the disease. The most commonly offered radical therapy for postmenopausal women is surgery to remove the uterus.

At ZI (echography)

A very important role in the examination is played by vaginal echography (ultrasound), which must be assigned first.

Ultrasound indicates signs of adenomyosis, it should be done a few days before and after menstruation, paying great attention to the basal layer of the endometrium.

The following echoal signs of adenomyosis, characteristic of the first degree, are distinguished:

  • “Tubules” from endometrium to myometrium are detected.
  • The change in the basal layer - the appearance of circles or ovals, the appearance of chipping, uneven layer thickness.
  • Defects in the endometrium.

Echo signs of adenomyosis of the first degree are characteristic of all subsequent degrees. The echo signs of adenomyosis of the second degree indicate an increase in the thickness of the walls of the uterus, but not the thickness of the uterus is detected in all patients, in contrast to the third degree.

Thanks to ultrasound, you can determine the form of adenomyosis:

  • Nodular adenomyosis on ultrasound is manifested in even round or oval zones in the walls of the uterus.
  • Signs of focal adenomyosis of the uterus on ultrasound are areas with jagged edges in the walls of the uterus.

The probability of determining internal endometriosis on ultrasound varies from 88 to 96% depending on the degree of the disease. As already mentioned above, the first degree of the disease remains the most difficult for correct diagnosis.

All of the above makes ultrasound (echography) quite reliable diagnostic device, but no one excludes the possibility of errors in the interpretation of data.

The most difficult to diagnose is a special case of internal endometriosis in combination with multiple myoma nodes. In this case, the ultrasound does not provide the necessary informative data.

Computer computed tomography (CT)

CT scan is not the main instrument for diagnosing adenomyosis, but it is possible to use it as an additional method confirming ultrasound.

When conducting CT use contrast agents. Depending on the form of the disease, the following symptoms are distinguished:

  • The focal form of adenomyosis is distinguished by the heterogeneous structure of the myometrium due to the small foci of different forms, so the contrast agent makes the myometrium look like a honeycomb.
  • The diffuse form is indicated by an increase in the uterus with different wall thickness and obscure contours.
  • When the nodular form of the uterus is also enlarged, round foci are in the thickness of the myometrium. Myomatous nodes differ in that they have clear boundaries.

X and surgical treatment of adenomyosis

The principle of surgical treatment of uterine adenomyosis is the maximum removal of the painful focus, but the main criterion for the choice of surgery is the woman's age and the desire to preserve reproductive function.

Indications for surgical treatment:

  • The operation is performed with a nodular and diffuse form of internal endometriosis.
  • If symptoms worsen and medication does not help.
  • If at 2 and 3 degrees of adenomyosis myometrium grows.
  • The presence of other gynecological diseases for the treatment of which requires surgery - fibroids, ovarian tumors and others.

About surgical interventions

In modern conditions, often the task is not to harm the reproductive system of a woman with a surgical method of treatment of adenomyosis. Use the following methods:

  • Interstitial laser-induced thermotherapy (ILTT) is used for the nodular form of adenomyosis. The impact on the nodes is carried out by converting laser energy into heat.
  • Resection (ablation) of the endo- and myometrium. Resection is a minimally invasive method for the treatment of adenomyosis. It is performed using a resectoscope, which is inserted into the vagina. The device is operated using an electrosurgical loop, thanks to which the endometrium layer is removed. The procedure is reminiscent of traditional scraping.
  • Focused ultrasound ablation (FUS), it is used in nodular form.
  • Embolization of the uterine arteries (EMA) - the effect in treatment is achieved by blocking the uterine arteries; after cessation of blood supply, the foci of adenomyosis should die.

Radical Surgery

If a woman has no interest in preserving the possibility of childbearing, or she is in pre and postmenopause, the attending physician suggests performing an operation to ampute or extirpate the uterus.

Various options are used to remove the uterus:

  • Laparotomy - the operation is performed using an abdominal incision, used for prolonged progression of internal endometriosis with damage to neighboring organs, with a large increase in the uterus, if there is a high probability of transition into a malignant form and if there are no opportunities for more benign surgeries.
  • Laparoscopy is used most often, but it has a number of contraindications - the large size of the uterus (more than during the 12th week of pregnancy), malignant tumors, the extensive distribution of endometriosis.

Laparoscopy is performed using different technologies, in each case there are advantages and disadvantages:

  • Supravaginal amputation of the uterus (laparoscopic supracervical hysterectomy)done with three punctures, while preserving the cervical stump and uterine ligaments. It has the abbreviation LSH.
  • Classic intrafascial hysterectomy (CISH) - a modified version of LSH,the advantage of which was a significant reduction in postoperative pain.
  • Total laparoscopic hysterectomy (TLH) is a more dangerous operation compared to LSH.

P oleoperative period

After the operation to remove the uterus, patients must follow the necessary recommendations.

Rehabilitation with laparotomy and laparoscopy varies. Laparoscopy is tolerated quite easily by patients, and discharge home can occur after 2 to 3 days. For the prevention of complications and to reduce the consequences, it is advised to get out of bed 4-5 hours after laparoscopy. Laparotomy is worse, tolerated after 24 hours.

After discharge from the hospital, you should be monitored regularly by a gynecologist and do an ultrasound scan once a year. Associated diseases, diabetes, anemia, hypertension and others, have a very strong influence on the recovery of a woman. If, in addition to the uterus, the ovaries are removed, hormone replacement therapy must be prescribed. Removal of the uterus (with a preserved cervix) will not affect the intimate life, but the menstruation will disappear.

Important! Organ-preserving operations do not cure adenomyosis, relapses may occur as early as 1-2 years. To prevent recurrence, hormone therapy is prescribed.

Treatment without surgery

Currently, not all women have indications to go for an operation, except that not everyone agrees to surgery, so hormone preparations, dietary supplements, and folk remedies are an alternative.

Speaking about the effectiveness of any drug, you can immediately say that not one of them can not destroy adenomyosis at the cellular level, drugs have only an indirect effect on the mechanism of disease development.

Regardless of the duration of treatment with drugs, the disease can recur, because internal endometriosis is a chronic disease.

To the conservative medical method

Hormone therapy is the main conservative treatment.

There is an opinion that if endometriotic foci actively “do not grow” and there are no symptoms that interfere with normal life, you should not begin treatment with hormones, because you can only provoke a disease.

The main hormonal drugs are:

  • Oral contraceptives - Zhannin, Yarin, Regulon and others. They stop the action of hormones responsible for ovulation - this causes anovulation, and the pathological foci do not grow, and the painful symptoms disappear.
  • Progestogens - Byzanna, Duphaston and others. Being synthetic analogues of progesterone, progestogens inhibit the activity of estrogen, which leads to a smaller increase in the endometrium. Accepted for six months cyclically or continuously.
  • Antigonadotropins - danazol and others. Previously, Danazol was very often prescribed, especially to achieve pregnancy, but now, due to its high androgenic effect and other side effects, it is almost never used. The impact of the drug leads to the fact that menstruation disappears, foci can not grow due to the lack of the necessary hormones, after the abolition of drugs, menstruation resumes.
  • AGNRG - zoladex, diferelin, synarel and others. The high price makes AGNRG inaccessible to most patients, their action is to create an "artificial menopause." All the symptoms of menopause are inherent in these drugs, in addition, they are strictly contraindicated for women who have a tendency to osteoporosis, since the condition of the bones worsens under the action of AGNRH.
  • Aromatase inhibitors - before using these drugs, ovarian function must be "turned on", so they are more intended for postmenopausal women.

It is important to understand that after a course of treatment of adenomyosis with hormonal drugs, the probability of a recurrence of the disease increases every year, and repeated treatment is sometimes contraindicated or ineffective. An alternative to hormonal drugs are dietary supplements: indiol, epigallat and others.

Phiotherapy of adenomyosis

The main methods of physiotherapy for internal endomeriosis:

  • Treatment with leeches (hirudotherapy) is a very controversial method.
  • Use low frequency currents (electrophoresis).
  • Magnetic therapy is indicated after surgery.
  • Reception of radon, iodide-bromine baths, but turpentine and sulphide baths cannot be used. Radon baths help to normalize the hormonal balance, have a beneficial effect on adhesive formation.

Attention! You can not use therapeutic mud, visit the bath, sauna, do a massage in the lumbar.

Recommended food

Nutrition in adenomyosis, as in other diseases, is based on the general principles of a healthy diet:

  • The elimination of junk food - sweets, soda, fast foods, etc.
  • Alcohol is recommended to use only red wine in limited quantities.
  • Greens, fruits, vegetables should be abundant (apples, citrus fruits, onions, broccoli).
  • Some sources recommend to exclude dairy products, fatty meat.
  • It is necessary to consume a sufficient amount of protein foods and with plenty of hemoglobin.
  • Give up coffee in favor of green tea.
  • Use the B vitamins.

And denomyosis of the uterus and pregnancy

Most doctors believe that pregnancy with adenomyosis is the best way to treat it.

There is not much information about the effect of internal endometriosis on pregnancy. As a rule, if a woman becomes pregnant independently without taking medications and surgery, then the child is carrying out calmly, but if the pregnancy took place while taking the drugs, you can not abruptly stop taking the drugs, because this can cause a miscarriage.

Pregnancy failure most often occurs in severe forms of the disease when a fertilized egg cannot attach to the walls of the uterus. Miscarriages in adenomyosis occur in the early stages.

And denomyosis and infertility

The cause of infertility in adenomyosis can be hormonal disorders, damage to the uterus.

Problems with conception does not always occur and not at all. If a woman cannot become pregnant with adenomyosis, only hormone therapy or organ-preserving surgery is indicated. Most often, Duphaston, Bezanne is prescribed. Duphaston is not a contraceptive and increases the pregnancy hormone (progesterone). Vizanna causes artificial climax, against the background of the abolition of the drug is often possible to achieve pregnancy.

Prevention

Speaking about the prevention of gynecological diseases (including adenomyosis), first of all it is necessary to mention regular visits to the gynecologist. Every young woman needs to be examined by this specialist once a year.

Советы гинекологов по профилактике внутреннего эндометриоза:

  1. Во время менструации женщине следует отказаться от больших физических нагрузок.
  2. With weak pelvic pain, a woman should rest more, relax, avoid stress.
  3. It is impossible to sunbathe intensively, an excess of solar energy provokes a disease.
  4. Timely pregnancy is the best prevention of the disease.

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