Adenomyosis
One of the most mysterious diseases in gynecology is endometriosis. Like all terms in medicine, the word is formed from two components: the endometer (s) and the suffix –oz. The suffix "oz" denotes a pathological process that proceeds as a chronic one, but without obvious signs of inflammation. The endometrium is the inner layer of the uterus, part of which is rejected every month. When pregnancy occurs, there are no periods. Unless a woman has adenomyosis, in which, in the initial stages, the appearance of a bloody discharge is possible.
The focus of menstruation outside the anatomical location is called endometriosis. This is the general name for the process, and when adenomyosis is meant, the uterus is involved and no other organs are involved.
Normally, bloody discharge containing endometrial cells is secreted from the vagina. When the focus of menstrual activity is inside the wall of the uterus, they are not completely rejected. In addition, adenomyosis is regarded as a tumor-like disease prone to growth and metastasis. The cells from the focus do not have cancer activity, however, adenomyosis is accompanied by severe pain.
The mechanism of development and the causes of the appearance of endometriosis and adenomyosis
Endometriosis is divided into genital, that is, adenomyosis, in which the uterus suffers, and extragenital - when the focus of menstruation is located outside the organ. According to the embryonic theory of the development of endometriosis, when the organs of the fetus are laid, the genetic program fails, as a result of which the cells of the inner lining of the uterus end up in other organs. In the iris of the eye, for example. Such incidents occur in 2-3% of cases.
Most often, adenomyosis develops, and the uterus enlarges towards the end of each menstrual cycle. The uterus is a hollow, powerful muscular organ, the width of the walls of which reaches 1-3 centimeters. Layers of the uterine wall:
- Mucous - endometrium;
- Muscular - myometrium;
- Serous - makes up the outer shell of the organ.
The inner layer - the endometrium increases by the middle of each cycle, in the second phase the cells mature. During menstruation, they are rejected into the uterine cavity. With adenomyosis, endometrial cells are trapped inside the muscle layer. This location is the main cause of the disease. The fact is that the cells of the inner layer of the uterus, being outside the anatomical localization, continue to function. They also increase in size, irritating the pain receptors of the muscles of the uterus. During bleeding with adenomyosis, the patients notice slight, smearing chocolate-colored discharge. So the cells of the endometriosis focus located in the muscular layer of the uterus are rejected. Since the endometrioid tissue is prone to growth, foci of adenomyosis spread deep into the wall of the uterus, which aggravates the course of the disease.
The main reason why endometriosis develops is a violation of a woman's personal hygiene. Adenomyosis that begins within the uterus has slightly different causes.
Violations of personal hygiene during the period of monthly bleeding, leading to endometriosis:
- Swimming in an open pond or bath;
- Sexual life during menstruation;
- Ignoring the rules for using vaginal tampons.
When swimming during menstruation, regardless of the quality of the pads, when immersed in water up to the waist, due to the pressure difference, endometrial cells are sucked into the fallopian tubes. This is how endometrioid cysts are formed, less often adenomyosis, if bleeding continues after the termination of pregnancy.
During sexual activity, the rule of pressure difference between the environment and the internal genital organs works in the same way. This is how endometriosis of the tubes and peritoneum is formed.
The contents of vaginal tampons, after six hours of use, are reabsorbed. If there are microcracks on the mucous membrane of the uterus, adenomyosis develops, in their absence, the endometrial cells move to the uterine appendages.
The reasons for the development of adenomyosis are exclusively surgical:
- Surgery to terminate pregnancy, in which the muscle layer of the uterus is inevitably damaged;
- Caesarean section with the penetration of endometrial cells into the space between the sutures.
After the operation to extract the fetus, adenomyosis develops much less frequently, since the cells of the inner layer of the uterus lose activity due to the physiological end of pregnancy.
Symptoms of adenomyosis
The manifestations of the disease are characteristic, and it is very difficult to confuse them with other manifestations. All symptoms of adenomyosis have a clear connection with the hormonal cycle:
- An increase in the size of the uterus before menstruation and a decrease after them;
- Increasing pain in the lower abdomen and lower back closer to the period of monthly bleeding;
- Discharge of chocolate color before and after menstruation;
- Infertility on the background of anovulatory syndrome.
At first, the symptoms of adenomyosis are smoothed out and are perceived as a normal premenstrual change in the body. Then, as it progresses, the intensity of the pain increases, and the time increases. Patients feel pain not only before menstruation, but also constantly.
Treatment of adenomyosis
The disease is associated with the hormonal background of the woman, therefore, the treatment of adenomyosis is effective only with the use of hormonal therapy. The operation is done only for health reasons, when the endometrioid tissue grows through all layers of the uterus to the abdominal cavity. But even after removal of the uterus, treatment of adenomyosis continues with the use of hormonal drugs. There are several ways of hormonal correction for adenomyosis, which have different directions:
- Termination of menstrual function;
- Pregnancy;
- Regulation of the hormonal cycle.
The drugs are prescribed by an obstetrician-gynecologist who chooses the most appropriate, optimal treatment method.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
