Pain in adenomyosis are almost always. Exceptions are asymptomatic forms of the disease. The appearance of pain associated with multiple compression of the nerve endings are located in the wall of the uterus. This contributes to inflammation and swelling, the average developing muscular layer of the uterus during menstruation.

Pain in adenomyosis - why do they occur?

To introduce into the muscle of the uterus, endometrial cells continue to function under the influence of cycles of female sex hormones (mainly estrogen). They proliferate (proliferation stage), and then torn away from the tissue in which are located, which is accompanied by bleeding. However, since blood flow portions endometrial nowhere, they accumulate in the muscular layer, wherein developing an inflammatory process accompanied by edema. Edema contributes to compression of nerve endings - this is a long aching.

Under the influence of a variety of biologically active substances released during inflammation, there is intermittent spasm of smooth muscles of the uterus, resulting in a dramatic compression of the nerve endings and strong spastic pain. Over time, the muscle layer of the uterus in which adenomyosis is a site undergoes metabolic and degenerative changes that lead to violations of the contractile function of the uterus. That is why adenomyosis is often accompanied by miscarriage Miscarriage - why you lose the most precious thing? .

Sometimes adenomyosis sites can be opened directly into the uterine cavity and to reject unwanted tissue in each menstrual cycle directly into the uterus. It contributes to the destruction of the basal layer of the endometrium (it is not normally rejected during menstruation and serves as the basis for restoring rejected by the functional layer) and the development of adhesions in the uterine cavity, where the pain is particularly strong. Very strong pain occurs in the first days of menstruation, when there is a rejection of the endometrium.

With such congenital anomalies of the uterus, as additional horn defeat this area adenomyosis Adenomyosis - avoid constant stress   It can cause severe pain, resembling an acute abdomen. This happens because the menstrual blood thrown into the pelvic cavity and cause signs of inflammation of the peritoneum - peritonitis.

The nature and duration of pain

Pain at large adenomioznyh nodes may be permanent aching in nature. They appear in the lower abdomen or in the lumbar region and is given in the crotch and thigh. In just a few days before menstruation pain intensified, and a few days after it began to decline. After the end of menstrual pain may subside or disappear altogether.

During amplification constant aching pain may alternate with very strong spastic pain to a greater or lesser duration. Sometimes the pain is so strong that there are signs of acute abdomen - a symptom of irritation of the peritoneum covering the uterus.

Such pain often occur when adenomyosis third degree, when areas of adenomyosis permeate myometrium and touching its serous membrane, which is part of the peritoneum. Particularly severe pain adenomioznyh lesions appear at the isthmus of the uterus and development in the uterus adhesions.

By the nature of pain can sometimes determine which portion of the uterus located adenomioznye nodes. Thus, at the location of stations in the corners adenomyosis uteri often give pain to the groin, in the region of the cervix - the rectum or vagina. Severe pain in the adenomyosis bad removed by conventional painkillers.

Out of menstrual pain it can not be. Sometimes they occur during sexual intercourse, as well as when performing gynecological procedures and hygiene (eg, irrigation).

Pain in adenomyosis and extent of the process

In the depths of the spread of endometriosis sites in the muscle layer of the uterus, there are three degrees of diffuse adenomyosis. When I level affects only the inner layer of cells of the myometrium adjacent directly to the basal layer of the endometrium. Grade II says that the defeat came to the middle of the myometrium, and grade III - that permeated the entire soi endometriosis myometrium and in contact with the outer serous membrane covering the uterus.

The intensity of the pain associated with adenomyosis depends on the extent of the process. For example, diffuse adenomyosis I level is almost never accompanied by pain, while in diffuse adenomyosis Diffuse adenomyosis - common disease of women   II and III, and in nodular adenomyosis Nodal adenomyosis - the terrible diagnosis   pains occur almost always increases with the foci of adenomyosis.

The nature, intensity and duration of pain associated with adenomyosis can tell a lot of experienced professionals.

Galina Romanenko

Inflammation of the uterus (adnexitis or salpingo-ophoritis) is a major cause of infertility in women The causes of infertility in women - and the main predisposing factors . Therefore, it is important timely diagnosis of inflammation of the appendages, which is conducted on the basis of identifying the main causes and symptoms of the disease, confirmed by lab tests.

What may reveal gynecologist

First of all, the gynecologist is interested in women's complaints. Can alert one- or two-sided lower abdominal pain, painful menstruation, heavy menstruation long, acyclic bleeding and so on. If you suspect a adnexitis, he deliberately asks her about her past infectious-inflammatory processes of sexual sphere (including sexual infections), as well as possible colds, stress, heavy loads, abortion, gynecological procedures (including the introduction of an intrauterine device with for contraception), and so on.

Further gynecological examination Gynecological examination: an important component of women's health   can confirm the diagnosis - to identify a single or bilateral painful increase in the uterus.

Laboratory research

In order to detect the presence of an inflammatory process, blood is taken from a woman in the overall analysis. Elevated blood levels of white blood cells, a large number of granular white blood cells (granulocytes), accelerated ESR indicate the presence of inflammation.

ALWAYS microscopic examination of vaginal smears, cervical canal and the urethra, as well as microbiological examination of secretions (bakposev on nutrient media) to identify the infectious agent and its sensitivity to various drugs. Material bacterial inoculation test for the better by taking puncture posterior vaginal vault or during laparoscopy. A study taken from the vaginal secretions is not always a high degree of certainty.

To detect intracellular pathogens (Chlamydia, Mycoplasma, Ureaplasma) used cytological diagnostic methods (cell tissue taken laparoscopically examined under a microscope) and immunological methods (determination of the type and amount of antibodies to various intracellular pathogens).

To identify complications adneksita from the urinary tract is performed urinalysis, which revealed characteristic changes in these diseases.

Ultrasound examinations

With transabdominal (through the abdominal wall) ultrasound can detect inflammation of the fallopian tubes and ovaries, the presence of abscesses, hydro or piosalpinks and establish the nature of fluid in them. Difficulties during ultrasound occur in a slight increase in the fallopian tubes, adhesions and significant development for a large amount of fat in the anterior abdominal wall.

Transvaginal ultrasound sensor (the sensor is installed in the vagina) to identify subtle changes in different segments of the fallopian tube. If you suspect a adneksit survey is conducted using transabdominal and transvaginal probes.

Inflammation of the appendages - diagnostics using laparoscopy

In some cases, further diagnosis adneksita and extent of its spread is performed diagnostic laparoscopy - endoscopy of the surface of the ovaries and fallopian tubes using a laparoscope optical apparatus. Diagnostic laparoscopy is an invasive examination method that is associated with the penetration into the body through the skin. At the same time the skin anterior abdominal wall make several mini-incisions through which the input of the optical system, which eliminates then the image on the screen.

The study not only allows a good view of the fallopian tubes and ovaries, but also to take the material for cytological, histological and microbiological studies. After diagnostic laparoscopy, the doctor usually knows all about the state of his patient.

Inflammation of the appendages - diagnostics using hysterosalpingography

Hysterosalpingography - this X-ray of the uterus and appendages with the introduction of a contrast agent. It is used to determine the permeability of the fallopian tubes and the severity of pathological changes in them in chronic adnexitis Chronic adnexitis: dangerous consequences .

The correct diagnosis of inflammation of the uterus Inflammation of the uterus - is one of the most common gynecological diseases   It can be made only after a comprehensive examination of the patient. That correct diagnosis is a guarantee that a woman will be assigned to appropriate treatment.

Galina Romanenko