Endometriosis (endometrial heterotopias) - gormonalnozavisimyh a pathological process in which in the muscle layer of the uterus or other reproductive organs and outside there are pockets, structurally similar to the endometrium. There are external and internal endometriosis, genital and extragenital endometriosis. Adenomyosis of the uterus - is an internal endometriosis, which affects women aged 40-50 years, it appears the introduction of tissue similar to the endometrium, in the thickness of the uterine wall.

The causes of uterine adenomyosis

The uterus is composed of three layers: endometrium (the mucous membrane of the uterus), myometrium (muscular wall) and subserous layer (cover outside the uterus). Normally, during the menstrual cycle the endometrium grows and prepares to accept a fertilized egg. If conception has not occurred, there is a rejection of the functional layer of the endometrium - menstruation. Upon germination of the endometrium into the muscle of the uterus becomes impossible to rejection during menstruation, which determines the clinical picture and complaints.

The causes of uterine adenomyosis is still not well established. It is believed that the predisposing factors include abortion, diagnostic curettage of the uterus and other intrauterine intervention (cesarean section, surgery on the uterus). Pathological childbirth and abortion violate the functioning of the uterus, ovaries, leading to the development of adenomyosis. Also, in the development of adenomyosis of the uterus is not the last role played by sun exposure, poor mud Mud - a pleasant and useful procedure , Stress, heavy physical labor.

The clinical picture of uterine adenomyosis

Clinic of the disease depends on the duration of flow, comorbidities, psycho-emotional state of the patient. The main manifestations of uterine adenomyosis:

• Typically a long, often progressive course of the disease. In postmenopausal Postmenopause - is it possible to control it?   can regress (reverse development) adenomyosis.
• The main symptom is a constant and pains that occur or are worse before menstruation, and prolonged and severe pain during adenomyosis do not pass after a month. The intensity of the pain depends on the prevalence of the process, especially strong pain in the involvement of the entire uterine wall, up to a serous cover.
• Increased size of the uterus, it acquires a rounded shape.
• There menstrual disorders, often manifests itself in the form of painful menstrual periods and spotting appears dark discharge before and after menstruation. The menstrual cycle becomes irregular, there may be dysfunctional uterine bleeding.
• Adenomyosis of the uterus is often complicated by infertility. Infertility is due to the development of anovulation, the inferiority of the secretory phase of adhesions in the pelvis Adhesions in the pelvis: Symptoms and Treatment . Often when adenomyosis uterus infertility explain phagocytosis of sperm.

There are diffuse nodosum (focal) form of adenomyosis. Nodular form is characterized by the growth of the local endometriodnyh tissue during palpation similar to myoma nodes.

At a depth of germination in the endometrium are four degrees of diffuse forms of adenomyosis of the uterus:

• First degree

The introduction of a small depth.

• Second degree

Endometriosis extends to the middle of the muscle layer of the uterus.

• Third degree

Endometriosis affects the entire wall of the uterus.

• The fourth degree

In the pathological process involved adjacent organs and peritoneum.

Diagnosis and treatment

The diagnosis of adenomyosis of the uterus is established on the basis of the complaints, typical symptoms (pain and an increase in the uterus before menstruation). It allows ultrasound to confirm the diagnosis, during which the celebrated cellular structure of the endometrium, or the point melkokistoznye structure in it, the border of the mucosa and muscle layer is rough, winding, different thicknesses of the front and rear walls of the uterus. It is effective in the diagnosis of adenomyosis Adenomyosis - diagnosis endometrioid lesions of the uterus   uterine hysterosalpingography (contrast agent located outside the contour of the uterus). Informatively hysteroscopy, which allows you to see the inner surface of the uterus, tubes and endometrial mouth moves.

Treatment of adenomyosis can be both conservative and operative. To preserve the reproductive function prescribed hormonal drugs (oral contraceptives, Mirena coil, progestins). Surgery is used in nodular form of adenomyosis, combined with uterine disease.

Anna Sozinova

Adenomyosis - a type of endomertioza - proliferation of endometrial tissue in areas of the muscle layer of the uterus. Adenomyosis - its causes less clear, they have yet to be explored. There are many theories of the disease, but united, which would explain all the features and causes of adenomyosis, no.

How is adenomyosis

Endometriosis - a disease that starts in contact with endometrial cells in other tissues and develop there own burgeoning areas of endometrial tissue - areas of endometriosis. Under the influence of female sex hormones at sites such as endometriosis occur cyclical changes, as in the endometrium.

As is known, the wall of the uterus is composed of three layers of the endometrium, myometrium, and perimeter.

Endometrium - is the inner layer of the uterine wall or mucosa. It is divided into an outer or a functional layer, which is rejected during menstruation and restored during each menstrual cycle under the effect of female sex hormones and an internal or basal layer. The basal layer is not rejected during menstruation and is a source of recovery of the functional layer.

Myometrium - a middle muscular layer of the uterus, consisting of smooth muscle cells. Normally it is securely protected the basal layer of the endometrium from being hit by a parting of the functional endometrial cells. But even if the endometrial cells fall into myometrium with a normal immune system, they will be immediately destroyed.

Perimeter - is the outer serous membrane covering the uterus.

The two main causes of endometriosis

There are two main causes of endometriosis, which today do not cause no one doubts. This hormonal disorders and impaired immunity.

If any form of endometriosis in the blood of women found high content of estrogen - the female sex hormones are responsible for hormonal support for the first half of the menstrual cycle. Sometimes there is a relative increase in the secretion of estroenov associated with a reduction in progesterone secretion Progesterone - norm and pathology   - Hormone second half of the menstrual cycle. Under the influence of estrogen in the first half of the cycle occurs proliferation (proliferation) of the endometrium. Progesterone begins to stand out in the second half of the cycle, it inhibits proliferation and causes the endometrium to allocate the necessary substances for pregnancy (secrete). Asli estrogen lot and progesterone low, this leads to a proliferation of endometrial immoderate, posleduyuschemi significant bleeding from gaping thrown at blood vessels and endometrial cells in other tissues.

But with normal immunity immune cells immediately attack the "strangers" and destroy them. Therefore, the second cause of endometriosis is impaired immunity.

Adenomyosis - the causes of

Adenomyosis - this is one of the most obscure and unexplored types of endometriosis Endometriosis - a serious problem with serious consequences . It is still unclear how the cells are rejected functional layer of the endometrium to overcome obstacles in the form of the basal layer of the endometrium. There are several theories to explain this process.

The first theory - is the presence of obstacles to the outflow of menstrual blood, which leads to an increase in intrauterine pressure and introduction of endometrial cells in the myometrium. The most common obstacle to the innate character, such as narrowing of the cervical canal, complete imperforate hymen, various anomalies of the structure of the uterus and so on. But the same obstacles may occur after an abortion (in the uterus or in the canal of the cervix grow spikes).

The second theory - is inborn errors of permeability of the basal layer of the endometrium, associated with some genetic peculiarities of the structure of tissues or harmful effects during pregnancy.

Factors that predispose to the development of adenomyosis

Adenomyosis may be asymptomatic, it does not prove itself all over the life of the woman, and then, with the onset of menopause, regress. But there are predisposing factors that contribute to the development of endometriosis, or move it in asymptomatic phase of manifestation, that is, the appearance of the characteristic symptoms of the disease.

Such predisposing factors include, primarily, manipulation, and operation in the uterus, which could result in damage to the basal layer of the endometrium and the development of adhesions in the uterus and cervix channel - abortion, dilatation and curettage, gynecological manipulation difficult birth, etc. .

Of course, also a risk factor is the high content of estrogen in the blood, or a decrease in progesterone. These hormonal disorders Hormonal disorders - oversupply and a lack of equally dangerous   often causes obesity - fat cells produce estrogen. Therefore, the correction weight is at adenomyosis Adenomyosis - avoid constant stress   mandatory.

Adenomyosis - the causes of the disease are not yet fully understood, but more often they are multiple.

Galina Romanenko