Adenomyosis - a condition in which the internal tissue of the uterine mucosa (endometrium) grow into the tissue of the muscular wall of the uterus - myometrium. Adenomyosis can cause cramping, similar to menstrual, feeling the pressure in the lower abdomen, severe bloating before menstruation and unusually heavy menstrual bleeding. This disorder can occur throughout the uterus or to be localized. Although it is believed that adenomyosis is not dangerous to health, frequent pain and heavy bleeding associated with this disorder may have a negative impact on the quality of life of the patient.

Symptoms of adenomyosis

Although some women have adenomyosis are asymptomatic, it can cause:

• Abnormally severe and prolonged menstrual bleeding
• Very strong cramping during menstruation, sometimes at another time
• Feeling the pressure, stress and unnatural fullness in the lower abdomen

Who develops adenomyosis?

Adenomyosis - a common violation. It is most commonly diagnosed in middle-aged women and women with children. Some scholars also suggest that the risk of adenomyosis is quite large in women who have had surgery on the uterus. Although the exact reasons adenomyosis is not set, it is assumed that a variety of hormones, including estrogen Estrogen - the key to bone health , Progesterone Progesterone - norm and pathology , Prolactin, and follicle stimulating hormone may trigger this disorder.

Diagnostics

Until recently, the only reliable way to diagnose adenomyosis was holding hysterectomy and subsequent study of uterine tissue with a microscope. However, modern medical imaging technology allow clinicians to detect adenomyosis and without surgical intervention, for example, using magnetic resonance imaging (MRI) or transvaginal ultrasound.

If you suspect that adenomyosis first step in diagnosis is a common gynecological examination in the course of which it is possible to understand that the uterus is enlarged, as is the case with adenomyosis. Using ultrasound the doctor may examine the endometrium and myometrium. US fails to accurately determine that the patient adenomyosis, but enables the elimination of certain diseases with similar symptoms.

Another technique that is sometimes used to assess the symptoms associated with adenomyosis, called sonogisterografiya (CHS). MRI is usually used to confirm the diagnosis in women with abnormally severe menstrual bleeding.

Because of the similarity of symptoms of adenomyosis is often misdiagnosed as uterine fibroids. These two diseases - not the same thing. Fibroids - a build-up on the wall of the uterus, adenomyosis is the abnormal formation within the wall of the uterus. Of course, the correct treatment is possible only if the correct diagnosis.

Treatment

The choice of treatment of adenomyosis Adenomyosis - treatment should be individualized   It depends on the symptoms - their severity, and whether, if the patient plans to have children in the future. Mild symptoms can be cured with the help of non-prescription drugs; to facilitate spasmodic pain is enough to use a heating pad.

When severe pain associated with adenomyosis, a doctor may prescribe nonsteroidal antiinflammatory drugs. Usually they begin to take 1-2 days before menstruation; Course dose lasts for several days.

At very painful and heavy menstrual bleeding associated with adenomyosis, appointed by hormone therapy.

There are other ways to treat adenomyosis.

• Uterine artery embolization - a minimally invasive procedure in which overlap the blood vessels supplying blood formation resulting from adenomyosis. Particles with which overlapping vessels are introduced through a thin tube inserted into the vagina. If there is no blood supply to benign gradually decrease.
• Endometrial ablation. During this procedure, the uterine lining breaks down. Endometrial ablation is effective for patients who have endometrial tissue has not penetrated too deeply into the muscle wall of the uterus.
• The only way to completely get rid of the symptoms of adenomyosis Adenomyosis: Symptoms - what to expect from the body?   It is the complete removal of the uterus. Sometimes it agree to a woman whose symptoms of this disorder worry too much and that you no longer plan to have children.

Can adenomyosis cause infertility?

As it is often the women who are diagnosed adenomyosis, endometriosis also have, it's hard to say what role plays the first of these diseases in the development of infertility. However, there is reason to believe that adenomyosis may affect a woman's ability to conceive.

Adenomyosis - the treatment of the disease usually consists of a whole range of methods selected for each woman individually, depending on the spread of the age and the desire to have children in the future. It is an individual approach to treatment ensures its maximum effectiveness.

Basic principles of treatment

Treatment of adenomyosis is conducted only after a full examination of women whose task is to identify the extent of adenomyosis and possible endometriosis in other organs and tissues. After the final diagnosis is the treatment, which may be of medical, surgical or combined.

Drug treatment to be diffuse and diffuse nodular form of the disease. But if the woman's condition is not improving, it is still losing a lot of blood and possible surgery - amputation of the uterus.

Endometrial nodes in the uterus is usually removed. In the childbearing years, when a woman has to have children implies, these operations are performed laparoscopically and retain female fertility. After the restoration of the health of a woman is recommended to pregnancy, which will consolidate the therapeutic effect of surgery and prevent a recurrence of the disease.

Women who are not intended to have children, it is proposed supravaginal amputation of the uterus that once and for all resolve all issues with adenomyosis.

Modern complex treatment of adenomyosis also includes the restoration of immunity, which is carried out with the help of drugs interferon and interferon inducers (stimulating production of its own interferon).

The structure of the complex treatment includes also medications and diet contribute to the treatment of iron deficiency anemia. Work is also symptomatic treatment - hemostatic drugs and analgesics.

Drug treatment of adenomyosis

The main component part of a complex medical treatment of adenomyosis is a hormonal treatment. For this purpose are used drugs that suppress the secretion of female hormones estrogen - these hormones are a major cause of adenomyosis Adenomyosis - the causes of endometriosis sites in the uterine wall .

Treatment of diffuse adenomyosis Diffuse adenomyosis - common disease of women   with severe symptoms (pain and bleeding) start with the appointment of synthetic agonists (analogues) gonadotropit-Riesling-hypothalamic hormone (GnRH agonists), which inhibit the production of pituitary gonadotropins (TG). Lack TG leads to a complete shutdown of the ovaries, causing the reproductive system of women temporarily stop working - this state is called medical castration. For a long time these hormones are not usually prescribed course of treatment lasts no more than three months in a row, as the complete lack of estrogen leads to the development of osteoporosis - bone fragility - there is a tendency for them to fracture. GnRH agonists are Diferelin, Dekapeptil, nafarelin, buselerin, zolodeks depot, lyukrin Depot and others. These drugs are often prescribed after the removal of endometriosis sites in the uterus to prevent the recurrence of adenomyosis.

To suppress the action of the pituitary gonadotropins prescribe drugs to antigonadotropnym action, they are usually long courses are appointed for a period up to six months. This group of drugs include Danol, danazol, danogen and others.

In order to suppress the synthesis of estrogens, used drugs - analogues of progesterone Progesterone - norm and pathology   (progestins) - djufaston, utrozhestan Utrozhestan - corrects the deficiency of progesterone , Norethisterone, checking linestrenol and so on.

If diffuse changes in the uterus or nodes are small and not too worried about a woman, sometimes prescribe combined oral contraceptives (COCs), creating them artificially lengthening the menstrual cycle. For this COC is prescribed by 63 or 84 consecutive days (3 or 4 packs), followed by one week apart for monthly. The same treatment is sometimes carried out after removal of nodes in the uterus.

Today, for the treatment of adenomyosis and infertility on the background successfully used targeted therapy - the use of drugs that act on a specific target (in this case the endometrial tissue) has minimal effect on the body as a whole. In the presence of infertility in the background adenomyosis light and medium should be used in conjunction with the COC targeted therapy in the form of the appointment of inhibitors of tumor growth (Indinol and epigallata) to preserve ovarian function and restore reproductive function.

Surgical treatment of adenomyosis

Surgical treatment of adenomyosis in our time is spent basically gentle way, using a laparoscope, which provides access to the operated tissues without cutting the skin (the skin is only a couple of mini-incisions). Such sparing surgery normally take place without the formation of adhesions, which is very important to preserve the fertility of women. Women of childbearing age are trying to remove endometrial only nodes, while maintaining the uterus. Women who do not involve in the future to have children, held supravaginal amputation of the uterus.

Combined treatment of adenomyosis is selected each woman individually.