- Adenomyosis - treatment should be individualized
- How to treat
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.