What is adenomyosis: symptoms and treatment

Adenomyosis is a disease that occurs with a Thickening inside the walls of the uterus. As a result, the woman will feel pain, bleeding and strong cramping, among other symptoms that we will see later.

This disease occurs when the tissue that normally lines the uterus, which is the endometrial tissue, develops in the muscular wall of the uterus. The displaced tissue continues to function normally, thickens, degrades and causes bleeding during the menstrual cycle.

Adenomyosis is a benign and common disorder in women who have given birth between the ages of 35 and 50 years of age. In addition, this condition can occur in two ways, taking into account the amount of tissue invaded:

• Diffuse adenomyosis: in this case, a large part of the uterus or in its entirety is affected.
• Focal adenomyosisIt is also known as adenomyoma. It consists of a mass located within the myometrium.

Causes of adenomyosis

Today, the exact causes that trigger this disease in the womb are not known. Some of the scientific explanations are:

• Traumas in the uterus as a history of uterine or gynecological surgery: as well as more than one pregnancy throughout life or a cesarean delivery.
• Invasive tissue growth: it is believed that it may be the result of direct invasion of the endometrial cells from the lining of the uterus into the muscle that forms the uterine wall.
• Origins of developmentIt is thought that it can originate inside the uterine muscle from the endometrial tissue that is deposited there when the uterus was initially formed in the fetus.
• Origins of stem cells: Another theory, although more recent, suggests that stem cells from the bone marrow could invade the uterine muscle and cause adenomyosis.

However, we must bear in mind that whatever its cause, the growth will depend totally on the concentration of estrogen that there is in the woman.

symptom

Approximately One third of women who have this disease do not have any symptoms. The other proportion does have symptoms, the main one being intense menstrual flow and very painful cramping.

Also, when the woman has sex, may bleed outside of the period of menstruation.

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Other common symptoms of adenomyosis are:

• Pelvic pain.
• Intense cramps.
• Anemia caused by heavy bleeding: it would be a complication of this disease. It appears when the bleeding is prolonged. As a result, the woman will feel tired and may have other health problems.
• Problems of infertility.

Despite not being a harmful disease, Pain and excessive bleeding can alter the lifestyle of these patients. They often try to avoid doing activities they once enjoyed because of the intense pain or the worry of starting to bleed.

Diagnosis

The uterus can be visualized by ultrasound or magnetic resonance techniques. The first technique is the most effective and the one that is more available to doctors today.

Thanks to ultrasound, the uterine texture can be observed in a heterogeneous way without the well-defined focal masses that characterize disorders such as fibroids.

Regarding the second technique, Magnetic resonance imaging provides better diagnostic capacity because they have a better resolution and it contrasts the images better, especially in the differentiation between a adenomyosis and a fibroid myoma.

On the other hand, in women without symptoms and without uterine volume increase, a diagnosis can be made with absolute certainty only through the evaluation of the uterus after a hysterectomy.

Treatment of adenomyosis

The only effective treatment for adenomyosis is the surgical removal of the uterus or hysterectomy. As Symptoms get worse after 40-45 years of age and go away after menopause, The majority of women end up without the need for radical treatment.

The administration of anti-inflammatories to control colic and the use of the contraceptive pill to control the release of hormones during the menstrual cycle usually help relieve symptoms.

However, in the case where the woman is far from menopause, she already has children and does not want to have more and is not able to reduce the symptoms of the disease, Surgery should be considered.