Heavy menstruation, inexhaustible, dysmenorrhea, infertility... The appearance of one alone is enough to annoy female friends.
The disease we are going to talk about today is a disease that may combine these symptoms and even plague women for a lifetime - adenomyosis.
The cause of adenomyosis is still a mystery, but it is speculated that it is closely related to the junction zone between the endometrium and the muscle layer, that is, the binding band is damaged.
The binding belt is like a "border defense line", if the defense line is broken due to artificial abortion, curettage, pregnancy, childbirth and other reasons, resulting in damage to the binding belt and rupture, the endometrium may enter the muscle layer along the fissure, grow in the muscle layer misalignment, and form adenomyosis.
Adenomyosis, more common in women's fertile function is the most vigorous period (mainly 20-40 years old), the most typical is now menstrual volume, dysmenorrhea, and even infertility.
/ High menstrual flow /
Adenomyosis causes high menstrual flow for two main reasons:
The area of the endometrium increases
The endometrium is the active "lining" that covers the uterus, which is affected by ovarian hormones to grow and peel off periodically, thus forming menstruation.
Even if the endometrium grows into the muscle layer of the uterus, this growth and dissection still exists.
However, the products after peeling are often difficult to excrete with menstruation, and they are prone to accumulation, which will lead to thickening of the uterine muscle layer. Correspondingly, the size of the uterus will become larger, and the area of the endometrium that covers the uterus will increase.
This is equivalent to increasing the area of menstrual bleeding, which leads to an increase in menstrual flow.
The binding belt is damaged
The conjugated band mainly controls the uterine contraction during the non-pregnancy period of women, and during menstruation, the conjugated band contraction can close the blood sinuses in the uterine cavity in time without excessive menstrual volume.
If the binding band is damaged, the hemostasis will not be in time, resulting in a large amount of menstruation, prolonged time, inexhaustible, and can even lead to long-term chronic blood loss, causing anemia.
/ Dysmenorrhea /
The uterine cavity is enlarged and will produce dysmenorrhea, but in daily life, many people have experienced dysmenorrhea, how can we be sure that it is caused by adenomyosis?
General dysmenorrhea will occur occasionally during menstruation, which may be due to abnormal positions such as excessive forward and backward tilt of the uterus, resulting in poor menstrual blood flow, or due to cold, diet, mood changes and other factors.
The dysmenorrhea caused by adenomyosis will continue to worsen, and in addition to the pain during menstruation, there may also be chronic pelvic pain during non-menstruation, with symptoms such as abdominal distension, waist acidity, and fatigue.
Some people even have painful intercourse, which may be related to the increase in blood supply in the pelvic cavity after the uterus enlarges, and it is easy to produce pelvic congestion.
/ Infertility /
As mentioned above, the binding band is like a "border defense line", under normal circumstances, the binding belt is complete and soft, which can provide a stable intrauterine environment for conception, and when the fertilized egg enters the uterine cavity, the binding band slowly contracts and also helps the implantation of the fertilized egg.
When the "border defense line" is broken, the integrity of the binding band is destroyed, the internal environment of the uterus is destroyed, and at the same time, the contraction function of the binding band decreases, which may lead to the failure of the implantation of the fertilized egg.
In addition, the foci of adenomyosis will also secrete some cytokines that disturb the uterine environment, which may lead to infertility.
Even if the conception is successful, the risk of adverse pregnancy outcomes such as miscarriage, fetal development abnormalities, fetal cessation, and premature birth may be higher, and it is necessary to follow the doctor's advice to the hospital on time.
01 Adenomyosis may worsen around menopause
Adenomyosis is a hormone-dependent disease that, in theory, after menopause, hormone levels drop and lesions can be slowly relieved by no longer being stimulated.
But in reality, most people can't make a safe transition to postmenopausal, but may be stimulated by premenopausal hormone disorders, and symptoms will worsen, such as severe anemia.
In addition, although the incidence is not high, adenomyosis may also occur before and after menopause, especially in people who recur after menopause adenomyosis, and the risk of malignancy is relatively higher.
Therefore, once the diagnosis is confirmed, it is recommended to treat it aggressively and reasonably, and review it regularly.
02 The failure to cure adenomyosis is mainly symptomatic relief
At present, there is no good cure for adenomyosis, but according to the patient's symptoms, age and fertility requirements and other personal circumstances, targeted choices such as drugs, surgery and other means to alleviate symptoms.
For young women with mild symptoms and fertility requirements, the treatment is mainly to control the lesion and promote fertility;
For those who do not have fertility requirements, the treatment is mainly based on symptomatic treatment and pain relief.
/ Medication /
The main drugs treated are oral contraceptives, progestin drugs, gonadotropin-releasing hormone agonists (GnRH-a), etc., which are used to inhibit ovarian hormone secretion, so that the body is in a low hormone level environment and block the further development of the disease.
Oral contraceptives also have a menstrual effect on younger patients, but are generally not used in women over 40 years of age.
If the pain is severe, temporary use of analgesic nonsteroidal anti-inflammatory drugs, such as acetaminophen, ibuprofen, etc. But painkillers can only do the effect of relieving pain, and have no therapeutic effect.
/ Surgical Treatment /
For women with severe symptoms, poor drug therapy, and no fertility requirements, surgery can be selected, including conservative surgery that only removes lesions and uterine removal surgery, each with advantages and disadvantages.
Conservative surgery often fails to completely remove the lesion and has a risk of recurrence; after uterine removal, fertility will be lost, and it may also cause some physical and psychological problems.
In the treatment, but also pay attention to regular review, generally need to be reviewed once a year, if the disease is found to be aggravated, the uterus enlarged, bleeding and other symptoms, it is best to recheck at least once every six months, according to the change of the condition in time to deal with, so as not to cause serious consequences.
References: Medical Microvision official website - Duan Hua Chief Physician "Adenomyosis"