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Adenomyosis

Adenomyosis is a condition in which endometrial tissue (the inner lining of the uterus) begins to invade the muscular lining of the uterus (myometrium). This causes inflammation, thickening of the uterine wall, and can cause a variety of symptoms, including pain and menstrual irregularities.

Causes of adenomyosis:

The exact causes of adenomyosis are not fully understood, but possible risk factors include:
Hormonal changes, including increased estrogen levels.
Early onset of menstruation or late menopause.
Frequent pregnancies and childbirth, abortions.
Heredity.
Uterine surgery, such as a cesarean section or treatment for other gynecological diseases.

Symptoms of adenomyosis:

Lower abdominal pain, especially during menstruation.
Increased length and volume of menstruation.
Pain during intercourse.
Irregular menstruation or bleeding between menstruation.
Infertility or difficulty conceiving.

Diagnosis of adenomyosis:

Gynecological examination: Detection of uterine enlargement or painful areas during palpation.
Ultrasound examination (US): To assess the structure of the uterus and the presence of changes in its walls.
Magnetic resonance imaging (MRI): This is the most accurate method of diagnosing adenomyosis, allowing you to clearly determine the depth of tissue damage.
Hysteroscopy: Examination of the uterus using a special instrument that is inserted through the cervix can help clarify the diagnosis.

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Treatment of adenomyosis:

Treatment of adenomyosis depends on the severity of the disease, the woman's age, pregnancy plans, and general health. Possible options:

Medication:

Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain.
Hormonal drugs, such as contraceptives, progestins, hormonal spirals (Mirena), as well as drugs that block the production of estrogen (gonadotropin-releasing hormone agonists).
Analgesics to reduce pain.

Surgical treatment:

Laparoscopy to remove or reduce endometriotic foci.
Hysterectomy (removal of the uterus) - in severe cases, when other methods are ineffective, and the patient no longer plans to have children.

Prevention:

The prognosis of adenomyosis depends on the degree of damage, age and the presence of concomitant diseases. If the disease is not treated, it can lead to impaired reproductive function. Therefore, it is important to undergo regular examinations by a gynecologist and seek help if symptoms appear.

Adenomyosis is a disease that can affect the quality of life, but with the right approach to diagnosis and treatment, women can live a full life.

How is the consultation for suspected adenomyosis?

Initial examination:

The doctor conducts a detailed conversation with the patient, asking about symptoms: pain during menstruation, duration and nature of bleeding, pain during intercourse and other manifestations.
Medical history assessment: The doctor finds out the presence of chronic diseases, previous surgeries, the presence of gynecological diseases such as endometriosis, and their impact on the patient's health.

Gynecological examination:

The doctor palpates the abdomen and uterus to detect changes in its size or tenderness.
The presence of painful areas when palpating the uterus or its walls is determined.

Diagnostic procedures:

Ultrasound examination (USG): Used to detect possible changes in the uterus, such as thickening of the walls or changes in the structure of the tissues.
Magnetic resonance imaging (MRI): Provides a more accurate picture of the extent of the disease and the depth of penetration of endometriotic foci into the myometrium.
Hysteroscopy: Examination of the uterus using a special camera that allows you to detect the presence of polyps or changes on the inner surface of the uterus.
Laboratory tests: Include complete blood counts (to detect anemia), hormone tests, and tests for infections that may have similar symptoms.

Discussion of the treatment plan:

After analyzing the diagnostic results, the doctor presents the patient with a treatment plan. This may be drug therapy (hormonal drugs, anti-inflammatory drugs) or surgery.
The doctor discusses possible surgical options, if necessary, and also indicates the pros and cons of each method.

Preparation for treatment:

If drug treatment is prescribed, the doctor explains how to take the medication correctly and what side effects to look out for.
If surgery is required (for example, laparoscopy or hysterectomy), the patient undergoes additional examinations and consultations with an anesthesiologist.
The doctor gives recommendations on preparation for surgery: limiting food and fluid intake, performing certain tests and examinations before surgery.

The consultation is an important stage in the treatment of adenomyosis, as it allows you to accurately determine the need for laparoscopy or other treatment methods and prepare the patient for surgery, ensuring maximum comfort and minimal risks.