Find out about gynecological diseases, uterine adenomyosis

 Hello! I'm mwollosee♥ 

Today, I will talk about adenomyopathy. 

I'm also going through this, so it's not stress, but stress, even writing it thinking that he's a very disgusting guy. But if you're a woman, you should know and if you knew, how to deal with it. I'd like to talk about that, too. So I'll post it.

What is adenomyopathy??

Women's reproductive organs consist of the uterus and ovarian fallopian tubes, and the uterus can be divided into endometrium, uterine muscles, and cervix. Diseases in which the endometrium infiltrates other parts of the uterus include endometriosis and uterine myopia, and endometriosis is a disease caused by the infiltration of the endometriosis into the uterine muscle layer.

When infiltrating tissue increases according to the menstrual cycle, regular menstrual pain occurs, and blood accumulated in the muscle layer escapes and appears as delayed menstruation. In many cases, it occurs intensively throughout the uterus, or in the anterior or posterior walls, giving the impression that the uterus is enlarged, but sometimes forms a mass called a myoma in certain parts of the uterus, such as uterine myoma. Uterine fibromyosis can also occur in young women of childbearing age, but occurs mainly in women after their late 40s, and is accompanied by uterine myoma and endometriosis in many cases.

Then what's the cause?

The cause of uterine adenomyosis is not yet known, but it is reported that the frequency is increasing due to childbirth, miscarriage, and Caesarean section. There is a theory that endometrial tissue penetrates or moves into the uterine muscle layer when the uterus is operated by surgery or inserting an intrauterine device. There is also a theory that endometrial cells penetrate the muscle layer by destruction and inflammation of endometrial cells.

statistics

In women with chronic pelvic pain, the frequency of uterine adenomyopathy is known to be about 15-25%, and up to 66% are reported if they include no symptoms. 70-80% of uterine adenomyopathy is found in the 50s and 60s, 5-25% in women before the age of 39, and only 5-10% in women over the age of 60. Meanwhile, 80-90% of adenomyopathy is found in women with fertility, and 5-10% in women with no fertility. As such, uterine fibrosis is a common disease found in many women, although there are differences in age and childbirth.

Symptom

Characteristic symptoms include excessive menstruation, long-lasting menstrual bleeding, sexual intercourse, menstrual pain, and chronic pelvic pain. As the uterus itself grows, the contraction of the uterus becomes stronger, and as the uterus grows, the amount of endometrium increases, causing excessive menstruation and severe menstrual pain. Uterine myopathy is sometimes asymptomatic in 50% of cases, but it typically causes symptoms of excessive menstruation, sexual pain, defecation disorder (dyschezia), and menstrual pain (convulsive pain) in the latter half of childbearing age (over 35 years old). These symptoms usually start a week before the start of menstruation and last until the end of menstruation.

Diagnosis and examination

Uterine adenomyosis can be clinically estimated, but diagnosis based on pathological findings is required for confirmation. Overall, if the size of the uterus is increased and the pregnancy test shows negative findings, it can be assumed to be uterine adenomyopathy, and if you have menstrual pain, it can be estimated to be secondary menstrual pain caused by uterine adenomyopathy. Clinically, abnormal uterine bleeding and severe menstrual pain are suspected when the uterus is swollen and feels firm during earthquake, and diagnosis is suspected when ultrasound or magnetic resonance imaging shows appropriate findings for uterine adenomyosis.

However, as mentioned earlier, the final diagnosis can be made through pathological histological examination after surgery, and it is clinically difficult to diagnose through symptoms and images because only about 38% of patients with uterine adenomy were finally diagnosed.

While uterine myoma shows clear boundaries in ultrasound, uterine adenomyosis is not clear boundaries, but it is often difficult to distinguish it from uterine myoma, leading many patients with uterine adenomyopathy to misunderstand their disease as uterine myoma. However, uterine myoma and adenomyopathy are completely different diseases, and the treatment of diseases should also be approached differently. Therefore, accurate diagnosis is very important.

therapy

Treatment depends on the patient's age and whether they want to get pregnant. In patients with severe symptoms, if they no longer want to give birth, the most reliable treatment is hysterectomy. For patients who need childbirth in the future and those who have a will to preserve the uterus, a number of auxiliary treatment methods to preserve the uterus are being used.

Non-surgical medical treatments include nonsteroidal anti-inflammatory drugs, oral contraceptives, progestin, reproductive gland stimulating hormone secretion hormone efficacy drugs, and aromatase inhibitors. Progestin treatment is effective in relieving symptoms by suppressing menstruation, including oral, injection, and progestin-releasing intrauterine contraceptive devices (LNG-IUD).

If adenomyosis occurs locally for uterine preservation, uterine wall wedge resection can be performed, but it is limited. If you have severe uterine bleeding, you can perform endometrial resection using a cervix. Recently, about 27 months of observation after uterine arterial embolization showed improvement in symptoms in 75.7% of patients, and treatment using High Intensity Focalized Ultrasound (HIFU) was effective in relieving excessive menstrual pain. However, until recently, uterine fibrosis with severe symptoms is considered to have no decisive treatment other than uterine extraction.

a personal opinion

It's a disease that's found more than you think. I've been suffering from this disease for nine years. When I first found out, I went to the gynecologist because of a very painful menstrual pain. I've never heard of this term before, but there's actually no cure. The answer is surgical as it gets bigger and bigger and bigger. When I first went there, I had such severe menstrual cramps.. I went there because I couldn't even do my daily life. I was so scared and scared by the story, but I'm not going to have surgery right away. What you can do is a periodic observation test. It's only a follow-up test. I can't help but hope my adenomyosis doesn't get bigger.

pomegranate good for female hormones. Beans that work on female hormones. Protein (milk, tofu, soy milk, etc.) Cold food. Meat. Don't eat it... Then what do we eat? I just ate it. I can't eat this and that (I'm not saying not to eat it, but preferably not to eat it), so what I want to eat is that I'm stressed out, so I've been eating hard for nine yearsIn the end, I gained weight! You started gaining weight in your mid-30s. I did a contraceptive procedure called Mirena. I heard that you gain weight and get pimples as a side effect. That's right. (You get a lot of pimples that you didn't get when you were in adolescence.) It's good because the amount of menstruation decreases a lot. In fact, menstrual cramps haven't disappeared at all. pain similar to before and after mirena.

Mirena can be used for about three to five years. I mean, postponing the surgery. That's about it.

Uterine myoma may vary in the difficulty of removal depending on the location, but most of them can only be removed, so the uterus can be preserved. However, uterine adenomyosis is difficult to remove lesions because the boundaries are unclear. Some have reported cases of adenomyectomy by attempting to resect the uterine adenomy, but it has not yet been used as a common treatment.

The most obvious treatment for uterine adenomy is removal of lesions through hysterectomy, but non-surgical treatments are also being attempted for unmarried women or women who want to give birth. However, non-surgical treatments have the disadvantage of frequent recurrence and temporary treatment.

Progestin-releasing intrauterine contraceptive implantation replaces surgery. In many cases, adenomyopathy is asymptomatic, mild, and alleviated by commonly used analgesic anti-inflammatory drugs, which do not require special treatment, especially if you are near menopause, so waiting may be an option. (I wish I could wait and have menopause without surgery, but I know things don't go my way. So, I think you can choose the right treatment for you at the right time.)

It would be better to go to a big hospital, not a neighborhood, on an expedition..

😐

In my next blog post, I will talk about the review of the Mirena procedure for uterine adenomyopathy.