Half of women who have reached the age of thirty can hear from a gynecologist an obscure diagnosis: adenomyosis of the uterus. Doctors do not go into details and do not explain the essence of this disease, which causes unnecessary panic in patients. What is adenomyosis and how dangerous is it? Uterine adenomyosis: what is it

The inside of the uterus is lined with a layer of cellular tissue called the endometrium. At the beginning of the menstrual cycle, it does not take up much space and consists only of the germinal membrane. From here, the endometrium begins development and growth. During the month, the cell tissue matures and prepares to receive a fertilized egg. If this does not happen, the overgrown endometrium is rejected and leaves the uterus. This phenomenon is called menstruation.

With the normal functioning of the female body, the process is repeated monthly during the reproductive age.

Adenomyosis of the uterus, scheme
With adenomyosis, the structure and thickness of muscle tissue changes. In some places, the uterus becomes denser, increases in size

With adenomyosis, a different picture is observed. The endometrium and the muscular tissue of the uterus are separated by a special layer. During the normal course of the cycle, endometrial cells grow only inside the uterine cavity. If pregnancy does not occur this month, the functional layer is removed, leaving behind the germinal membrane. With adenomyosis, the endometrium penetrates the dividing tissue of the uterus and grows into the muscular tissue. Moreover, this does not happen evenly, but at several points. In those places where cells of another layer invaded the muscle fibers, the uterus responds by thickening the muscle tissue. This process causes deformation of the reproductive organ. The menstrual cycle goes astray, which ultimately affects the ability to conceive a child.

If we compare the endometrium with a plant, we can draw an interesting parallel. The roots of the shrub, which have grown and take up a lot of space in the pot, break through the walls of the container in search of free space. The endometrium behaves in the same way with adenomyosis of the uterus. Types and forms: nodular, diffuse, focal and others

The whole trouble of the disease lies in the fact that the growth and development of functional cells occurs in a confined space. The neoplasm is not excreted from the body and remains in the muscle body constantly, causing pain and reproductive dysfunction female body.

The form of adenomyosis is determined depending on the nature of the germination of the endometrium:

If the endometrium has penetrated the muscle tissue of the uterus and grows in length, causing the appearance of channels of various sizes, a diffuse form of adenomyosis will be diagnosed. With this type of disease, the entire surface of the uterus is involved in the process. Sometimes endometrial cells grow so that they penetrate through the muscle fibers, leaving the opposite wall. Cell growth can be directed through the uterus towards other organs.
When the endometrium forms nodes of various shapes and sizes in the space of muscle tissue, adenomyosis of the nodular type develops. Connective tissue accumulates around the germinated cells, which seals the walls of the formed "pocket". Every month, it fills with blood or dark fluid, which is formed when the upper layer of the endometrium is shed. Having no way out, it causes prolonged swelling and swelling of the muscle, hemorrhage.
Focal adenomyosis is established when the endometrium grows into the uterine muscle not singly, but as a whole colony, forming a focus of the disease. Unlike the diffuse variety of the disease, with a focal form, the affected area has clearly defined boundaries. In a severe form of the disease, the focus grows so much that it forms a fistula into the pelvic cavity.
There are cases when the structure of the overgrown endometrium contains nodes and branches, which indicates manifestations of a mixed form of the disease. If the doctor sees that the cells growing into the muscle form passages and seals, the woman is diagnosed with a diffuse-nodular form of the disease.
Adenomyosis that develops only within the uterus or fallopian tubes is called internal.
If endometrial cells affect neighboring organs and penetrate the ureters, bladder, kidneys or intestines, adenomyosis is considered external.
Symptoms and signs

Women who have painful menstruation throughout their lives often do not notice the manifestations of adenomyosis of the uterus. This is due to the fact that the symptoms of the disease are similar to other ailments that are rarely paid attention to.

The first symptom that all patients with adenomyosis of the uterus note is profuse bleeding during menstruation. Allocations are not only intense, but also long-lasting. Women notice that bleeding begins 3-4 days before the expected date of menstruation and lasts 3-5 days after it ends. At the same time, before and after menstruation, the discharge is periodic, smearing and differs in color from the red menstrual fluid.
Patients with adenomyosis are characterized by the appearance of pain in the lumbar region, sacrum and lower abdomen before and after menstruation. The same sensations appear during intercourse.
In some cases, there is weakness, drowsiness, dizziness and a predisposition to infectious diseases.
Women who are subsequently diagnosed with adenomyosis turn to the gynecologist with a complaint of infertility and miscarriage.
In half of women with adenomyosis of the uterus, the disease is asymptomatic and may regress with the onset of menopause.

Pregnancy test is negative
Adenomyosis is often considered the cause of infertility.

The intensity with which certain symptoms of the disease appear is related to the severity of adenomyosis. In total, four stages are distinguished, which vary depending on the distribution of the endometrium:

Cell growth is limited to the inner space of the uterus and does not go beyond its shell.
The endometrium grows into the body of the uterus at ½ the depth of the muscle layer.
Proliferating cells affect the entire uterus from the inner to the outer surface.
The endometrium extends beyond the uterus and, growing, involves neighboring organs in the pathological process.
The higher the stage of the disease, the more pronounced pain and disruption in the menstrual cycle.

The reasons

Until now, researchers have not identified unambiguous reasons why adenomyosis occurs. It is believed that the reason for the development of the disease are surgical interventions or deviations associated with a violation of the integrity of the tissues of the uterus.

These include:

operations like caesarean section, curettage, removal of fibroids, and so on;
abortions;
childbirth.
Adenomyosis of the uterus can be diagnosed in young women who have never experienced such manipulations. In this group of patients, the disease develops due to congenital pathologies or insufficient opening of the cervix during menstruation.

The same factors that cause other inflammatory processes contribute to the occurrence of adenomyosis. Doctors were able to identify groups of patients who most susceptible to this disease.

Women experiencing frequent stress, overstrain, psychological stress.
Business women working in constant overload mode. Women who combine work and household, active sports and raising children.
Women genetically predisposed to diseases of the reproductive organs.
Women who are overly fond of visiting solariums and beaches.
Diagnosis: echoes on ultrasound, hysteroscopy and others

At the first visit to the gynecologist, information about risk factors and adverse circumstances that may affect the development of the disease is entered into the patient's card. Complaints are recorded and an initial examination is carried out on a gynecological chair. Adenomyosis of the uterus is most noticeable on the eve of menstruation. As a result of a physiological examination, the doctor will be able to note that the uterus is enlarged and has a spherical shape.

Vaginal or obstetric ultrasound examination helps to confirm the diagnosis. If adenomyosis does occur, ultrasound will show local thickening of the muscular tissue of the uterus, its heterogeneity, and cystic cavities. There will be no clear boundary between the constituent layers. Otherwise, these indicators are called echo signs of adenomyosis. To determine the degree of the disease and possible complications, the gynecologist may prescribe an additional examination. As ancillary measures, magnetic resonance imaging (MRI), hysterosalpingography or hysteroscopy is prescribed.

MRI allows not only to detect adenomyosis, but also to characterize its type. The resonance image will show how much the endometrium has grown into the muscle tissue of the uterus and whether this process is accompanied by the appearance of nodes or foci.

Hysterosalpingography is an x-ray that can be done with the preliminary introduction of special contrast fluids into the uterine cavity. The purpose of this examination is the same - to determine the way the endometrium spreads and the nature of its penetration into the tissues of the uterus.

Hysteroscopy is a procedure that is performed using a special apparatus under local anesthesia. Not all women can be examined by this method, as it has a number of contraindications. During the study, the doctor sees the inner wall of the uterus and fallopian tubes, can evaluate uniformity and structure of tissues, the thickness of the inner layer. If adenomyosis affects the uterus at several points, the structure of the organ will look like a honeycomb. Is the combination of adenomyosis and uterine fibroids dangerous?

The mechanisms of the appearance of fibroids and adenomyosis are very similar, so these two pathologies are often detected simultaneously. Moreover, during the examination, it is easy to confuse one disease with another, since they look almost the same. The difference is that with diffuse adenomyosis, the uterus returns to its original form after menstruation, but not with myoma. Both diseases can be treated, but most often it consists in surgical intervention. Possible consequences

The growth of the endometrium outside the inner space of the uterus leads to the fact that the mucous membrane of the organ is broken, becomes thinner and more fragile. She is unable to receive and