Adenomyosis is the progression of the intrauterine layer (endometrial tissue) into the muscle layer of the uterus (myometrium). This causes the muscle layer of the uterus to thicken. Although the exact cause is not known, it is thought to be related to increased estrogen levels. Adenomyosis usually disappears after menopause.
Adenomyosis risk factors:
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Being between the ages of 40-50
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Having given birth
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Having had a uterine surgery such as cesarean section or myoma removal
WHAT ARE THE SYMPTOMS OF ADENOMIOSIS?
Adenomyosis patients may sometimes have no symptoms or mild discomfort. However, most patients have significant complaints. The most common symptoms are:
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Excessive and prolonged menstrual bleeding
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Serious cramps or stabbing pain in the abdominal area during menstruation
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Cramps that continue throughout the menstrual period and complaints that increase with age
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Pain during intercourse
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Breaking bleeding during non-menstrual periods
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Bleeding with clots during menstruation
HOW IS ADENOMIOSIS DIAGNOSED?
The first step in diagnosing adenomyosis is a pelvic examination. It is manifested by an enlarged and tender uterus on pelvic examination. In ultrasound, various parts of the fundus are observed as thick and the intrauterine layer is irregular. Since irregular and excessive bleeding can also be seen in myomas, it is most often confused with myomas. MR imaging gives the most accurate result in differential diagnosis. Most of the time, the diagnosis is determined by the pathology result of hysterectomy surgeries performed for various reasons.
ADENOMIOSIS TREATMENT
Anti-inflammatory drugs:
Two menstrual cycles. -Anti-inflammatory drugs can be given starting 3 days before. These medications help reduce bleeding and relieve pain.
Hormone therapy:
Combined estrogen-progesterone-containing birth control pills, hormone-containing patches or vaginal rings may help reduce excessive bleeding and pain due to adenomyosis. It helps. Progestin-only intrauterine device (MIRENA) or continuous use birth control pills may cause amenorrhea (cessation of menstrual periods). test) and reduces symptoms. GNRH analogues can be used in treatment, but they are not preferred because they cause menopause-like symptoms.
Uterine artery embolization:
In this technique, the aim is to reduce the size of the lesions by cutting off the blood flow in the vessels feeding the area affected by adenomyosis.
Surgical treatment:
Adenomyosis foci on the anterior and posterior walls of the uterus can be surgically removed. In this way, the growth of the foci is stopped, the uterus returns to its normal size, and painful and heavy menstrual periods return to normal. In patients with very severe symptoms, hysterectomy (uterus removal) is the definitive solution.
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