What is the difference between endometriosis and adenomyosis?

There are many diseases of the uterus, and endometriosis and adenomyosis are both such diseases. The two diseases are similar in general, both are caused by endometriosis, but they are significantly different, so they cannot be treated in the same way. So what is the difference between the two and how to distinguish them?

1 First, it is important to remember that both are caused by endometriotic growth and can coexist. Secondly, the pathogenesis, clinical manifestations and hormone sensitivity of endometriosis and adenomyosis are different. The former is more sensitive to hormones, while the latter is insensitive to hormones. Therefore, drug treatment is more effective for the former.

2 Endometriosis usually occurs in the ovaries, and its clinical manifestations include progressively worsening dysmenorrhea, infertility, discomfort during sexual intercourse, heavy menstruation, prolonged menstruation, etc. Its occurrence is related to the retrograde flow of menstrual blood, so personal protection should pay attention to avoiding menstrual operations and sexual activities during menstruation.

3 Adenomyosis is caused by the invasion of endometrial glands into the myometrium. The clinical manifestations are heavy menstruation, prolonged menstruation, and progressive dysmenorrhea. The pain usually starts a week before the onset of menstruation and lasts until the end of menstruation. Gynecological examination may reveal that the uterus is uniformly enlarged or has a localized bulge, is hard and tender. The treatment mainly involves using drugs to relieve pain and symptoms for those with mild symptoms; hysterectomy can be performed for those who do not desire to have children.

TCM Syndrome Differentiation of Adenomyosis

Adenomyosis is a disease name in Western medicine. According to its clinical symptoms and signs, it can be classified into the categories of "dysmenorrhea", "menorrhea", "prolonged menstruation" and other diseases in traditional Chinese medicine. From the perspective of traditional Chinese medicine, dysmenorrhea, menstrual disorders, and abdominal masses.

Adenomyosis and other diseases are related to internal blood stasis, while the formation of blood cancer is related to pathogenic factors such as cold stagnation, qi stagnation, phlegm and dampness. It can be understood this way: adenomyosis often occurs secondary to postpartum, artificial abortion, and curettage. Due to the damage to the vital energy after childbirth or surgery and the reduced resistance, it is easy to be affected by cold evil and form cold stagnation and blood stasis; it is easy to have mood swings and liver qi stagnation, thus forming qi stagnation and blood cancer; it is easy to have abnormal circulation of body fluids, which accumulate into phlegm and dampness, blocking the flow of blood and forming phlegm stagnation and blood cancer. Therefore, from the essence of adenomyosis, it is caused by blood stasis, which belongs to the category of excess syndrome. However, as the disease progresses, blood loss and Qi consumption lead to Qi and blood deficiency, which turns into a mixed syndrome of deficiency and excess. In terms of treatment, we should take promoting blood circulation and removing blood stasis as the principle, while also taking into account the causes of blood stasis and the degree of weakness. For example:

Qi stagnation and blood stasis syndrome

The main symptoms are bloating or spasmodic pain in the lower abdomen during menstruation, refusal to press, accompanied by irritability, chest and breast pain, heavy menstrual flow or prolonged menstruation, enlarged uterus, petechiae on the tongue, and a wiry and hesitant pulse. This type of syndrome is mostly caused by depression and liver qi stagnation after childbirth or surgery. The treatment should focus on soothing the liver and regulating qi, removing blood stasis and eliminating symptoms. Xiangleng Pills with added ingredients can be used.

Phlegm coagulation and blood stasis syndrome

The patient now suffers from lower abdominal pain that refuses to be pressed, heavy and thin menstruation with blood clots, fullness in the stomach, nausea and vomiting, and an enlarged uterus. Normally, there may be a lot of vaginal discharge, which is white and thick. The tongue coating is white and greasy, and the pulse is deep and slippery. The formation of this syndrome is related to the deficiency of both spleen and kidney, the failure to transform dampness, the accumulation of dampness into phlegm, and the resulting phlegm and blood stasis. The treatment method is to eliminate phlegm and dampness, resolve blood stasis and relieve symptoms. You can choose Kaiyu Erchen Decoction combined with Huoluo Xielingdan with modifications.

Cold-stagnation and blood stasis syndrome

The characteristics of this syndrome are lower abdominal cramps or cold pain during menstruation, which is severe and resistant to pressure but can be relieved by hot compresses. The menstrual flow is heavy but dark purple in color, with clots, accompanied by cold limbs and fear of cold, dark tongue, and deep and tight pulse. This syndrome is mainly caused by exposure to cold evil after childbirth or abortion. In terms of treatment, it is necessary to both warm and dispel the cold evil and to promote blood circulation and eliminate bad habits.