Does adenomyosis really require a hysterectomy?

A woman's uterus may develop many diseases, such as adenomyosis. According to experts, the disease is very harmful. If the disease develops seriously, the uterus needs to be removed. However, not all patients need to have a hysterectomy. It depends on the specific condition.

1. Does adenomyosis really require hysterectomy?

Adenomyosis is the invasion of endometrial glands and stroma into the myometrium, accompanied by compensatory hypertrophy and hyperplasia of the surrounding myometrial cells. It is more common in multiparous women aged 30-50 years. In recent years, its incidence has shown a significant increase and a trend of getting younger, and there is even the possibility of cancer. It has now become a common and difficult-to-treat gynecological disease, seriously endangering the physical and mental health of patients. Its main clinical manifestations are: progressively worsening dysmenorrhea, prolonged menstrual period, enlarged uterus, thickening of uterine wall, and increased CA125 value in laboratory tests.

2. Whether or not to remove the uterus for the treatment of adenomyosis depends on the severity of the disease, whether the patient has fertility requirements, and the diagnosis of complications. Surgical removal of the uterus includes total hysterectomy and partial hysterectomy. Hysterectomy is generally suitable for patients whose fibroids are not large but have obvious symptoms, or whose fibroids grow rapidly and malignancy cannot be ruled out.

3. If the fibroids are found to grow rapidly in a short period of time and have a tendency to become malignant or cystic (the fibroids become larger and softer and are filled with blood or water), the uterus should be removed.

4. Western medicine has no ideal cure for this disease except radical hysterectomy. Radical surgery will cause the loss of internal reproductive organs, affect fertility, and have a psychological impact on the patient; hormone therapy requires long-term maintenance treatment, which will lead to amenorrhea, endocrine disorders, and certain side effects. Acupuncture and moxibustion have been used to treat dysmenorrhea for many years and have accumulated rich clinical experience. Acupuncture and moxibustion have good clinical effects in treating this disease. Many dysmenorrhea patients have significantly relieved pain with the help of moxibustion, and their menstruation gradually returns to normal.

5. Female hormones mainly come from the ovaries. After the ovaries are removed, the level of female hormones in the body drops significantly, which will definitely cause symptoms of low estrogen. Such as decreased libido, breast shrinkage, osteoporosis or other symptoms. Therefore, if you want to remove the ovaries, it is generally best to consider it when you are over 45 years old. Including hysterectomy. If the patient is very young, hysterectomy is not recommended because the uterus has certain endocrine functions in addition to being a reproductive organ. In addition, if the hysterectomy is removed, it will affect some functions of the ovaries to a certain extent. Therefore, whether to remove the uterus must be determined based on the patient's age and condition. Of course, if the condition is very serious or even recurs repeatedly, and the patient has completed childbearing, hysterectomy can also be considered, but it depends on the patient's specific situation and cannot be generalized.