Causes of Endometriosis and Adenomyosis

Women are prone to many diseases. When treating women's diseases, we must choose the right method so that there is no harm to the female body. Common treatments for women's diseases are vaginitis and pelvic inflammatory disease. These diseases have many causes. When treating them, drugs and surgery are good choices. Endometriosis and adenomyosis are also common diseases for women. What are these diseases like?

Endometriosis and adenomyosis:

Causes of Endometriosis

1. Implantation Theory

Menstrual blood flows backwards and endometrial implantation occurs. During the menstrual period, menstrual blood flows downstream from the cervix and vagina. However, a small amount of menstrual blood or other reasons mixed with shed endometrial fragments flow into the abdominal cavity through the fallopian ducts and implant on the surface of the pelvic organs to form endometriosis lesions.

2. Metaplastic endometrium

Serosa epithelium, metaplastic intima. During the human embryonic development period, the ovarian surface epithelium, peritoneum, vaginal rectal diaphragm, and umbilicus are all derived from the metaplasia of the body cavity epithelium. These tissues can be transformed under the stimulation of gonadal hormones, inflammation, and mechanical factors to form another type of tissue, which can also metaplasia into the endometrium.

3. Benign metastasis

Hematolymph, benign metastasis. This is a relatively rare cause of the disease. Endometriosis that occurs in the lungs, meninges, pericardium, limbs, and other distant parts is caused by the transfer of endometrial debris through the blood circulation or lymphatic system and retention in certain organs or tissues.

4. Iatrogenic endometrial transplantation

This is an artificial process that causes the endometrium to be transplanted to certain parts of the uterus. It is common in cesarean sections, curettage in early and mid-term pregnancy, episiotomy during delivery, and artificial abortion.

5. Defective immune defense

The endometrium that flows back into the abdominal cavity with menstrual blood is like a foreign body. It will activate the body's immune system and mobilize a large number of immune cells and body fluids to encircle and eliminate it. If the body's immune function is defective, it will develop into endometriosis.

Causes of adenomyosis

The cause of adenomyosis is still unknown. The current consensus is that because the uterus lacks a submucosal layer, the basal cells of the endometrium proliferate and invade the myometrium, accompanied by compensatory hypertrophy and hyperplasia of the surrounding myometrial cells, forming a lesion.

Traditional Chinese medicine believes that this disease is caused by qi stagnation, cold stagnation, heat burning, qi deficiency, and kidney deficiency, which lead to blood stasis blocking the Chong, Ren, and uterus, and dysmenorrhea when menstruation is not smooth. The main pathogenesis is blood stasis blocking Chong, Ren and Baogong.

Clinical manifestations

In the past, adenomyosis mostly occurred in multiparous women over 40 years old, but in recent years it has shown a trend of gradually becoming younger, which may be related to the increase in intrauterine surgeries such as cesarean sections and artificial abortions.

1. Symptoms

(1) Menstrual disorders (40%-50%) are mainly manifested by prolonged menstruation and increased menstrual volume. Some patients may also experience spotting before and after menstruation. Severe patients may develop anemia.

(2) Dysmenorrhea (25%) is characterized by secondary and progressive dysmenorrhea. It often begins a week before menstruation and is relieved when the menstrual period ends. Taking painkillers can relieve dysmenorrhea in the early stages, but as the disease progresses, the dosage of painkillers required for dysmenorrhea increases significantly, making it impossible for patients to tolerate it.

(3) About 35% of the other patients have no obvious symptoms.

2. Physical signs

Gynecological examination shows that the uterus is often uniformly enlarged and spherical, and adenomyoma may appear as hard nodules. The uterus is generally no larger than 12 weeks of pregnancy. As the menstrual period approaches, the uterus feels tender; during the menstrual period, the uterus enlarges, becomes softer, and the tenderness is more obvious than usual; after the menstrual period, the uterus shrinks. The uterus is often adhered to the surrounding area, especially the rectum at the back, and has poor mobility. 15% to 40% of patients have concomitant endometriosis, and about half of the patients have concomitant uterine fibroids.

After understanding the causes of endometriosis and adenomyosis, women also need to prevent endometriosis and adenomyosis in their daily lives. Once these diseases occur, they have a great impact on their own fertility. At this time, women will also have symptoms such as dysmenorrhea and bleeding, which will cause damage to themselves in many aspects.