Is your menstrual cramps getting worse? It could be adenomyosis at work!

31-year-old Ms. Huang suffered from increasingly severe dysmenorrhea, which affected her normal work and life. She went to the gynecology clinic of Yiyang Central Hospital and was diagnosed with adenomyosis. Why is dysmenorrhea caused by adenomyosis? Let's find out.

1. What is adenomyosis?

When the endometrial glands and stroma invade the myometrium, it is called adenomyosis.

Simply put: the endometrial tissue "goes to the wrong place" and grows into the uterine muscle layer. These "lost" endometriums will bleed every time the menstruation comes , but the blood cannot be discharged, causing the uterus to swell and ache as if it is "inflated". This disease often occurs in multiparous women of childbearing age between 30 and 50 years old.

2. Symptoms of adenomyosis

1. Dysmenorrhea: This can be said to be the most typical symptom of adenomyosis. Many women describe dysmenorrhea as a small hammer hitting their stomachs constantly, causing them to be unable to straighten their backs and break out in cold sweats. In severe cases, even normal work and life are affected. Moreover, this type of dysmenorrhea will become more and more severe. At the beginning, taking painkillers may work, but later on, the medicine may not have much effect.

2. Excessive menstrual flow and prolonged menstrual period: Menstruation is like a "faucet that can't be turned off tightly", with heavy flow and long duration (may be delayed for more than 7 days). Excessive menstrual flow for a long time can lead to anemia, and the whole person will become pale, dizzy and weak.

3. Anemia: Due to prolonged menstruation and increased bleeding, the body will experience fatigue and anemia. Anemia caused by adenomyosis is usually difficult to make up for, because each menstrual flow is very heavy, which will cause anemia. (Many adenomyosis patients often develop moderate to severe anemia before seeking medical treatment, and even need blood transfusions.)

4. Uterus becomes "fat": Gynecological examination shows that the uterus is uniformly enlarged or has localized nodules, hard and tender. (When there are no symptoms, it is difficult to distinguish it from uterine fibroids).

3. Treatment Methods

Depending on the patient's symptoms, age and fertility requirements, there is currently no effective cure.

1. Symptomatic treatment - make your body feel better

Hot compress magic tool: 40℃ hot water bag on the lower abdomen (more effective than drinking brown sugar water);

Painkillers to choose: Ibuprofen is most effective when taken when pain first occurs;

Dietary adjustment: Eat more broccoli and tofu (containing natural anti-inflammatory ingredients), and less fried chicken and milk tea.

2. Drug treatment - control the "runaway" endometrium

False pregnancy therapy: oral short-acting contraceptives make the endometrium "dormant";

Pseudomenopause therapy: GnRH-a injection (such as leuprolide) temporarily stops menstruation;

New weapon: Dienogest tablets (suitable for sisters who do not want to have an IUD);

Mirena IUD (an intrauterine device, short for levonorgestrel intrauterine sustained-releasing system. After the Mirena IUD is placed, it can significantly reduce the amount of menstruation, thereby correcting anemia.)

3. Surgery - the ultimate solution

Conservative treatment: lesion resection (preserving the uterus, suitable for women who want to have a baby);

Radical treatment: total hysterectomy (suitable for those who have no fertility needs and severe symptoms).

4. Latest progress :

High-intensity focused ultrasound ablation (HIFU) - it is a non-invasive treatment method that does not require surgery, puncture, bleeding, and is minimally painful. The heat generated by ultrasound focusing "burns" the ectopic endometrial lesions, causing relatively little damage to the uterus and with quick recovery. The patient can usually be discharged from the hospital the next day after treatment.

Adenomyosis is not cancer, but it requires long-term management, timely medical treatment and standardized treatment. You can coexist peacefully with it!

References

Obstetrics and Gynecology 9th Edition People's Medical Publishing House

Standardized training book for obstetrics and gynecology nurses Hunan Science and Technology Press

Hunan Medical Chat Special Author: Tian Qing from Yiyang Central Hospital

Follow @湖南医聊 to get more health science information!

(Edited by Wx)