What are the symptoms of severe adenomyosis?

Adenomyosis, also known as uterine fibroids, is a common symptom in women. Most women do not show symptoms in the early stages, and the disease is often discovered through B-ultrasound examinations. However, as the disease progresses, when adenomyosis becomes severe, there will often be multiple symptoms such as uterine bleeding, pain, and abdominal pressure. Uterine fibroids can seriously affect the health of the uterus and women's fertility, so we must pay attention to it.

[Symptoms of severe adenomyosis]

(1) Uterine bleeding is the most common symptom of uterine fibroids, occurring in more than half of patients. Among them, cyclical bleeding is the most common, which can manifest as increased menstrual volume, prolonged menstrual period or shortened cycle. It may also present as irregular vaginal bleeding that is not related to the menstrual cycle. Uterine bleeding is more common with submucosal fibroids and intramural fibroids, while subserosal fibroids rarely cause uterine bleeding.

(2) Abdominal mass and compression symptoms: When the fibroids gradually grow and cause the uterus to enlarge to more than the size of a 3-month pregnant uterus or become a large subserosal fibroid located at the fundus of the uterus, a mass can often be felt in the abdomen, which is more obvious in the early morning when the bladder is full. The mass was solid, movable, and non-tender. When the fibroids grow to a certain size, they can cause compression symptoms of surrounding organs. Fibroids on the anterior wall of the uterus close to the bladder can cause frequent urination and urgency; giant cervical fibroids compressing the bladder can cause difficulty in urination or even urinary retention; fibroids on the posterior wall of the uterus, especially those in the isthmus or posterior lip of the cervix, can compress the rectum, causing difficulty in defecation and discomfort after defecation; giant broad ligament fibroids can compress the ureter and even cause hydronephrosis.

(3) Pain: Adenomyosis can be severe or severe. Generally, uterine fibroids do not cause pain, but many patients may complain of a feeling of heaviness in the lower abdomen and back pain. When the pedicle of subserosal fibroids is twisted or uterine fibroids undergo red degeneration, acute abdominal pain may occur. It is not uncommon for fibroids to be combined with endometriosis or adenomyosis, which may cause dysmenorrhea.

(4) Increased leucorrhea. Enlargement of the uterine cavity, increase in endometrial glands, and pelvic congestion can cause increased leucorrhea. When submucosal fibroids of the uterus or cervix ulcerate, become infected, or necrotic, bloody or purulent leucorrhea will be produced.

(5) Infertility and miscarriage: Some patients with severe adenomyosis are infertile or prone to miscarriage. The impact on conception and pregnancy outcomes may be related to the growth location, size and number of the fibroids. Giant uterine fibroids can cause deformation of the uterine cavity, hindering the implantation of the gestational sac and the growth and development of the embryo; fibroids compressing the fallopian tubes can lead to obstruction of the lumen; submucosal fibroids can hinder the implantation of the gestational sac or affect the entry of sperm into the uterine cavity. The spontaneous abortion rate in patients with fibroids is higher than that in the normal population, with a ratio of about 4:1.

(6) Anemia: Long-term menorrhagia or irregular vaginal bleeding can cause hemorrhagic anemia. More severe anemia is more common in patients with submucosal fibroids.

(7) Others: A very small number of patients with severe adenomyosis may develop polycythemia and hypoglycemia, which is generally believed to be related to the production of ectopic hormones by the tumor.