Adenomyosis

Adenomyosis

Uterus consists of 3 layers from inner to outer side namely endometrium, myometrium and perimetrium. Endometrium is inner lining of uterine cavity. Myometrium is made up smooth muscle and perimetrium is connective tissue that covers the uterus. Adenomyosis is defined as growth of endometrial tissue into the muscle wall of uterus.

Causes and risk factors

Exact cause of Adenomyosis is not known. It is observed in women of childbearing age group [mostly 40-50 years]. It is mostly seen when there is history of uterine trauma during pregnancy, LSCS, MTP, tubal ligation, surgery for fibroids, endometriosis. Some theories state that adenomyosis is caused due to invasion of invasion of stem cells into the uterine muscle, or as a result of developmental defect in the lining of uterus.

Clinical presentation

Many times patient is asymptomatic. However symptoms such as heavy and prolonged menstrual bleeding lasting for 8-14 days, longer menstrual cycles than normal, blood clots during menstrual bleeding, spotting between periods, severe menstrual cramps, tender abdominal area, a bearing down feeling, pain during sexual intercourse are observed.

Investigation

Medical history by the patient and Clinical examination by the gynaecologist helps in diagnosis. Ultrasound of the pelvis, MRI of the pelvis will help in further evaluation. Exact diagnosis of adenomyosis is only possible by examining uterine tissue after hysterectomy surgery. (Surgical removal of uterus).

Treatment

Adenomyosis condition disappears after menopause. Thus treatment depends on the age of woman i.e. whether she is in perimenopausal age. If the patient is nearing menopause treatment with analgesics, Anti-inflammatory medications, hormonal medications is done. transdermal patches and progesterone-releasing intrauterine devices to regulate menstrual cycle will also help in managing the condition. Hysterectomy may be suggested in severe cases and where pregnancy is not desired.

Other Modes of treatment

The other modes of treatment can also be effective in treating Adenomyosis. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Adenomyosis.

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