Most women have experienced dysmenorrhea. Common dysmenorrhea can be relieved by taking some painkillers. Drinking more hot water is also of little use. However, some people's dysmenorrhea is so painful that it is almost useless to do anything. This severe dysmenorrhea must be careful, which may reflect physical diseases.
The girl suffered from dysmenorrhea, and even her normal pregnancy was affected.
Mary is such a girl suffering from dysmenorrhea. Monthly menstrual visits and waiting for her are unforgettable pain! Even if she pays more attention to life and doesn't stay up late, not spicy and greedy food, the deep pain still clings to her.
Mary began to be afraid, even depressed. She needs a lot of painkillers every time she is overcome with pain. She began to look for doctors everywhere, hoping to get a radical cure for dysmenorrhea.
The examination in the hospital found that her dysmenorrhea was not ordinary but originated from a disease called
adenomyosis.
After seeing her uterus, most doctors shook their heads and said: serious adenomyosis is the culprit that causes dysmenorrhea! Moreover, it can cause difficulties in pregnancy. The doctor's words sounded like a bolt from the blue. No wonder he had been pregnant for so long and not been pregnant. The key problem was here.
What is adenomyosis?
Adenomyosis is a benign uterine disease characterized by ectopic endometrial glands and stroma in the myometrium and the reactive proliferation of smooth muscle cells around the myometrium.
Like endometriosis, adenomyosis is a disease caused by endometrium tissue "running away from home" and planting in an abnormal uterine cavity. Adenomyosis usually occurs in women of childbearing age, and the incidence rate is 7%~23%. The clinical symptoms of adenomyosis include severe dysmenorrhea, menorrhagia (even severe anemia), and infertility, which will seriously affect patients' physical and mental health.
Some studies have reported that adenomyosis is related to infertility, which may interfere with normal embryo implantation and lead to abnormal early and late abortion.
The reason why adenomyosis leads to infertility is, first of all, the apparent enlargement of the uterus. Because the basement layer of the endometrium lacks submucosa, the endometrium directly contacts the muscle layer. Moreover, many patients with adenomyosis are often combined with hysteromyoma and endometrial hyperplasia, which is not conducive to fertilized eggs and is likely to cause abortion and embryo termination, leading to infertility.
Moreover, the frequency, time, and amplitude of uterine contraction will be somewhat affected for women with adenomyosis. Even if sperm and egg can successfully combine to form a fertilized egg, uterine implantation will be slightly affected. After all, the environment of the uterus is not very healthy, which will also affect the further development of the fertilized egg.
Of course, not all adenomyosis will lead to infertility, but the probability of infertility will increase significantly. So, patients still need treatment, especially when they have some discomfort symptoms.
Treatment of adenomyosis
Nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly used to relieve the pain of adenomyosis and reduce the amount of menstruation. Side effects: especially gastrointestinal reactions, occasionally abnormal liver and kidney functions. The long-term application should be alert to the possibility of gastric ulcer.
Oral contraceptives are mainly used to relieve the pain of adenomyosis and reduce the amount of menstruation. But some side effects: less, occasionally with digestive tract symptoms or abnormal liver function. Patients over 40 years old or with high-risk factors (such as diabetes, hypertension, history of thrombosis, and smoking) should be alert to the risk of thromboembolism.
Oral progesterone drugs can relieve the pain of adenomyosis and reduce the amount of menstruation. Among them, dienogest is a new type of synthetic progesterone that moderately inhibits gonadotropin secretion through negative feedback, resulting in a low estrogen endocrine environment. It can hinder endometrial hyperplasia, inflammation in the endometrium, and angiogenesis. Side effects are mainly irregular uterine bleeding.
Gonadotropin-releasing hormone agonist (GnRHa) can effectively and rapidly relieve pain, treat menorrhagia and reduce uterine volume. However, if GnRHa is stopped, the uterus will increase again after the recovery of menstruation, and dysmenorrhea and other symptoms will appear again.
The levonorgestrel intrauterine sustained release system (LNG-IUS) is easy to place and can continuously release levonorgestrel for five years. The clinical application shows that LNG-IUS effectively treats dysmenorrhea, chronic pelvic pain, and menorrhagia of adenomyosis.
Fuyan Pill, a traditional Chinese medicine, can also treat and relieve pain. It can effectively reduce pain and regulate menstruation. Moreover, it is made of more than 50 natural plants, and long-term use will not harm the body.
Total hysterectomy:
The radical treatment of symptomatic adenomyosis patients is total hysterectomy, which can be completed by laparoscopy, laparotomy, or vagina. The surgical path selection is based on considering multiple factors such as uterine size, pelvic adhesion, etc.
Fertility preserving surgery:
Patients with adenomyosis should first choose medication to alleviate symptoms and promote fertility. Patients of childbearing age who cannot tolerate long-term drug treatment or fail to receive drug treatment can select the operation of preserving the uterus to maintain fertility. The timing of fertility-preserving surgery should be considered comprehensively according to ovarian function and adenomyosis type.
For patients who do not need fertility, uterine artery embolization, high-intensity focused ultrasound, ablation, and other treatments can also be selected.