bbc presenter Naga Munchetty revealed last year that she was suffering Adenomyosis, a chronic disease that affects the uterus. She talked about how her pain left her immobile and how her recent worsening of symptoms was so severe that her husband had to attend to her urgently. Call an ambulance.
Many people have never heard of this condition, even though it affects many people. 1 in 5 women.
Adenomyosis can cause symptoms such as irregular and heavy menstrual bleeding and pelvic pain. The severity of symptoms varies from patient to patient. one third of women If you have adenomyosis, you may have few or no symptoms.
Condition can also affect fertility. If a woman with adenomyosis becomes pregnant, increased risk miscarriage, premature birth, preeclampsia, postpartum hemorrhage, etc.
So what causes adenomyosis? And how is it diagnosed and treated? There’s still a lot we don’t know about this condition, but here’s what we know so far. Let me explain a little.
What causes adenomyosis?
The uterus has two important layers. The endometrium is the inner lining where the embryo implants. If you are not pregnant, this layer is shed during your period.
Myometrium is the muscular layer of the uterus. It expands during pregnancy and causes contractions. In people with adenomyosis, endometrial-like cells are in the wrong places. myometrium.
Many women with adenomyosis also have endometriosis, but adenomyosis is a different disease than endometriosis. endometriosis.
In endometriosis, endometrial-like cells are also found in the wrong place, but in this case outside the uterus, primarily in the pelvic cavity.
thanks to the study, public engagementand Social media, In recent years, awareness of endometriosis has increased. However, adenomyosis is still relatively unknown.
Diagnostic options are changing and improving
Adenomyosis is a difficult disease to diagnose. Historically, the presence of endometrioid-like cells within the myometrium could only be verified by pathological evaluation when the myometrium was damaged. examined under a microscope After a hysterectomy (surgery to remove the uterus).
In recent years, the number of diagnoses has increased due to the development of imaging technology. MRI and detailed Pelvic ultrasound examination.
Adenomyosis is now commonly diagnosed without the need for a hysterectomy, but doctors are still working to develop standardized methods for non-surgical diagnosis.
As a result, exactly how many women have adenomyosis remains unclear. we know that, but about 20% of women If you have a hysterectomy for reasons other than suspected adenomyosis, a pathologic evaluation will reveal evidence of the condition.
Adenomyosis is a complex disease
The type of adenomyosis tissue that grows within the myometrium can be either focal (affecting a portion of the uterus) or diffuse (affecting a large area of the muscle).
Adenomyosis can be further classified according to the depth of invasion of endometrial-like tissue into the myometrium.
Scientists and doctors are still investigating the type and depth of the lesions. related to symptoms – Symptoms and severity of lesions do not always correspond.
Although it is still unknown why some women develop adenomyosis, evidence shows Prevalence increases with age.
It is thought that the area between the endometrium and myometrium is damaged. natural process Menstrual cycle, pregnancy, childbirth, medical procedures, etc.
In some women, damage to the endometrial tissue layer does not heal properly, and endometrial-like cells enter the myometrium and grow abnormally.These interfere with normal functioning myometrium This can lead to pain and bleeding.
Different mechanisms may be involved and there may not be one common disease cause behind adenomyosis.
How is adenomyosis treated?
treatment strategy These include oral contraceptives, progesterone-containing tablets, progesterone-releasing coil insertions (such as Mirena), or hormonal drugs such as a drug called . GnRHa It stops the natural production of sex hormones.
Non-hormonal therapies include: tranexamic acid. These treatments are aimed at minimizing menstrual bleeding. Pain is often treated by: non-steroidal anti-inflammatory drugs.
The argument that there are multiple types of adenomyosis becomes even more important because treatments that work for some women don’t work for others. Treatment strategies should be tailored to the patient, depending on the patient’s fertility wishes and symptoms.
If medical treatment does not sufficiently relieve symptoms, there are surgical options such as removal of the local lesion or hysterectomy.
What lies ahead?
Adenomyosis is a common disease that affects many women, including those of reproductive age, but it has received insufficient clinical and research attention.
There is also. Lack of knowledge and awareness There is growing interest in adenomyosis among many medical professionals and the general public. This needs to change to improve our understanding of the condition, diagnosis, and treatment options.
Scientists and doctors specializing in adenomyosis continue to search to find accurate, non-invasive diagnostic methods and, hopefully, a cure.
Jen SouthcombePrincipal Investigator/Group Leader, Nuffield Department of Women’s Reproductive Health, oxford university and Nura fitnato tobas selkukiPhD Candidate, Nuffield Department of Women’s Reproductive Medicine; oxford university
This article is republished from conversation Under Creative Commons License.read Original work.
A previous version of this article was published in May 2023.
