Adenomyosis is a condition in which the tissues that lines the uterus grows into the muscular wall its muscular wall. The tissue that grows into the muscular wall, continues to act like the endometrial tissues, bleeding and shedding at each menstrual cycle. This causes a lot of pain and discomfort for the affected person. The exact cause of this disease isn’t known yet, however, the disease is more prevalent after menopause. This disease typically occurs in women between the ages of 35 and 50. Although, it can also occur in younger women. Patients affected by adenomyosis do present with symptoms such as painful menses, a large amount of menses, pain during sexual intercourse, irritation of the urinary bladder, and long-term pain in the pelvis. Some of the risk factors associated with adenomyosis include childbirth, previous caesarian section, age and so on. Some of the complications of adenomyosis include chronic anaemia, which might occur as a result of the profuse bleeding, associated with adenomyosis, Others include tiredness and other illnesses. Physicians make a diagnosis of adenomyosis based on the signs and symptoms presented by the patient. Pelvic examination is also done. Other diagnostic procedures that might be carried out by the physician include imaging tests, such as ultrasound, magnetic resonance imaging, endometrial biopsy, and so on. This disease often goes away after menopause. Physicians treat this disease based on how close the patient is from menopause. Medications such as anti-inflammatory medications might be given. Hormone drugs such as estrogen-progestin pills might also be administered, to reduce the profuse bleeding. Exosomes are also important in the treatment of adenomyosis

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What Are Signs And Symptoms Of Adenomyosis?

Some of the signs and symptoms of adenomyosis include the following;

  1. Chronic pelvic pain: This occurs mostly because the endometrial tissues that grow into the myometrium still act like the endometrial tissue. They bleed and break down during menstrual cycles. This causes a lot of pain for the affected person.
  2. Heavy menstrual bleeding: This occurs more in women with deeper adenomyosis. The bleeding can lead to chronic anaemia if it persists for a long time. Other symptoms that are associated with adenomyosis include weakness, dizziness and so on.
  3. Pain during sexual intercourse: Women affected by adenomyosis do experience pain when they engage in sexual intercourse.
  4. Painful menstruation: This occurs in up to 30% of women affected with adenomyosis. This happens mostly because the endometrial tissues that grow into the myometrium still act like the endometrial tissue. They bleed and break down during menstrual cycles. This causes a lot of pain for the affected person.
  5. Menorrhagia: Some women do experience a heavy loss of blood when they’re menstruating. This might not happen every time they menstruate, but it could be quite frequent. In addition to this, some women do experience bleeding in between their menstrual periods.
  6. Pressure on bladder: Patients might feel some pressure on their bladder. This is due to the accumulation of blood.
  7. Infertility: According to statistics, about one-third of women affected by endometriosis do have problems with fertility. There have been many theories about how infertility develops in people affected by this disease. There is a hypothesis that infertility in the early stages, is due to inflammatory reactions, while adhesions, irritation and other endometriosis complications could be responsible for the later stage of the disease.

What Are The Causes Of Adenomyosis?

      There is no specific cause of Endometriosis but there are some theories regarding how Endometrial tissue gets to other parts of the body. They include:

  • One theory is that the endometrial tissue is deposited in other locations by the retrograde flow of menstrual contents through the Fallopian tubes into the pelvic and abdominal cavities. The cause of this retrograde menstruation is not clearly understood. It is clear, however, that retrograde menstruation is not the only cause of endometriosis, as many women who have retrograde menstruation do not develop the condition.
  • Another possibility is that areas lining the pelvic organs possess primitive cells that are able to develop into other forms of tissue, such as endometrium. (This process is known as coelomic metaplasia.)
  • There is also the possibility of direct transfer of endometrial tissues at the time of surgery. This may be responsible for the endometriosis implants occasionally found in surgical scars (for example, Cesarean section or Episiotomy scars ). Transfer of endometrial cells through the bloodstream or l
  • The lymphatic system is the most viable explanation for the rare cases of endometriosis that are found in the brain, lungs and other organs remote from the pelvis

What Are The Risk Factors Of Adenomyosis?

There are some factors that increase the risk of developing adenomyosis. Some of the factors include the following;

  1. Previous uterine surgery: Women that have undergone surgeries such as the caesarian section, or fibroid removal have a high risk of developing adenomyosis.
  2. Genetics: People who have relatives that have suffered from the disease, are prone to having this disease. The chances of having this disease are higher in women who have a direct sibling that has the disease. According to statistics, they are six times more likely to have endometriosis. This disease has been attributed to a change in some genomes.
  3. Middle age: Adenomyosis occurs more in people between the ages of 40 and 50. It has been suggested that this may be due to the longer exposure to estrogen, as compared to those of younger women.
  4. Childbirth
  5. Low body weight: The chances of having endometriosis is higher when a woman has a low body mass index. The body mass index is divided into 3 main parts. These are low body mass index, normal body mass index, overweight and obese. People that belong to the low body mass index must have a body mass index that is less than 18.

How Is Adenomyosis Treated?

Physicians treat this disease based on how close the patient is from menopause. Medications such as anti-inflammatory medications might be given. Hormone drugs such as estrogen-progestin pills might also be administered, to reduce the profuse bleeding.

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References

Becker, C. (2015). Diagnosis and management of endometriosis. Prescriber, 26(20), pp.17-21.

FUKUDA, H. and MUKAI, H. (2010). Cutaneous endometriosis in the umbilical region: The usefulness of CD10 in identifying the interstitium of ectopic endometriosis. The Journal of Dermatology, 37(6), pp.545-549.

Hendarto, H. (2016). Thinking Out Loud On Endometriosis And Stem Cell Relationship. Journal of Stem Cell and Regenerative Biology, 2(1), pp.27-28.