Chronic pain in the groin, lower abdomen and waist … Intense and prolonged menstrual bleeding, intermittent bleeding … Severe levels of anemia … Pain in sexual intercourse and the sexual reluctance that develops as a result of it … Even worse, it prevents pregnancy, it can lead to miscarriages even if pregnancy occurs. The name of this disease is adenomyosis.
The endometrium tissue lining the inner space of the uterus is removed from the body with menstrual bleeding every month. The growth of this tissue in the uterine wall muscle due to various factors is called “adenomyosis”. Although there is no clear data on the incidence of adenomyosis, which affects women in their reproductive age since it is dependent on estrogen and ends in menopause, it is stated to be a very common health problem.
Experts say that the biggest problem in this disease is delaying treatment.
It shows common symptoms with other diseases, making it difficult to diagnose. In addition, patients might not need to consult a physician, considering that heavy menstrual bleeding and pain in the groin area are normal. As a result they suffer from these pains for years, and even worse, they cannot achieve the dream of motherhood. Therefore, especially in cases of groin pain and heavy bleeding, a physician should be consulted, and annual gynecological examinations should never be neglected even if there is no complaint.
The reason is not known yet
The exact cause of adenomyosis is unknown, but there are various theories. Although it has not been scientifically explained yet, the frequency in family history in adenomyosis patients suggests that the genetic factor is also effective. In addition, it is stated that the presence of endometrial foci in the uterine muscle from birth, surgical procedures such as cesarean section and birth trauma that cause damage between the inner wall of the uterus and the middle muscle layer, infections and stem cells placed in the uterine wall may be the cause of this disease.
If there is even one of these symptoms …
Adenomyosis may not cause any symptoms in 35 percent of patients or may progress with very mild complaints. The most common symptoms can be listed as follows:
Excessive and prolonged menstrual bleeding: Menstrual bleeding should not last more than 7 days. The number of sanitary napkins used daily should not exceed 2-4.
Intermediate bleeding that develops outside of menstruation. Severe cramps or sharp, stabbing lower abdominal pain during menstruation with no other cause.
Chronic groin and low back pain, feeling of fullness in the pelvis.
Pain in sexual intercourse and as a result of it, lack of sexual desire.
Miscarriages which have unknown causes.
Anemia caused by heavy menstrual bleeding: The result of this situation is the development of chronic fatigue, unhappiness, decrease in energy, anxiety or depression.
It may prevent being a mother
Another important problem caused by adenomyosis is that it harms infertility and increases the risk of miscarriage one after another. Adenomyosis can affect pregnancy in 2 ways: The first effect is that it blocks the sperms from passing in the tubes by disrupting the uterine wall structure. Secondly, when pregnancy occurs, the disease creates high pressure in the environment where the embryo will settle, thus preventing it from adherence.
Miscarriage risk can be doubled in cases of adenomyosis. the existence of an undetected Adenomyosis gradually decreases the chance of the patient to become pregnant or to continue with a pregnancy. If adenomyosis is accompanied by involvement of endometriosis in the ovaries, tubes and peritoneum, the risk increases further. If the diagnosis is made, thanks to the IVF method and the more intensive application of protective measures against the risk of miscarriage, the chance of the patient to become a mother is quite high.
Regular inspection is very important
Regular gynecological examinations and informing the physician about the menstruation are of great importance in early diagnosis. Annual controls should be started at a very early age, especially in those with a family history. Whether or not there is this disease in the family, a gynecological examination should be conducted in the first years of menstruation, that is, between the ages of 13 and 14. Then, up to the age of 20, to be examined every 3-4 years is sufficient. Annual checks should not be neglected from the age of 20.
Having a larger uterus is seen as an important clue for diagnosis. Diagnosis can be made by ultrasonography, but MRI (magnetic resonance imaging) method may be needed in suspicious cases.
Solution can be provided with treatment
Treatment in adenomyosis is arranged according to the patient’s age, complaints and whether he / she wants to have a child. For example, if menstrual bleeding is very intense, hormone supplements to reduce bleeding are advised while pain medication is used to relieve the pain complaints. Adenomyosis foci, which is assumed to cause severe pain and intense bleeding or to prevent pregnancy, can be reduced with medication or removed with appropriate surgical techniques.
If the symptoms are very severe and the patient has completed their reproductive age, the removal of uterus may be recommended for a definitive solution. However, medications that control pain and bleeding are beneficial as long as they are used. When they quit using these drugs, the problems start again. In addition to drug therapy, another option is progesterone-releasing spirals. The spirals applied in suitable patients can significantly reduce the complaints of bleeding and pain for 5 years and stop the progression of the disease. With this method, the patient can avoid surgery.