Treatment of adenomyosis

Adenomyosis is a disease that is a special case of endometriosis. In endometriosis, endometrial cells are found in tissues where they should not be. In particular, in the muscular layer of the uterus, in the ovaries, in the fallopian tubes. The standard treatment regimen for adenomyosis involves the use of hormonal therapy.

In particularly difficult cases, endometrial cells can be found even in the abdominal organs. In this case, such cells obey the laws of the menstrual cycle, i.e. they menstruate at a certain period. In this case, there is no normal outlet for blood discharge, discomfort up to acute pain occurs. Bloody discharge is possible in the intermenstrual period. If we are talking about adenomyosis, then this is the case when endometrial cells are found in unnatural places only within the uterus. With adenomyosis, the ingrowth of the endometrial layer can be insignificant, or it can completely penetrate the muscle tissue, forming nodes and accumulations of bloody discharge in them.

Treatment regimen for adenomyosis

Depending on the degree of complexity of adenomyosis itself, as well as the presence of concomitant diseases, a treatment regimen is selected.

Hormonal therapy for adenomyosis is used quite often, the effect of such treatment will be visible no earlier than 3-6 months after the start of taking hormonal drugs. A course of anti-inflammatory and painkillers is also prescribed to relieve symptoms, which significantly affect the patient's lifestyle. In case of severe ineffectiveness of hormonal therapy, surgical treatment of adenomyosis is resorted to. Surgical intervention may involve hysteroscopy (mechanical removal of the endometrial layer of the uterus), removal of endometrial cell nodes from the thickness of the muscular layer, as well as complete removal of the uterus (only the body of the uterus or the body and cervix).

But the approach to surgical treatment is extremely individual. It is possible to combine surgical and hormonal methods. For example, removing particularly complex formations surgically, and trying to overcome further pathologies with the help of drug treatment.

Traditional treatment of adenomyosis

Cases of adenomyosis have been known for a long time. This disease has always caused great inconvenience to women, significantly reduced their quality of life, and greatly interfered with their normal social and moral self-realization. Therefore, since ancient times, there have been means and methods to combat this disease, designed to alleviate the patient's condition. Today, there are many different approaches to treating adenomyosis and relieving its symptoms.

Modern medicine has made great strides in studying the causes and features of the development of this disease. But folk remedies that have come to us from the distant past have not lost their relevance. Many of them have been tested by time. Also, patients who for one reason or another do not trust classical medicine turn to folk remedies. But not only this fact makes folk methods of treating adenomyosis relevant. Sometimes the use of classical medicine is simply unavailable. Then herbs, decoctions, leeches and other methods of folk medicine come to the rescue, which are well known to us in the treatment of various other diseases.

When using folk remedies, different methods are used, such as taking general-action drugs (drinking infusions, decoctions, extracts), and local (douching, compresses, applying leeches), even aromatherapy is used. But in such a situation, it is important to understand that adenomyosis is a disease that requires combating both the clinical manifestations themselves, deep disturbances of physiological processes, and the symptoms of the disease itself. Traditional medicine has proven its effectiveness in combating symptomatic manifestations of the disease, but in its complete cure. Therefore, traditional medicine cannot be considered the only method in the fight against adenomyosis.

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Treatment of adenomyosis with leeches

One of the popular methods of alternative medicine is hirudotherapy or treatment with leeches. This method of treatment has been well known since ancient times. Moreover, it was once one of the main ones in the arsenal of classical doctors and was used for a very wide range of diseases. And this is not without reason. The main feature and distinctive feature is the treatment tool itself - the leech. Medical leeches are used in hirudotherapy. Their unique properties have long been noted. The main thing is that when a leech bites, a large number of useful substances enter the blood, which help reduce inflammation, increase the tone of the immune system, and improve blood microcirculation in the bite area. Leeches are blood-sucking organisms. Therefore, albeit to an insignificant extent, they help, when applied locally, to reduce blood filling in the pelvic organs, which greatly worsens the symptomatic manifestations of the disease in adenomyosis.

In addition, when using hirudotherapy, the woman's hormonal background is normalized, which significantly accelerates and increases the likelihood of recovery. It was also noted that the effect achieved when using medical leeches is quite stable over time.

Of course, leeches cannot completely cure adenomyosis, but this method is a very worthy part of complex treatment.

Treatment of adenomyosis with herbs

Herbal treatment or phytotherapy is one of the most common methods of both folk and traditional medicine. Herbal treatment has been known for a long time. With this method, the therapeutic effect does not occur quickly, compared to drug therapy methods, but nevertheless it is not only quite stable, but also more gentle for the whole body. The use of herbs in the treatment of adenomyosis cannot be the only method, but nevertheless it significantly helps to combat symptomatic features, relieves pain, and reduces bleeding.

When using herbal medicine, herbs can be bought in pharmacies or specialized organizations, or you can collect them yourself. But when collecting herbs yourself, not only for the treatment of adenomyosis, but also for other purposes, you need to understand well when to collect, which parts of the plant to collect, how to process and prepare them later (the need for grinding, drying and storage conditions).

Herbs such as white willow, black cohosh, cinquefoil, plantain, tansy, calamus, celandine, anise, licorice, clover, sage, eucalyptus, currant and juniper fruits have become popular in the treatment of adenomyosis and its symptoms. These components are combined into various mixtures, from which decoctions are prepared for drinking or douching. It is important to understand that even the use of herbal medicine requires a fairly thoughtful approach. The use of certain decoctions is possible not on a permanent basis, but during certain periods of the menstrual cycle. There are also a number of contraindications to the use of certain herbs and mixtures. For example, such treatment should be especially careful during pregnancy, breastfeeding, and the patient's age should be taken into account.

It is also important to remember that herbal medicine is an effective remedy in combination with drug treatment of adenomyosis and cannot be used as an independent method of combating this disease.

Treatment of adenomyosis with orthilia secunda

A special role in the treatment of adenomyosis with folk remedies, in particular in herbal treatment, was played by such a plant as the orthilia secunda.

Ortilia secunda or Ortilia secunda is a perennial herbaceous plant that is widespread throughout the globe in a temperate climate - in Asia, Europe, Japan, North America, Ukraine, Russia, Belarus, Mongolia, China, the Caucasus. It grows in mixed forests, but it can also be found in meadows or meadows. The above-ground part of the plant - leaves, stems, inflorescences - is used for medicinal purposes.

The Orthilia secunda is also called "women's herb". Since its effectiveness in combating various diseases of the female genitourinary system has long been known. Today, in a number of countries, the Orthilia secunda is officially recognized by the health care system and is widely used to combat cystitis, algomenorrhea, polycystic disease, premenstrual syndrome, menopause symptoms and many other diseases. The use of the Orthilia secunda for infertility remains controversial, since a number of studies have revealed not only its ineffectiveness in such cases, but also an aggravation of the disease.

The orthilia secunda has a pronounced anti-inflammatory, diuretic, analgesic effect, it also promotes the resorption of neoplasms, increases the body's immunity.

The uterus of the forest is used mainly in the form of alcohol or water infusions. The dosage is measured by the number of drops of infusion. You can use both infusions of the uterus of the forest itself and its combinations with a number of other herbs.

Water infusions are more often used for douching, while alcohol infusions are used for internal use.

The uterus of the orthilia contains flavonoids and hydroquinone, which have anti-inflammatory properties, arbutin, which has a diuretic effect, saponins, which have a mucolytic, sedative and diuretic effect. But in addition, the orthilia contains coumarin. It thins the blood and can make bleeding longer, which is very dangerous in adenomyosis. Therefore, when using preparations from the orthilia, whether pharmacy products or home-made, you should consult a doctor about both the dosage and the method of preparation.

Treatment of adenomyosis with homeopathy

Among the various alternative medicine methods used to treat adenomyosis, homeopathy is also used.

Homeopathy is a treatment principle that involves the use of drugs whose active ingredients are diluted many times. The principle of drug selection is carried out mainly focusing not on the disease, but on the person himself. Although the principle of "fight fire with fire" is the basis of treatment with homeopathic drugs, that is, to treat a certain disease, a drug is selected that, when used by a healthy person, causes symptoms of the same disease, there is still a whole system of classifying patients into different types, which significantly affects the choice of one or another homeopathic drug.

It is important to note that of all the methods of alternative medicine, it is homeopathy that the World Health Organization is most skeptical about, believing that the effect of homeopathic drugs is similar to the placebo effect.

To make homeopathic preparations, extracts of various plants and microelements are used, but their content in the solution is very small. These can be either monopreparations, that is, solutions containing only one drug, or solutions that contain many different active substances. There is no specific drug for a specific disease. Moreover, homeopathic remedies are selected not only depending on the type of disease, but also adapting to the personality of the person. However, there are some general recommendations. In particular, preparations of Thuja occidentalis have proven themselves well in the fight against adenomyosis. Young tops of branches that have not yet become woody are used to make preparations. The preparation has a similar name - Thuja. Also quite effective is a preparation from Black cohosh. Only the underground part of the plant is used to make the preparation. Black cohosh is generally considered a "female herb" and is used for various diseases of the female reproductive system. Although it can also be prescribed to men for various symptoms as a homeopathic remedy. The drug of Black Cohosh for the treatment of adenomyosis is Actaea racemosa (Actaea racemosa). It is important to remember when using homeopathy that it is best if the drug is selected by a specialist in accordance with all requirements, and not simply bought at the pharmacy "by eye".

Treatment of adenomyosis of the uterus with drugs

Adenomyosis has become much younger today. Previously, this disease was found in women who had given birth aged 40 to 50 years. Adenomyosis is asymptomatic in the initial stages, so it was often studied only on examples of uteruses that were removed due to other diseases. But today, adenomyosis can be found in women aged 25 years and older, including both those who have given birth and those who have not. At the same time, new progressive research methods and surgical interventions have appeared during this time, which allow us to study this disease in more detail.

Medical research keeps pace with pharmaceutical developments. Therefore, along with the study of endometriosis and adenomyosis in particular, specialized drugs were developed, some of which have undergone clinical trials and proven their effectiveness, some of them remain in doubt. However, today there is a wide range of possibilities for drug treatment of adenomyosis.

Adenomyosis is a hormone-dependent disease. Therefore, the main direction of drugs for adenomyosis in classical medicine are hormonal agents. When choosing hormonal drugs, the patient's age, general condition, and concomitant diseases play an important role. There are several groups of drugs that differ in the mechanism of action, side effects, and sensitivity of endometrial foci to them.

Hormonal treatment of adenomyosis

The main therapy for adenomyosis is the prescription of hormonal drugs. Other drugs, whether painkillers or anti-inflammatory, are designed to combat the symptoms of the disease, which greatly reduce the patient's quality of life. Hormonal drugs directly affect the development of the disease itself, leading not only to a halt in the development of the disease, but also to regression up to a complete cure.

Among the hormone-containing drugs that are used to treat adenomyosis, there are several main groups.

The first group includes oral contraceptives that contain ethinyl estradiol. This is a synthetic analogue of the hormone estrogen. Do not think that contraceptives are used only to prevent unwanted pregnancy. In any case, these are hormone-containing drugs. In this case, those that contain at least 0.03 mg of synthetic estrogen are prescribed. These drugs suppress endometrial foci. Sometimes their complete disappearance is achieved.

The second group of drugs includes those that contain progestins. These are steroid hormones that are produced in the ovaries, in the placenta. In fact, they are responsible for the ability to get pregnant and carry this pregnancy. When exposed to such drugs, estrogen receptors in the endometrium atrophy, and as a result, atypical foci of the endometrium atrophy (sometimes completely disappear).

The third group of drugs includes those that contain analogs of gonadotropin-releasing hormone. This hormone affects the functioning of the genitals, the production of gonadotropic hormones (to a greater extent, luteinizing hormone). Under the influence of such drugs, the growth of adenomyosis foci slows down, and the hormonal background is corrected.

The fourth group of drugs includes those that contain androgens. These are, roughly speaking, male sex hormones, which, however, are produced in both men and women. When using this drug, old foci of adenomyosis stop growing, and new ones do not appear. The result of such therapy is quite stable.

But it should be remembered that when taking hormonal drugs, multiple side effects may occur. Such as weight gain, amenorrhea, decreased libido, liver damage, osteoporosis, and decreased ovarian function. Often, the presence of these side effects becomes the reason for patients to refuse to take hormonal drugs and resort to various alternative treatment methods. This is a very dangerous approach, since precious time may be lost and there will be no hope for therapeutic treatment. Therefore, you need to see a doctor and together with him select not only a suitable group of drugs, but also the specific one that will be most suitable in this situation for this patient. If there is a desire to use auxiliary non-traditional methods of treatment, then you should also tell your doctor about them, since some infusions and procedures may conflict with drug treatment or may not be suitable at all in a particular situation.

Treatment of adenomyosis with duphaston

Today, there are several popular drugs that are often recommended by doctors for the treatment of adenomyosis and a number of other diseases. One of these drugs is Duphaston.

Duphaston is a drug that contains an artificial analogue of natural progesterone (progestogen). Progesterone is a steroid hormone that is secreted by the corpus luteum of the ovary. The corpus luteum is formed in the ovary during ovulation and is a temporary endocrine gland (produces progesterone). The formation of the corpus luteum occurs in the luteal phase of the cycle under the influence of luteinizing hormone. The development of adenomyosis is often associated with a deficiency of these hormones, so the use of Duphaston provides support for the hormonal background. The results of such therapy are not only effective, but also quite stable over time. Duphaston is a modern drug, the side effects of its use are minimized. Moreover, it is fashionable to take it during pregnancy. It is known that one of the most negative manifestations of adenomyosis is a very low probability of pregnancy and its gestation. Therefore, Duphaston is used both before pregnancy to balance hormones, and sometimes during it. Since adenomyosis may be associated with a low level of production of the hormone progesterone by the corpus luteum cyst, which is very important in the early stages of pregnancy, the use of Duphaston can significantly reduce the risk of spontaneous abortion.

Treatment of adenomyosis with Janine

Also, the most popular and effective drug for the treatment of adenomyosis is Janine. It is quite well known among women, as it is often used not as a therapeutic agent, but as a contraceptive.

Zhanin contains two groups of hormones. It is a low-dose drug, which allows to minimize side effects when using it both as a contraceptive and as a therapeutic agent for adenomyosis and a number of other diseases. Another positive quality is that Zhanin is absorbed by almost 85%, so there is no need for large volumes of the drug.

The drug Janine contains a gestagenic and estrogenic component.

The active substance dienogest acts as a gestagenic agent. Under its action, the growth of endometrial cells is suppressed. Thus, pathological foci of endometrial growth are reduced, up to complete disappearance.

The active substance is the estrogenic component. It promotes the growth and development of the ovarian follicle, ovulation.

In general, Janine balances hormonal metabolism in the first and second phases of the menstrual cycle, which helps prevent the development of new foci of adenomyosis and effectively combat existing ones.

Treatment of diffuse adenomyosis

There are several variants of adenomyosis development. Diffuse adenomyosis is the most common. With this type of disease, the endometrium grows into the muscular layer of the uterus, creating blind pockets, and sometimes penetrates through, creating fistulous exits. But with diffuse endometriosis, the endometrial tissue that penetrates the muscle does not grow. At the same time, the muscular layer of the uterus itself thickens significantly, reacting to penetration.

Any variant of adenomyosis development may require both drug and surgical treatment.

In case of diffuse adenomyosis, surgical intervention is rarely necessary. The use of hormonal therapy in the vast majority of cases is quite effective. It achieves not only a decrease in the growth of endometrial tissue that penetrates the mucous membrane, but also a complete disappearance of adenomyosis foci. Although the latter is observed in a fairly small number of cases. But in addition to treating the direct proliferation of the endometrial layer through the dividing layer of tissue into the muscle, therapeutic influence is also required regarding other manifestations of diffuse adenomyosis.

With this disease, the symptoms are quite unpleasant for the patient. These include painful menstruation, pain during intercourse. At the same time, the usual painkillers do not bring the same effect. Therefore, it is important to choose the right painkillers, take vitamins, organize the daily routine and exercise, which can alleviate the manifestation of these symptoms.

Spotting outside of menstruation and heaviness in the lower abdomen may also occur. These symptoms, depending on their severity, require intervention.

Treatment of nodular adenomyosis

Another form of adenomyosis development is nodular adenomyosis. In this case, the endometrial tissue grows into the muscle tissue in the same way as in diffuse adenomyosis. But the main difference is that in nodular adenomyosis, the endometrial tissue cells that have entered the muscle layer begin to grow. This is how nodes are formed. They are quite dense. Sometimes they are compared to benign tumors that have a capsule. This is due to the fact that both such tumors and endometrial tissue nodes in adenomyosis have a connective tissue membrane. But the main difference is that in tumors, all pathological cells are inside the capsule. And in adenomyosis, the endometrial cells are both inside the connective tissue capsule and outside it. As is known, with a disease such as adenomyosis, the endometrium, located in places unusual for it, obeys all the laws of the menstrual cycle. Including periodic bleeding. But unlike diffuse endometriosis, in which the resulting blood has a relative possibility of exiting, with the nodular form of this disease, all the blood remains inside the capsule near the node. Over time, it acquires a chocolate color.

Treatment of nodular adenomyosis is more complicated. Of course, drug methods are used. In any case, they are necessary, since the appearance of endometriosis of any form is associated with hormonal disorders. But the use of surgical methods in the case of the nodular form of adenomyosis is most often inevitable. In particularly critical cases, it is necessary to remove the affected organs - the uterus, ovaries. This causes quite serious harm to the general health of the patient. Previously, only this method was used. But with the development of medicine and treatment methods, it became possible to carry out organ-saving operations. For this, endometrial tissue nodes are removed from the muscle layer. Such formations are clearly visible during ultrasound diagnostics. When using such gentle methods of surgical intervention, it is also necessary to carry out hormonal therapy, take anti-inflammatory drugs, lead a healthy lifestyle, and regularly undergo preventive examinations to avoid relapse of the disease.

Treatment of 1st degree adenomyosis

There are several degrees of development of adenomyosis.

The first stage is characterized by very minor changes. In this case, the cells of the uterine endometrium grow, penetrating into the submucosal layer of the uterus. But they do not penetrate it completely. This is the mildest form of adenomyosis. Its main danger is that it is almost asymptomatic. Therefore, doctors often deal with the treatment of adenomyosis of the following stages. If adenomyosis was detected at the first stage of development, then much depends on how exactly the disease develops in a particular patient. At this stage of the disease, it is impossible to talk about its form of progression (diffuse, nodular, focal), since there is no germination into the muscle layer, the excess of endometrial cells is relatively small. But at the same time, some patients may experience severe bleeding during menstruation. If this is observed, then hysteroscopy is recommended. In this case, it makes it possible to both solve the problem with excess endometrium and stop the bleeding, and to obtain additional material for diagnosis. If there are no such complex symptoms, then hormonal therapy is used, a complex of supportive therapy is prescribed, such as vitamins, microelements. Such a condition requires regular monitoring. With the right approach at the first stage of adenomyosis development, the chances of a complete cure are very high, practically guaranteed.

Treatment of 2nd degree adenomyosis

At the second stage of adenomyosis the situation is already more serious. This stage is well defined by ultrasound examination. In addition, at the second stage the symptoms are much more pronounced, causing discomfort to patients. Menstrual pain is more pronounced, bleeding is much more abundant. This state of affairs often makes you see a doctor. Therefore, treatment of the second stage of adenomyosis is much more common, more studied and developed.

Second-degree adenomyosis is when endometrial cells penetrate the submucosa and enter the muscular layer of the uterus, but do not reach its middle. The walls of the uterus thicken. At this stage, there may already be various options for the further development of the disease - diffuse, nodular, mixed. Depending on this, the most optimal treatment tactics are chosen. In any case, it will be advisable to use hormonal therapy. At this stage, surgical intervention is not desirable and is used in cases where other measures to combat the disease have already been carried out and did not give the desired result. Surgical intervention may also be used if the growth into the muscular layer occurs very quickly and causes concern.

Treatment of grade 3 adenomyosis

Third-degree adenomyosis is a stage of the disease in which the endometrial cells that have grown into the muscular layer of the uterus have not only reached the middle, but have also advanced further. Sometimes, cases where the grown clusters reach or even overcome the serous layer of the uterus (the film on the outer surface of the uterus) are called the fourth stage of adenomyosis. But in most cases, even this degree of complexity can be classified as the third.

As at any of the previous stages, hormonal therapy is necessary and mandatory. But there is no longer any need to talk about the doubtfulness of the surgical approach at this stage of the disease. Surgical intervention in such a situation is simply inevitable. In the best case, it is possible to remove the foci of the disease. But, unfortunately, quite often at this stage of adenomyosis we are talking about removing the uterus and, possibly, appendages.

Quite often, adenomyosis develops together with uterine fibroids. And the latter disease is also an indication for hysterectomy (not in all cases).

In third-degree adenomyosis, both streaks of endometrial cells and entire nodes can form in the muscular layer of the uterus. The walls of the uterus thicken significantly, reacting to the endometrium penetrating them.

Surgical treatment of adenomyosis

In a disease such as adenomyosis, surgical intervention is considered an extreme measure, but sometimes unavoidable. But there are many methods and approaches to the surgical approach to solving such problems. This diversity is due to both progress in the study of this disease (and similar ones), and the development of new methods of instrumental medicine.

There are two main divisions of surgical intervention methods - open and so-called laparoscopic (endoscopic). The latter is a fairly new and actively developing method. Although the choice of how exactly to perform the operation is determined by many factors. These include the severity of adenomyosis, and the presence of indications or contraindications for a particular method, the presence of concomitant diseases. Another important factor is the material and technical base of the medical institution in which such an operation is performed. Although it should be noted that with adenomyosis, it is extremely rare to encounter urgent unplanned operations. The diagnostic process itself is quite long and there is a high need for a very accurate assessment of the situation to choose the most gentle method of surgical treatment, if necessary. Therefore, there is an opportunity and time to choose a clinic where the most suitable method of surgical intervention can be technically implemented.

Surgical treatment for adenomyosis is used to remove endometrial cell nodes in the thickness of the muscular layer of the uterus, to remove endometrial thickenings that lead to bleeding. Also, material is surgically collected for analysis, histological and cytological examination for the purpose of further diagnostics. In any case, during surgical treatment of adenomyosis, they try to preserve all organs. But much depends on the degree of damage. The extreme case is amputation of the uterus and appendages, if it is otherwise impossible to localize the disease.

Removal of the uterus for adenomyosis

A radical measure for treating adenomyosis is the removal of the uterus. This procedure is called hysterectomy. There are different options for this process. Much depends on the accompanying diseases and affected areas. Removal of the uterus can be accompanied by the removal of only the body of the uterus, or the body of the uterus together with the cervix, the upper part of the vagina and adjacent tissues that support these organs. In addition, the fallopian tubes and the ovaries themselves can be removed. Such operations can be performed using various access methods. One of these methods is the removal of the uterus through the vaginal access. This operation does not leave external scars. In addition, with the development of medical equipment, it is possible to perform this operation under visual control by inserting a laparoscope. To perform a hysterectomy through the vaginal access, a very small incision is made on the abdomen to insert the laparoscope, an incision is made in the vagina close to the uterus, through which the uterus will be removed. But there are a number of contraindications to this method of performing the operation. It is possible to remove the uterus through the vaginal access only if its size is relatively small. And in the case of adenomyosis of the last stages, which most often require such an operation, the size of the uterus can be significantly increased. This is due to the fact that even with a small penetration of endometrial cells into the muscular layer of the uterus, the latter thickens, resisting the pathological process. If the tissue proliferation is very extensive, a large number of nodes have formed, the endometrium itself is thickened, then it is impossible to perform a hysterectomy through the vaginal access. In this case, abdominal hysterectomy is used. This is a method of performing an operation when an incision for access to the uterus is made on the abdomen. Adenomyosis is often accompanied not only by an increase in the size of the uterus, but also by various types of neoplasms, the most common of which are fibrous tumors. Therefore, in such a picture, only abdominal access is possible.

With vaginal access, the patient recovers fairly quickly after surgery, but there is a risk of damage to the urinary tract. With abdominal access, the risk of associated damage is very low, but the recovery period is much longer and more difficult.

In addition to the complications directly related to the operation, there are also a number of features with the consequences of hysterectomy. Much depends on whether this operation is performed in the post-menopausal period or before it. If the patient has not reached menopause at the time of the operation, and not only the uterus but also the ovaries are affected or subject to removal, then hormone replacement therapy is necessary. If a total hysterectomy was performed, that is, not only the uterus was removed, but also the cervix, as well as the upper part of the vagina, then problems with sexual intercourse may arise, which is especially important if menopause has not occurred.

In any case, no matter what approach is chosen, the psychological burden of patients undergoing hysteroectomy is also of great importance. Therefore, surgical treatment of adenomyosis should be carried out together with visits to a psychologist or group psychological assistance on this topic.