Endometriosis of the uterus: symptoms and treatment. Ultrasound as a method of early diagnosis for timely treatment of endometriosis
When everything is in order in the female body, the endometrium is the mucous membrane of the uterus, which undergoes cyclic changes, grows into the uterine cavity and is rejected at a certain time. However, due to reasons unknown to this day, a large number of women are faced with a disease called endometriosis. With it, endometrial cells grow in other parts of the body. There are cases when they can be found far beyond the reproductive system.
Classification of endometriosis
Depending on the new location of the endometrial cells, the disease is classified into genital and extragenital. Genital endometriosis. in turn, is divided into:
Extragenital develops outside the reproductive system and has varieties:
Endometriosis - signs and symptoms
Many representatives of the fair half of society, who do not consider it obligatory to undergo a preventive examination by a gynecologist, may not even be aware of the presence of the disease at first. This is due to the possible absence of any signs of endometriosis in women. But still, if you listen carefully to your body, then in the event of endometriosis, you can immediately notice the following signs:
It is important to note that the pain subsides or even disappears after the cessation of menstruation. This is due to the cyclical development of mucosal tissue.
Whatever the signs of endometriosis, the final diagnosis should be made by a qualified specialist after a series of examinations. The most reliable results of the condition of the genital organs can be obtained using ultrasound. So, only signs of endometriosis noted on ultrasound can be considered the most accurate for making a final diagnosis. So, for example, characteristic echo signs of internal endometriosis are:
It is important not to miss the appearance of signs of endometriosis in a woman and to prescribe treatment in a timely manner. Not only her general well-being and health depend on this, but also her reproductive function, which is especially important for women of reproductive age.
The treatment is hormonal therapy, which temporarily blocks the growth of the endometrium. After completing the course, its development can resume. Therefore, maintenance medications are then prescribed. Depending on the severity of the disease, age and future plans regarding pregnancy, surgical treatment methods may be used. The most optimal option in our time is laparoscopy. allows you to reduce the risk of consequences and maintain the functionality of the genital organs.
Endometriosis of the uterus
The female reproductive system is very complex, and sometimes it is even too easy to disable it, but it can be much more difficult to restore it. One of the most common diseases in women today is endometriosis. It occurs, perhaps, even too often.
Unfortunately, it is difficult to provide more accurate information, since the disease is often asymptomatic. Previously, this disease occurred mainly in women aged 30-50 years. Unfortunately, today it has become significantly younger; patients with endometriosis aged 20-25 years are becoming increasingly common.
How does the disease progress?
Endometriosis is a serious disease associated with disorders in the inner layer of the uterus - the endometrium. With endometriosis, endometrial cells begin to grow outside the uterus. The disease is very dangerous, including because it is quite difficult to diagnose. On the one hand, it is often asymptomatic; on the other hand, the symptoms that may nevertheless appear are characteristic of a number of gynecological diseases. Therefore, it is very important to undergo a full examination at the first signs of endometriosis.
In this regard, I would like to emphasize the importance of regular preventive examinations with a gynecologist, which, unfortunately, many women neglect.
Types of endometriosis. Adenomyosis
Depending on the location of the pathological tissue and the degree of damage, endometriosis is divided into several types. So, they highlight genital endametriosis . that is, affecting the organs of the reproductive system, and extragenital . that is, affecting neighboring organs: bladder, intestines, kidneys, peritoneal walls, and so on.
Genital endometriosis is divided into external endometriosis, which develops in the vagina, rectal wall, fallopian tubes and ovaries, and internal endometriosis of the uterus, or adenomyosis.
Let's talk about the last type in more detail. Adenomyosis is essentially endometriosis of the uterine body. Under normal conditions, the endometrium develops cyclically: first it thickens in preparation for egg implantation, then, at the end of the cycle, it is rejected and released along with menstrual blood. In this case, the endometrium grows only into the uterine cavity, and its muscular layer is reliably protected by a special membrane.
However, in some cases, the growth of the uterine mucosa changes, increases, and also finds weak spots in the protective membrane and grows into the muscular layer of the uterus. As a result, firstly, excess mucous tissue is not completely removed from the uterus, and secondly, muscle tissue is affected. Doctors distinguish 4 different stages of this disease: stage 1 or 2 endometriosis of the uterus means that the endometrium has grown approximately to the middle of the myometrium. Grade 3 indicates that there is germination to the serous layer, while grade 4 means that the peritoneum is already affected.
Adenomyosis also differs according to the type of development. Perhaps the most difficult and unpleasant option is diffuse endometriosis of the uterus. With diffuse adenomyosis, endometrial growth occurs evenly throughout the entire uterus, layer by layer. It is very difficult to cure this condition.
However, focal adenomyosis still occurs more often, when only certain parts of the uterus are affected: the anterior or posterior wall. Another variant of endometriosis of the uterine body is nodular. It has a lot in common with focal, however, in this case the muscle tissue begins to defend itself and resist the “invasion.” As a result, a compaction, a small nodule, forms around the foci of germination. This, in turn, leads to an increase in the size of the uterus. However, in terms of upcoming treatment, there is simply no big difference between the second and third types.
Reasons for the development of the disease
Unfortunately, doctors and scientists still cannot say with certainty what exactly leads to the development of adenomyosis. There are several theories, none of which, however, have been proven.
Thus, some scientists argue that the cause of the development of endometriosis is retrograde menstruation . a phenomenon in which some menstrual blood flows deeper into the uterus, into the fallopian tubes and sometimes into the abdominal cavity. Menstrual blood always contains endometrial particles. As a result, these cells can attach to very unusual places.
Various factors can also lead to the development of endometriosis of the uterus. procedures and interventions into her cavity. Miscarriages, abortions, curettage, removal of polyps, any operations that may disrupt the integrity of the membrane, including laparoscopy and cesarean section. Of course, after the operation, the membrane is restored quite quickly, but scar tissue appears at the site of damage, which is much less effectively able to resist the germination of the endometrium.
Undoubtedly, the development of the disease is influenced by hormones . so any disruptions in this area, disruption of the glands, can also cause endometriosis. According to research results, women who are often faced with stressful situations and are also exposed to constant .
Some scientists note the influence hereditary factor . According to their research, if a case of endometriosis has already been encountered in the family, then the woman’s risk of encountering this disease increases.
At the moment, there is even information that doctors are developing a special DNA text that will make it possible to identify in advance whether a woman has a genetic predisposition to endometriosis. This will allow women at genetic risk to focus on preventive measures.
Symptoms and diagnosis
Diagnosis of uterine endometriosis, unfortunately, is extremely complicated for a whole range of reasons. Firstly, in a number of cases the disease is completely asymptomatic until the moment when serious complications begin. Secondly, most of the symptoms characteristic of endometriosis can signal many other diseases.
To accurately make a diagnosis, it is necessary to conduct a number of studies, including a routine gynecological examination with speculum, ultrasound, colposcopy and laparoscopy.
Ideally, every woman should know the signs of endometriosis of the uterine body in order to be able to consult a doctor in a timely manner. Most of the symptoms are somehow related to the menstrual cycle.
So, one of the most striking and common symptoms is painful menstruation. The pain begins to bother women 1-2 days before the start of menstruation and reaches its greatest intensity, as a rule, by the 3rd day of discharge.
The causes of pain during menstruation can be very different. In particular, it can be caused by an excess of prostaglandins, which cause muscle contraction. When the concentration of these substances in the tissues of the uterus is not uniform, painful sensations occur. Pain can also result from contact of the affected areas of the uterus with other organs and tissues.
Pain can haunt a woman not only during menstruation, but also in the middle of the cycle. The cause may be inflammation that occurs against the background of pathological processes.
A symptom of adenomyosis is menstrual irregularity. This symptom occurs especially often in cases where the disease itself is hormonal in nature. There may be a change in the duration of menstruation or, more often, a change in the nature of the discharge. Often your periods become much heavier.
If the lesion extends to the cervix or vagina, the woman may experience severe pain during intercourse. Scanty bleeding after sex is also possible.
Often with adenomyosis, an increase in the size of the uterus and a change in its shape are observed. Of course, a woman will not be able to determine on her own what size her uterus is. But this is clearly visible on ultrasound.
Why is endometriosis of the uterine body dangerous?
The consequences of uterine endometriosis can be extremely unpleasant and even dangerous. First of all, this disease often leads to infertility. The nature of this phenomenon is not fully understood, however, in 60% of cases, women with endometriosis experience difficulties conceiving and bearing children .
According to some versions, conception is complicated precisely by disorders of the uterine mucosa. That is, the fertilized egg simply cannot implant. In addition, the overgrown endometrium can block the entrance to the fallopian tubes, which also interferes with conception. Hormonal levels are also important. In some cases, with endometriosis, ovulation does not occur at all.
The formation of nodules on the body of the uterus is fraught with a change in its shape. In some cases, a fixed bend of the uterus is formed. And this also prevents conception.
Fortunately, in most cases, infertility can be cured after eliminating the disease itself. Although sometimes, when damage to the uterus reaches a critical point, and other treatment methods do not help, the woman has her uterus removed.
If pregnancy does occur, it will be extremely difficult to maintain it. Early miscarriage in women with adenomyosis occurs many times more often than in healthy women. This means that a woman with endometriosis will have to carefully monitor herself throughout the entire pregnancy and avoid physical and emotional stress.
However, infertility is not the only danger of adenomyosis. Heavy periods can cause another serious disorder - anemia . Along with blood, a woman also loses iron every time. However, during normal menstruation, no more than 80 ml of blood is lost; with adenomyosis, this amount can increase several times. At the same time, the supply of iron from the outside remains the same.
But iron is responsible in our body, first of all, for the transfer of oxygen from the lungs to other organs. As a result of a lack of hemoglobin, less oxygen reaches the organs, and oxygen starvation begins. The woman begins to feel weak, tired, and constantly unwell.
In some cases, endametriosis can provoke development of uterine fibroids . This is due to defense mechanisms. In a more dangerous scenario, we can talk about the degeneration of pathological endometrial cells into cancer cells. In this case, removal of the uterus will most likely not be possible.
Treatment and prevention
From the above, it becomes clear how important timely and qualified treatment of uterine endometriosis is. If you suspect adenomyosis due to any signs, do not delay visiting your doctor.
There are three fairly effective methods of treatment: conservative (medication), organ-preserving surgery in combination with medication, and radical surgery. Which method will be chosen in which case depends on the specific situation.
Before prescribing treatment, the doctor must conduct all the necessary studies. Only on their basis, depending on the degree of damage to the organ, the form of the disease, the age and general physical condition of the woman, as well as taking into account her plans for the future, in particular with regard to childbearing.
As a rule, doctors try to manage with conservative methods. Medications are used to prevent women from menstruating for up to six months. During this time, excess overgrown endometriotic tissue is removed from the body. And the growth of the endometrium stops. Muscle tissue is also cleansed during this time.
Naturally, treatment is carried out using hormonal agents. As a rule, these are 2 or 3 phase contraceptives. Many women worry about the need to take hormonal pills for a long time. In this regard, more effective and safe products are constantly being developed. Now it is very important that, firstly, the doctor who is treating you is aware of all the latest developments. Secondly, it is necessary that your condition be constantly monitored throughout the duration of the medication.
If conservative methods do not help or the degree of damage is too high, uterine cleaning may be prescribed. Of course, curettage can only be discussed in the case of focal or nodular adenomyosis. In the case of diffuse damage to the uterus, the affected area is too large for it to make sense to scrape it out. In such a situation, you have to rely only on drug treatment for endometriosis.
In addition to surgery, this case also involves the use of hormonal drugs. In some cases, medications are prescribed in the preoperative period. This allows you to prepare the body for a stressful situation, as well as restore reproductive functions.
In exceptional cases, when neither the first nor the second methods help, surgery to remove the uterus may be required. Doctors are trying in every possible way to avoid this, and not only out of a desire to preserve the ability to bear children, but also because a woman’s entire life directly depends on hormonal levels, and the removal of the uterus and ovaries greatly changes it, and therefore changes the woman’s life.
Unfortunately, it is quite difficult to talk about complete prevention of this disease, because the causes of endometriosis still remain a mystery in most cases. However, something can still be done.
First, try to avoid stressful situations. And in any case, excess loads do not have a positive effect on a woman’s health. Secondly, try to take care of your health. Abortions, curettages, miscarriages and, of course, various inflammatory processes and diseases lead to damage to the protective membrane, and scars at the sites of damage can subsequently become those weak points through which endometriosis “breaks through.”
Perhaps this is all that can be done in terms of preventing endometriosis. The remaining measures relate to methods of early detection of this disease. In no case should you neglect regular preventive examinations with a gynecologist. This will help to track unwanted processes in time and stop them in time.
Traditional methods of treatment
Let's return to the question of women's concerns regarding hormonal drugs. Unfortunately, many patients reject doctors’ prescriptions and try to use folk remedies to treat endometriosis of the uterine body.
This could be various homeopathy, some semi-magical rituals, and various diets. Of course, some of these remedies, such as beetroot juice or properly selected homeopathic medicines, can lead to a general improvement in the body and may even relieve the external symptoms of endometriosis, but this does not mean a cure.
Adenomyosis will again go into the asymptomatic stage, the woman will decide that she is completely cured and will forget about her illness. The same will continue to progress. In the future, it will be much more difficult to cure an advanced disease.
So it’s better not to get carried away with traditional methods of treating endometriosis of the uterine body. It is best to simply discuss the details of treatment with your doctor, find out what side effects are possible, when you can expect results, and whether you can choose other medications. This will help you understand how the medicine works and understand how necessary it is.
Endometriosis of the uterine body is a serious and dangerous disease that needs to be treated promptly. Monitor your well-being, condition and do not forget to visit an antenatal clinic every six months. Otherwise, the disease can lead to infertility and removal of the uterus. And this is the hardest blow for any woman.
Of course, modern medicine makes it possible to cope with even quite severe forms of the disease, but this is not a reason to let everything take its course.
Educational video: a specialist talks about methods of treating endometriosis
Echo signs of internal endometriosis
Uterine adenomyosis of the 1st degree is a stage of endometriotic lesions of endometriosis, in which the initial penetration of the endometrium into the muscle tissue of the uterus occurs. After the introduction of individual cells of the functional layer of the endometrium into the myometrium, due to cyclical changes in the level of estrogen, their proliferation begins. Factors in the development of this disease are genetically determined or congenital permeability of the basal layer of the endometrium, as well as increased intrauterine pressure, which is caused by the presence of disturbances in the outflow of blood during menstruation.
Adenomyosis echo signs begin with the appearance of changes in the hormonal background due to an increase in the level of the female sex hormone estrogen in the blood. Estrogen in the first half of the monthly cycle promotes active growth of the endometrium. In this case, based on the fact that its quantity exceeds the norm, the duration of the menstrual period increases. Also, with an excess of estrogen, menstrual blood comes out in much larger quantities.
In addition, grade 1 adenomyosis of the uterus and the appearance of endometriotic tumors in the myometrium are accompanied by disturbances in the functioning of the immune system. Adenomyosis of the uterus 2 degrees is characterized by a deep degree of germination of the endometrium into the muscular layer of the walls of the uterus. In this case, it extends up to half the thickness of the myometrium.
At this stage of the progress of such an endometriotic pathological process, there may be a complete absence of any pronounced symptomatic manifestations. The main signs that may indicate its presence in the body may be an increase in the duration of the menstrual cycle and the appearance of dark brown discharge in the periods between menstruation. It is also possible to experience pain symptoms in the lower abdomen, heaviness in the abdomen and a feeling of discomfort.
In some cases, there is an increase in the intensity of pain that occurs during menstruation. As a result of excessive amounts of estrogen, the disease can be accompanied by internal endometriosis disorders, headache, nausea, vomiting, tachycardia and increased body temperature.
Adenomyosis of the uterus 2 degrees causes changes in the structure of the inner surface of the uterine cavity. The formation of tubercles takes place, it acquires greater density, and a significant decrease in elasticity is noted.
Uterine leiomyoma with adenomyosis is a combination of two diseases, each of which individually is one of the most common lesions of the uterus. They have significant similarities with each other in the reasons that cause their appearance, and in many cases when leiomyoma occurs, it is accompanied by adenomyosis, and vice versa. The reasons for the development of internal of these gynecological pathologies lie in the hormonal imbalance of the body, disorders in the immune system, and the presence of infectious processes in the chronic stage.
Gynecological diseases in an advanced form, repeated abortions, and stress factors can also cause their occurrence as an echo sign of progress.
Until recently, uterine leiomyoma with adenomyosis did not provide for other forms of treatment other than surgery to remove the uterus and appendages. However, given that young women of early childbearing age are often at risk for this disease, the advisability of such a radical measure in many cases is an echo sign.
Today, the optimal treatment is the use of minimally invasive surgery methods, such as operations using laparoscopy and hysteroresectoscopy. Based on the fact that, by its definition, adenomyosis is characterized by the appearance of benign tumor formations, the question arises of the degree of ureaplasma and the conception of this disease in men, what serious threats does it pose and why is uterine adenomyosis dangerous?
What is characteristic of adenomyosis is that when the endometrium appears in other tissues and organs, the genetic structure of its cells does not undergo any changes. This feature, plus the tendency to spread throughout the body, as well as resistance, that is, resistance to external influences - all this makes this disease close in nature to oncology.
We cannot discount the possibility of the onset of echo-signs of internal endometriosis cellular transformation at the genomic level. Extragenital endometrial cells can provoke a wide range of complications and pathologies that require immediate medical measures.
Among the complications of leech ointment, the danger of uterine adenomyosis, it should be noted in particular the likelihood of intestinal obstruction due to endometriosis of the gastrointestinal tract, hemothorax - filling of the pleural cavity with blood as a result of damage to the lung, etc. Due to the large amount of blood loss, both during the monthly cycle and in connection with pathological processes in adenomyosis, iron deficiency anemia develops.
Lack of oxygen causes dizziness, fainting, frequent headaches, echo signs of internal endometriosis, and memory impairment. There is a general decrease in the vital tone of the body and a significant deterioration in performance.
Endometriotic damage to the uterus also results in the growth of cells through the myometrium of the uterus into the serous membrane, and the involvement in the development of pathological endomtriosis of organs located in close proximity to the uterus.
Such as organs located in the peritoneal cavity, bladder and rectum. One of the most significant consequences of adenomyosis is the likelihood of infertility, which is caused by both impaired ovulation and the inability of the embryo to attach to the walls of the uterus. The consequences of uterine adenomyosis are also manifested by such an unfavorable factor as the fact that in terms of the difficulties associated with conservative treatment of this disease, it approaches lesions of an oncological nature.
Pathological endometrium, which grows in other tissues and organs, has a tendency to degenerate into malignant neoplasms, echo signs of internal endometriosis. Diagnosis of uterine adenomyosis involves, first of all, an examination of the genital organs, which boils down to examination using mirrors and a colposcope - an optical device that provides multiple magnification when examining the cervix.
In addition to such visual methods, swabs are taken for appropriate laboratory analysis, and echo signs of internal endometriosis epdometriosis respiratory and circulatory organs, digestive organs and urinary system. If a woman has certain chronic diseases or body characteristics associated with individual intolerance to certain medications, additional consultations are prescribed with relevant specialists.
After carrying out these measures, as a rule, an ultrasound examination of the pelvic organs is also prescribed. Ultrasound is one of the most common diagnostic methods in gynecology. If there are appropriate indications, diagnosis of uterine adenomyosis is carried out using laparoscopy and echo signs of internal endometriosis. It is also possible to analyze the vaginal microflora for echo signs of internal endometriosis of all kinds of unfavorable bacteria.
One of the most widespread, as well as the most effective and efficient types of echo signs of internal endometriosis in internal gynecology is the method of transvaginal ultrasound examination. Diagnostic measures carried out using this method provide research results with the highest degree of accuracy. The following echo signs of uterine adenomyosis, agreed upon and confirmed by a significant number of medical specialists, are identified.
Adenomyosis of the uterus is manifested in this study by the presence of different thicknesses of the walls of the uterus, with its obvious asymmetry. The next echo sign that indicates this endometriotic pathology in the female organ is the spherical shape of the uterus, which it acquires due to an increase in its posterior and anterior dimensions. The presence of adenomyosis of the uterus is indicated by the echo sign that it differs in significant size until six weeks of pregnancy, and sometimes even later.
Echosigns of uterine adenomyosis also include the appearance of cystic formations ranging in size from 3 to 5 millimeters before the onset of menstruation.
Currently, methods of direct study of tissue fragments from the walls of the uterus, vagina and internal organs are used to detect diseases of gynecological endometriosis. Another type of diagnosis is ultrasound. During an ultrasound, it is possible to visually assess the condition of the uterus, as well as possibly identify structural changes and signs of pathologies.
Thanks to the use of this diagnostic method, it becomes possible to timely detect uterine adenomyosis by ultrasound. Since the penetration of ultrasound waves into the uterus is obstructed by the skin-fat layer of the peritoneal cavity, to achieve diagnostic efficiency, a transvaginal method of such research is used. This involves inserting an ultrasound probe directly into the vagina.
Adenomyosis of the uterus on ultrasound manifests itself in the form of a set of certain echo signs, by which the presence of this disease can be established. A clear and unambiguous interpretation of the research results is of great importance.
Thus, the detection of fairly common diffuse changes in the myometrium can often be mistaken for adenomyosis. Based on this, analysis and diagnosis based on the data obtained is solely within the competence of the appropriate specialist in the field of gynecology.
Adenomyosis - should it be treated?
Internal endometriosis, adenomyosis of the uterus, seems possible using one of two ways to get rid of this disease. The therapeutic method involves using all possible means of drug treatment to achieve restoration of internal endometriosis of the immune system and bring the body's hormonal levels to optimum.
Drugs used for the therapeutic treatment of uterine adenomyosis are prescribed in accordance with the individual characteristics of the woman’s body in such proportions as to minimize the likelihood of side effects while being most effective. Most drugs currently produced have the ability to provide the maximum possible positive therapeutic effect, while the possibility of negative consequences from their use is small.
These are mainly gestagens, that is, those that are characterized by the content of hormonal substances. Among their main positive qualities, it should be noted that they contribute to a successful pregnancy. Treatment of internal endometriosis is carried out using, for example, Duphaston, dydroghemterone, which comes in the form of 10 mg tablets.
The duration of the minimum course is 3 months, during which the drug is taken 2 to 3 times a day, starting on the 5th day and ending with the 1st day of the cycle. The drug can cause a number of side effects of internal endometriosis, manifested in the form of: The course of treatment is prescribed for a duration of 3 months to six months. Within a week of treatment, severe atrophy occurs in the endometrium, and the uterus decreases in size.
The use of the drug may be accompanied by headache, drowsiness, apathy, nausea and vomiting; can lead to deterioration of appetite, decreased libido, decreased duration of the menstrual cycle and intermediate bleeding.
When calculating the dose, individual tolerability of the drug and therapeutic effectiveness are taken into account. Side effects include headaches, nausea and vomiting; bloody vaginal discharge of an acyclic nature may occur; there is a tendency to increase body weight, the appearance of a skin rash is possible and the Moscow State Phlebology Center. Using the drug for a long time can be fraught with thrombosis and thromboembolism.
Treatment of uterine adenomyosis through surgery is carried out in order to eliminate as many localization zones of this pathology in the body as possible. Such surgical intervention is more effective the earlier the stage of development of the pathological process it is performed. The likelihood of a quick cure also depends on the severity of endometriotic damage. As medical science develops, various methods of ill health during menstruation appear, aimed at internal endometriosis with this disease.
Today, electrocoagulation is increasingly beginning to be used. This method of removing tumor formations can be used under anesthesia, which completely eliminates pain. Prevention of uterine adenomyosis mainly comes down to regular visits to a gynecologist. A big misconception is the widespread belief that such visits are justified only during pregnancy, or in cases where any alarming signs appear that may raise suspicion of the onset of the disease.
It is recommended to visit the doctor at least once every six months for a primary gynecological examination and possible identification of pathological changes inherent in adenomyosis of internal endometriosis.
A specialist can promptly correctly identify such symptoms and prescribe appropriate treatment. In addition, prevention of uterine adenomyosis involves the need for periods of rest, relieving tension and the consequences of stressful situations if a woman notices the appearance of mild pain symptoms in the pelvic area. To do this, after consulting a doctor on this matter, it may be advisable to use all kinds of internal endometriosis-appropriate calming effects, physiotherapeutic procedures and relaxation massages.
A woman’s meaningful and attentive care of her own health is the best prevention of a large number of gynecological diseases.
Adenomyosis of the uterus is largely characterized by an asymptomatic course of the pathological process, which can last for many years and even decades. This disease may not manifest itself for a long time as a clear cause of a detrimental effect on the body, leading to exhaustion or, in worst cases, causing its death. The prognosis of uterine adenomyosis, with regard to the likelihood of all sorts of complications, is determined by the fact that, first of all, due to the large amount of blood loss from uterine bleeding, there is a risk of anemia in acute or chronic form.
At the same time, the progress of the disease has features inherent in pathologies of an oncological nature, and just like malignant hyperplasia, cancer, internal endometriosis. sarcoma, etc. internal endometriosis. The prognosis of uterine adenomyosis seems favorable if, after recovery has been established, no relapses occur within a five-year period.
A positive point in this regard is also the fact that during this period there is no resumption of pain in the pelvic area and no other characteristic symptoms are observed.
Kyiv National Medical University. Bogomolets, specialty - “General Medicine”. Skip to internal endometriosis content. Forms Complications and consequences Diagnostics What needs to be examined? Treatment Who should I contact?
Additional information about treatment Prevention Prognosis Latest research. Internal endometriosis Adenomyosis of the uterus Symptoms of adenomyosis of the uterus manifest themselves primarily in the form of heavy and prolonged bleeding during the monthly cycle. Adenomyosis of the uterine body Adenomyosis of the uterine body, also called endometriosis of the uterine body, is a form of this disease that is characterized by echo signs of heterotopic, abnormally located, pathological foci of the myometrium.
Adenomyosis of the cervix Adenomyosis of the cervix, like other forms of endometriotic lesions, is characterized by a pathological spread of mucosal cells in the tissue separating the endometrium and myometrium. Why is uterine adenomyosis dangerous? Diagnosis of uterine adenomyosis Diagnosis of uterine adenomyosis involves, first of all, a gynecological examination of the genital organs, which boils down to an examination using mirrors to see if the ligaments of the knee joint are fused with the help of a colposcope - an optical device that provides multiple magnification when examining the cervix.
Echosigns of uterine adenomyosis One of the widespread, as well as the most effective and efficient types of echography in gynecology is the method of transvaginal ultrasound.
Uterine adenomyosis on ultrasound Currently, to detect gynecological diseases, methods are used to directly study tissue fragments from the walls of the uterus, vagina and internal endometriosis.
X-ray of the uterus and ovaries. The course is 1.5 months. From the 15th day of the cycle, add 2 tbsp to the collection. Dear Yulia Evgenievna, please help. Natalya is writing to you, 46 years old, Ukraine. I suffer from sinusitis and tonsillitis. Also VSD of the hypertensive type. But I am more concerned about gynecology, according to ultrasound - fibroadenomyosis. I didn’t give birth, my periods lasted for days, and at the end I was spotty for a few days. I feel very bad 10 days before my period. I was prescribed Epigalin, but because of my stomach I couldn’t take it.
Please help me, how to treat adenomyosis? Try to follow a proper diet. The main thing is warm, light food in small portions; exclusion of coarse fiber from fresh vegetables; medicinal oatmeal and buckwheat jelly every day; and the stomach does not “object” to herbs. Leave for 3 weeks in a dark place at room temperature, shake occasionally. Drink 30 drops 4 times a day, half an hour before meals.
Course - 2 months, break 14 internal endometriosis and repeat the course. Conduct at least 3 courses per year. Blue cyanosis - 1, Baikal Scutellaria - 1; Meadowsweet internal endometriosis- 2, Knotweed - 2, Loosestrife - 1, Walnut leaf - 1, Raspberry leaf - 1, Red rowan fruit - 2. Simmer over low heat or boiling water under the lid for 15 minutes.
Drink 0.0 ml 3 times a day before meals, in small sips. Hog Queen and Red Brush. The regimen for taking Borovaya Uterus and Red Brush consists of 4 short cycles of 2 weeks each, with a break of 1 week between them. The herbal infusion is prepared in an enamel bowl in a water bath. Cool, echo signs. strain, squeeze out the remainder.
Add herbs to portions of infusion according to Art. Or drink with a little honey. Irrigation with Comfrey root. Pour a glass of boiling water over the roots again and leave for half an hour. For irrigation, 0 ml of warm solution is required. Douche according to all the rules, filling a 0 ml syringe or rubber bulb with the solution.
Lie down in the bathtub with your legs on the side in the posture of a woman in labor and inject the solution in portions, holding each for minutes. At the end of the procedure, soak the cotton-gauze swab generously and leave it overnight.
Preparation and storage
I want to help my mom! She is 54 years old, we cannot understand what is happening to her. In the inner year, she began to have a change in mood, tearfulness, a strong heartbeat, and dizziness, ear stuffiness. We at first attributed it to hormones, she began to develop echo signs. And they calmed her down. She finally went for treatment to a neuropsychiatric clinic, where she received injections, pills and an IV.
For about six months she walked like a normal person. Then it all started again echo signs. she went again, only this time it didn’t really help. One day is normal, two days I’m in some kind of panic. He takes anti-panic pills and his little toe hurts a lot. She keeps complaining about some bad thoughts, which ones specifically, and doesn’t say that she has a blocked ear, so she’s nervous. My sister and I support it as best we can.
And we scold her with a whip so that she pulls herself together, that everything is fine with her, it’s just hormones, we need to learn to live with it, that all women live with it and everything is fine with them! And with gingerbread - we regret it. Now we scold her more because she behaves like a child, she says that she is bored. internal, How else can I describe it? Endometriosis, which women have already approached you with this situation? What medicinal drink should I give her to make her feel better? endometriosis
If the mother does not have her period and the bleeding has stopped completely, then she has a pathological menopause, which already requires treatment! I don’t know what they gave her in neurology, I would immediately give her estrogen. The fall in estrogen in many women is associated with depression, outbreaks of echo signs of internal endometriosis or tearfulness; vascular crises and even heart attacks. Feel free to add Feminal contraindications - endometrial hyperplasia and tincture of Scutellaria baicalensis root, write 2 weeks after the start of use.
While the Skullcap tincture is being prepared, give mom blood-red hawthorn tincture, 30 drops, three times a day. Drink as above, but with water. We'll all be in menopause there! My name is Olga, I am 59 years old, height - cm, weight - 82 kg. Today the main problem is the thyroid gland. I am turning to you for help. I want to try herbal treatment before deciding to have another operation. I really don’t want to, but the endocrinologist recommends treatment with radioactive iodine or a repeat operation to completely remove the thyroid gland, echo signs of internal endometriosis .
After several TAB - manifest thyrotoxicosis, surgery is recommended. In the postoperative period she took eutirox, 5 mcg. Cancellation of the drug in the city. There is a goitrogenic effect of thyreostatics in the city. Nodules appeared, first one, this year the second.
Impaired carbohydrate tolerance. After 40 years, I began to gain weight. Beautiful hairstyles for girls 10 years old with red dots of different sizes appeared on the body.
The joints on my fingers began to hurt and became somewhat deformed. My back hurts in the echo-signs of internal endometriosis, I can cope with a massage in the lumbar-sacral area, it radiates to my left leg. A separate problem with hair was always not very pleasing, only in the first pregnancy with echo signs of internal endometriosis, menopause was simply a disaster.
My mother had a goiter after she gave birth to me, maybe this had an effect, my relatives have normal hair. Condition after right hemithyroidectomy. The residual volume of gland tissue is 31.16 cm3. Nodular formations of the left lobe of the gastrointestinal tract, requiring dynamic control: In dynamics from Blood test for hormones Blood test for hormones from The stomach and right side hurt less, but there was pain on the left and there was some unusual smell of endometriosis in the urine.
I reduced the dose of antihypertensive pills, sometimes I didn’t take them at all, since my blood pressure was normal. I tried a decoction of the roots of Skullcap, internal echo signs - my head became worse. Now I am again taking 5 mg of Carbimazole and a tincture of Cinquefoil and a decoction of Kalgan roots. HD stage 1, risk 3.
The cardiac cavities and myocardial thickness are within normal limits. Consolidation of the walls of the ascending section of the ao. Moderately pronounced, marginal compaction of the AoC valves without dysfunction. Moderate compaction of the MV leaflets with 1st degree regurgitation, insignificant in volume. TC regurgitation of the 1st degree, insignificant in volume. Compared with ultrasound from Signs of stress on the left ventricle. Echoscopically, endometriosis of moderate hepatomegaly due to the left lobe, diffuse changes in the echostructure of the liver, such as fatty hepatosis, compaction of the walls of the gallbladder, inhomogeneous contents of the gallbladder, polyps of the gallbladder, probably cholesterous, diffuse changes in the echostructure of the pancreas.
Two single small lesions remain in the right and left lobes of the liver, probably hemangiomas differential. Signs of chronic cholecystitis with thick sediment in the lumen of the gallbladder. Diffuse dystrophic changes in the pancreatic parenchyma of the type of fatty degeneration and atrophy with an increase from the city. Multiple fibroids of the uterine body with moderate degenerative changes in myomatous internal endometriosis without significant dynamics according to ultrasound from braiding easily and beautifully. Echosigns of physiological serozometers of small sizes.
The echo picture of the M-echo and the single right ovary corresponds to the duration of postmenopause. Degenerative-dystrophic changes in the lumbosacral spine. Signs of hemangioma of the L1, L2 vertebral bodies. Infiltrative and focal changes in the lungs are not detected. Heart and aorta without if the child is clubfoot. P-signs of widespread osteochondrosis of the thoracic spine.
We need to fight for the thyroid gland! Now we are taking on it, the liver, adjusting the pressure and slightly influencing the metabolism of minerals. Elecampane tall - 1, Wheatgrass creeping - 2; common hop cones - 1.5, hill solyanka - 2, motherwort - 3, common lilac flowers - 3, medium chickweed - 3, European rosewort - 3. Full course - 2 months. About control analysis for hormones. I understood correctly, Olga, that you took the last test for them 4.
Then control TSH, T4 st. Is it possible to suppress it with herbs? Write what worries the person most: And prepare the herbs like this. echo signs of internal. Drink drops diluted in a tablespoon of water 3 times a day, before meals. Baikal Scutellaria - 1, Siberian Shiksha - 1, blood-red hawthorn fruits - 2, Mistletoe - 1 tsp.
How to choose a lipstick tone, please choose a treatment. I would like to improve digestion and the state of the nervous system; echo signs of internal treatment have not yet produced much results. I have a tendency to feel anxious lately and it easily turns into panic. Internal endometriosis 39 years old, height - cm, weight 45 - kg.
During pregnancy, the weight increased by about 60 kg for a year and stayed there for a year until I started getting nervous and lost weight due to stress. The temperature can be below 36, approximately 10 days before the start of the cycle it stays at 37.1 and occasionally gets higher.
When lying on your side, your nose gets stuffy. As a result of the examination, internal hemorrhoidal colitis was also revealed. She had a colonoscopy 2 years ago and an FGDS. Ultrasound of internal organs without pathology. Conclusion Ultrasound of the uterus and appendages: Ultrasound signs of uterine fibroids along the anterior wall in the lower third, a subserous node on a narrow base of 13 mm. Signs of varicose veins of the small pelvis. Since childhood, chronic tonsillitis, rinsing the tonsils 2 times a year.
There is a tendency to acne mainly in the chin area. Blood was donated on the 1st day of the cycle. General blood test, biochemistry and ESR for endometriosis are normal. The psychotherapist prescribed Alprazolam in August, after about a month of taking the cycle, insomnia began, it lasted for more than a month, withdrawal symptoms also set in, and panic added.
Now I often have shallow sleep, I wake up before 5 o’clock with endometriosis. I don’t take any medications now; I didn’t take any echo signs. Among the herbs, I have been drinking Shiksha according to the general recipe for the third month, 5 times a day at night, Skullcap powder. Fractional meals 5. There is noise in the head, on the right side the sound is more pronounced. As you get nervous, the burning sensation, tingling in the face, and indigestion intensify. The regularity of the endometriosis cycle was not restored 1.5 months when the failure occurred and the duration of the last cycle was 40 days.
My last period is shorter than usual - 6 days instead of the usual 9. I have long noticed that the discharge is often not red, but pink and not abundant. I hope for your help, sincerely, Julia.
You, dear Yulia, definitely need to start with the intestines. In general, it is the root of all problems, but unfortunately for you. During constipation, place a glycerin suppository in the morning and massage the sigmoid area.
Angelica officinalis - 1, Valerian officinalis - 1; Fenugreek - 1, fruits of caraway - 1, coriander - 1, dill - 3, endometriosis - 3, fireweed - 1, echo signs of internal endometriosis. First mechanically, to small pieces, then using a coffee grinder. Remove, add 1 tsp. Drink 0 ml 3 times a day, before meals, warm.
If you don't like the taste, let me know right away. endometriosis. But it is these herbs that relieve flatulence and improve digestion.
Adenomyosis of the uterus - diffuse and nodular, symptoms and signs, treatment algorithm, folk remedies
Of course, there are signs of endometriosis. For now, let's try local treatment. Borovaya uterus - 1.5, Chamomile pharmaceutical echoprzinaki 2, Melilot officinalis tears of the meniscus according to stoller 2. Strain, squeeze, add to 0 ml, pour in 1 hour. Good afternoon, internal endometriosis, please, what herbs should I take for chronic lymphocytic leukemia? I am 46 years old, I have internal CLL, I was not prescribed chemotherapy.
The hematologist advises not to start chemotherapy yet. I would like some advice on herbal treatment. I believe that if the ESR is not higher than 25, there are no blast forms, chemotherapy will wait. And we use a wonderful herb from which drugs for the treatment of leukemia are made - Blue Periwinkle or Lesser Periwinkle. The remaining herbs will increase the stress threshold, rebuild the immune system, make you calmer and stop the growth of the lymphocyte lineage.
Tincture of Euphorbia pallas root. Start with 1 drop 3 times a day before meals, dosing with an eye dropper. Drop into 50.0 ml of water or milk. Starting with 10 drops, increase the amount of water to 70.0 ml. Every day you need to add 1 echosign for each dose and thus reach 20 drops 3 times a day.
Starting from the next day, start reducing, removing 1 drop from each dose. Complete the course with 1 drop, three times a day. Take a break for 14 days, repeat the course if necessary. Baikal skullcap - 1, echo signs of internal endometriosis. Naked licorice - 1 hour. Best wishes, Natalya, see you! You have been assigned the SHIELD-1 code for quick exchange of letters!
It started last January with stopping breathing for a few seconds. It happened again in March and May. In May, an EEG was done - epileptiform activity in the right temporo-parietal-occipital region. MRI shows slight asymmetry of endomctriosis of the horns at the level of the heads of the hippocampus.
MRA - without internal endometriosis. In June, the deterioration began, attacks with respiratory arrest and drooling appeared. Attacks occur during sleep, either when falling asleep, or in the morning. We started taking Depakine Chronosphere. There were no echoes of the month echo signs of internal endometriosis at the minimum dosage. The dosage was increased to the maximum. At the same time, they started taking Shiksha. Three weeks were treated for foot hyperkeratosis attacks.
Then again after a week or two. They donated blood for concentration, it was increased. They told me to reduce Depakine and add Keppra. I really don’t want to add yet. We take Shiksha for months on how to choose a lipstick tone. Could you please tell me if I could add any other herbs?
She also suffers from nocturnal enuresis. Before Shiksha, sowing on SGB, since May, I was peeing almost every night, now less, but still. And she is very inattentive.
He writes and constantly misses letters. Probably also due to illness. The girl is probably very impressionable and emotional, hence the enuresis. But now, don’t let us drink after 18:00, drink the entire daily allowance of water, juices and other internal endometriosis before. The daily allowance for an 8-year-old child is 1.0 liter. The girl is already big, there are echo signs for her to train her bladder under your guidance. Learn to hold urine, but urinate as soon as the urge appears. If she is in school, warn the teacher to let the child out as soon as she raises her hand.
You can do sitz baths. Pour hot water into one basin and cold water into another. Sit in each for literally seconds. To begin with, 5 times are enough, gradually increase the time to 15 seconds, and the number of basin changes to Siberian Shikshu should be continued for up to six months WITHOUT a break and add such herbs.
Valerian officinalis - 1 dec. Internal endometriosis 50.0 ml 4 times a day, echo signs of food, warm. Course - 2 months. If you flatly refuse Keppra, I will not agree with this. But try giving calming herbs through the nose. This is a direct path to subcortical structures. Pour the dry herb, crushed to 3 mm, with unrefined vegetable oil 1: Stir, not allowing the oil to boil, for hours. Internally in the refrigerator, warm up the required amount before use.
Drip in a reclining position with your head turned to one side, 5 drops, slowly, 4 times a day. Course - 3 weeks, break. Hello, please tell me, is there anything else that can be done to prolong life at least a little or is there nothing else that can be done? A 67-year-old relative has stage 4 cancer. In January of this year, the rectum was removed; there were metastases. I recently suffered a pulmonary embolism and was miraculously saved.
It was a blood clot breaking off from metastases in the lung. Now I have been discharged home, under the supervision of an oncologist. The oncologist said that there would be no treatment, my heart was very weak. He only advised the hospice and to buy a special pillow so that when he starts to choke, he can breathe with. All hope was lost, the patient inside was really hoping for some kind of treatment. The person has suffered so much that it is impossible to refuse him help; it is very cruel and unprofessional. You can always give moral support and advice. Hospice is an option for homeless or lonely people who have no one to care for.
For such patients, there is also alternative care in the form of small specialized hospitals and traveling oncologists. In all other cases:.
The oncologist must provide adequate pain relief. At the beginning it is Tramadol, and then the most modern narcotic drugs, which are impregnated with Fendivia self-adhesive patches. Pain relief alone can prolong a person’s life! The oncologist is obliged to provide both observation at home and the necessary procedures, including IV drips.
Internal endometriosis, slow down the growth of metastases, improve the mood and condition of the heart, liver, blood; raise hemoglobin, reduce swelling, lower or increase blood pressure, cope with constipation or diarrhea, and much more! And even take your mind off the problem by preparing a collection for yourself.
The main collection, taking into account thromboembolism, if he drinks Warfarin, the collection is the same. Internal endometriosis Baikal - 1, Rhodiola rosea - 1 dec. Drink 0 ml in the morning, sips; and another 0 ml 2 times a day, before meals. The course so far is 1.5 months. If you are ready, send a scan of your cardiology extract to resolve the issue of using poisons. I have stage 1 hypertension, I am at the very beginning of the disease. I have insomnia and loss of energy. Apparently, I'm 49 years old and going through menopause. Can I use golden or maral root in combination with motherwort or other blood pressure lowering herbs?
Well, this is too simple a solution and hardly correct. For the selection of herbs, pressure numbers are very important, Lena, or rather the numbers when it jumps. Let's start with a survey. Why immediately menopause? Scutellaria baicalensis Sweet clover officinalis flowers Blood-red hawthorn Melissa officinalis Meadowsweet.
Drink 70.0 ml 3 times a day before meals, in small sips. The course is 1 month for now. Colonoscopy - everything is clear. The stomach is also fine.
The inferior vena cava is compressed, its lumen at the level of the pathological formation is not clearly visible. The intrahepatic bile ducts are not dilated. All other organs are clean. Exclude hepatocellular carcinoma. Externally, the liver is enlarged; manicure with seashells photo has lost weight. There is swelling in the legs.
Endometoiosis veins on the abdomen. They said that the manager would decide whether to hire us or not. I hope very much for your help. We would like to try purified kerosene. More endometriosis I prepared a collection of 16 herbs. In addition to the Cat's Paw, I found it. The echo sign eats everything except meat and spicy foods, more vegetables and dried fruits, internal. greenery
Drinks Chaga for 2 weeks. He started drinking quail eggs. Now we want to try propolis and beet juice. Tell me, what else can we do to heal? But I categorically reject kerosene.
Judging by the description, the liver is decompensated and its neutralizing function is suffering. The consequences of endometriosis from kerosene are unpredictable, but it is possible to take Todicamp by drip. Moreover, I want to warn you right away, Nastya! Bleeding from the esophageal veins may open at any moment: If there is no jaundice, a collection of 16 herbs can be used, but it is too general. Your father already has signs of heart failure and may have night attacks internal. Now we need to think about...
When the raw materials run out, I will give other herbs for Endometriosis spring, Gorse, Kuril tea. Now complete it. Tincture of Scutellaria Baikal root. Drink 25 drops three times a day. To remove alcohol, you need to drip the tincture into 15.0 ml of slightly cooled boiling water at about 70 degrees and drink internal echo signs for 15 minutes.
Remove internal endometriosis to .0 ml with hot water and strain. Place the cake in a gauze cloth, moisten it in a warm broth and fix it on the liver area for thirty to forty minutes, 2 times a day. Course - 3 weeks. For shortness of breath and tachycardia, give 30 drops of Motherwort tincture and, after 30 minutes, 10 drops of Lantoside.
Please help me with the following problem. I have different kinds of fears. Mainly socially oriented. Tests did not reveal any organic brain lesions.
And the fact is that I understand the senselessness of these obsessive fears and concerns, but I can’t do absolutely anything about it. The doctor prescribed me the antidepressant Fluoxetine, I did not feel any good effects, then another doctor prescribed Prozac. He helped for a short time, and then the fears returned again. All these symptoms of endometriosis cause me great discomfort, to say the least.
That’s why I decided to write to you, as an excellent specialist, in the hope of at least some relief. Whatever diagnosis your respected psychiatrists give you, you can use echoprinzacks internal resources, your brain.
And it’s very good that you have criticism of your condition. It has long been said and proven that only a healthy mind is present in a healthy body.
And, if you are physically healthy, you need to go in for sports, which will immediately improve your condition. The feeling of muscular joy drives away both the blues and fears and uncertainty. It will be given to you by endorphins - joy hormones and testosterone. Both are produced when the muscles are stressed! Our body has rich internal resources, mood regulation centers.
First of all, this is the subcortex, the ancient brain. You, like many modern people, have lost the connection between the subcortex and the brain. Aromas have a powerful genetic influence on the subcortex; with their help, a person can control it.
A joyful mood is created by essential oils of Lavender, Lemon, Orange, Juniper, Pine, Palmarosa. It is enough to have an aroma lamp at home, or wear an aroma medallion, or simply inhale them from the palms of your hands to take your mind off fear and loneliness.
It is a known fact that aromas also increase potency. There is food against the blues and fears: There is wine treatment, enotherapy. But there should be a person next to you whom you trust and who can immediately switch you to another wave. This is a Friend, your girlfriend, a professional psychotherapist, a priest. Herbs, of course, will slow you down and make the feeling of fear less acute. But only one uterine fibroid 6 weeks of general health systems will help you completely get rid of fears from your head.
I suggest you familiarize yourself with some and endometriosis something for. Wanderer program, holotropic therapy, Nishi system, Ednometriosis. Roots of Scutellaria baicalensis - 1, Valerian officinalis - 1; fruits of blood-red hawthorn - 2, St. John's wort - 1.5, meadowsweet - 2, black currant leaf - 1, common toadflax - endometriosis dec.
Drink 0.0 ml 3 times a day before meals in small sips. Course - from 1.5 months, change of herbs. It is a natural anxiolytic that reduces the degree of anxiety of internal endometriosis, improves sleep, reduces headaches and tension, and activates the movement of cerebrospinal fluid; It has mild diuretic effects, and at the same time contains a good vitamin-mineral complex. The raw materials are represented by twigs and a small scattering of needle-like leaves.
Make and drink it, just like a prescription for internal endometriosis, separately from other herbs. Do not remove the herb from the decoction; store the decoction in the refrigerator.
It is convenient to pour out a volume of about 0.0 ml in the morning and drink a sip at least once a day. Repeat daily until the decoction is gone. Then refill the same raw material with 0 ml of water and prepare in the same way. Cook the broth in this way until it becomes pale 3 times and only then use new raw materials. The course is 4 months without a break. I will try to briefly tell you my painful story. Over the years, acne started appearing out of nowhere. Not the whole face, endometriosis is spotty, pieces of internal endometriosis are on the face, the cycle began to float, echo signs. delays.
I went to doctors for a long time, prescribed hormone pills, but did not take a hormone test. Then I went to see my relative, she is a doctor, she finally took the hormones, it turned out that the male hormone was elevated, I don’t remember which one exactly, again I chose more gentle hormonal pills, Lindinet I got tired of being stuffed with edometriosis pills and quit again.
And then again there is a lot of stress, 2 months pass and acne appears again. I went and took hormones 1 how to quickly pump up your calves echo signs phase I will write the result at the end.
The doctor again recommends taking hormones to “put to sleep” the ovaries and “wake up” their internal endometriosis when I plan a pregnancy. Since I’m diligently resisting internal endometriosis, I suggested taking Time Factor Vitamins for a new cycle. He says that this is how my body reacts to severe stress: I wrote a thesis, defended myself at the university, had an operation, and every time my legs hurt a lot at the bottom.
After the failure, hormones again. I really don’t want to take pills, I really want to get rid of the problem, but enchometriosis is a consequence. I started drinking Peppermint from the pharmacy, it helps a little, but I think pharmacy herbs are not entirely effective.
Is it possible to correct my problem with the help of herbs? Katya, you are paying maximum echopriseaki to acne of internal endometriosis, and I am interested in your monthly estradiol of the first, follicular phase, ultrasound in the last third of your cycle and the period after discontinuation of coke. You have read my thoughts about the quality of pharmaceutical herbs, I will be happy to offer ours, all on the website in the Shop section.
Peppermint tea made from 20.0 grams of peppermint per 1 liter of water will really reduce echogenicity, but this is not enough. You will need Fenugreek hay Alfalfa Internally perforated Meadow shootInternal endometriosis hilly Scutellaria baicalensis or Fireweed angustifolia echo signs. Hello, I beg you, please answer the question. What viruses and bacteria can cause a temperature of over 37?
So far we have found Klebsiella 10 to 7 degree and Acinetobacter baumania 10 to 8 degree in the intestines. Cytomegalovirus was found in the blood,2; Epstein-Barr virus 22.3.
Please tell me, could this be the reason for this condition? Maybe some other tests should be checked? I'm sure echo signs of internal endometriosis that you have a pathological menopause with possible hyperthyroidism.
But Veutrenny insists on the viral version and has already bought something that does not have the good antiviral effects that are attributed to these drugs. Tincture of the herb Internal kopeechnikova. Internal Baikal - 1; Greater celandine - 1 hour. We need tests for echo signs of internal endometriosis and the DNA of these viruses. They will absolutely confirm or deny the presence of the virus in the body. The type of tumor is moderately differentiated carcinoma. Start with a tincture of red fly agaric in a “slide” pattern.
It is a strong antitumor mushroom with analgesic and hematopoietic effects. The choice of herbs is not so clear. The first metastases occur nearby, in the small pelvis, and only then distant ones. You need to know all this. Drink according to haircuts for thin and oily hair, go through the hills and, based on the results, switch to a stronger tincture of Djungarian Aconite or a less strong Hemlock.
What is the name of the doctor for hair on the head - do not stop antitumor therapy for a single day, with the exception of 2-week breaks.
Baikal skullcap - 1, Marsh cinquefoil - 1; Saussurea willow - 1 dec. Remove, add 1 hour at a time. Course - 2 or more months. Local treatment is mandatory, especially if the tumor has affected the pelvic peritoneum. Mix the tincture and castor oil 1: I want to ask you for help.
My husband is 69 years old, he was diagnosed this year: He categorically refused therapeutic help. Over the course of three years, the condition did not change much, but recently there has been severe weakness, shingles-type rashes on the skin, severe itching, like valves in the veins, very weakened immunity.
The last internal tests were taken in August. I ask you to recommend herbal treatment to improve the condition of this disease.
I sympathize very much, the disease is complex and almost always endomntriosis is caused by the activation of all viruses, especially herpetic ones. Therefore, we will take this into account in the diagram. Tincture of the herb Lespedeza kopeechnikova has a strong antiviral effect. Use externally, extinguishing rashes twice a day. To remove alcohol, drop the tincture into 15.0 ml of slightly cooled boiling water at about 70 degrees and drink after 15 minutes.
During this time, the alcohol simply evaporates, leaving everything useful in place. Eleutherococcus senticosus - 1 hour. Drink 0.0 ml in the morning and at lunch; and before dinner another 50.0 ml. When the temperature rises, add 2 tbsp to the mixture. In the morning, heat until steam appears, wrap and leave until completely cool.
An infusion of the herb Veronica officinalis and a mash prepared from Starch echo signs of internal cold water will help cope with itching.
I come to you for help and advice, if you allow. Once upon a time I already wrote about an oatmeal mask for the problem, but a lot has changed and a lot has gone through since then.
At that time they did not agree to the operation, echo signs of internal endometriosis; God probably took it away. At age 7, endometriosis had the first photosensitivity epileptic attack. During all this time, attacks recurred once a year or once every 2 years, usually due to photosensitivity, so they did not take AEDs. This spring, after a serious car accident and problems at the institute, I received 2 attacks in a row, a week apart.
Although the first one was on a very sunny day, with the whitest snow at the dacha, again photosensitivity. This is a very alarming factor for us; we really don’t want to take AEDs, although epileptologists insist. Problems with alcohol began. And if this happens, then binge for a day. He himself still understands that something needs to be done. There was an encoding in February, but in June it failed, and since then there has always been a failure once a month. I am 48 years old and have not had my period for a year now.
According to endometriosis, endometriosis is postmenopausal. I periodically take advertised medications, but echo signs of internal endometriosis. Maybe you can suggest a collection of herbs for the manifestations of menopause.
There is also tachycardia, insomnia, and hot flashes. But, apparently, due to the drugs, the symptoms are smoothed out.
Key tags: Echosigns, internal, endometriosis
Collapse
Ultrasound examination is one of the most commonly used diagnostic methods in gynecology. It can be performed transvaginally and transabdominally, but the first method for diseases of the reproductive system is more informative. This diagnostic method is also used if endometriosis is suspected. But is such a study really effective and informative, and is endometriosis reliably visible on ultrasound?
Indications
In what cases is such a procedure necessary? Strictly speaking, the very suspicion of endometriosis raised by a doctor is an indication for such a diagnosis. However, in the case of endometriosis, ultrasound is not as informative as in many other diseases (for example, fibroids, cysts). If neoplasms are visually visible on ultrasound, this often does not happen with adenomyosis. This is due to the fact that the changes may be quite minor.
So, at the first and second stages of the development of the disease, when there are only small isolated foci of insignificant depth, ultrasound examination is completely useless, since it almost certainly will not show them. The only reliable way to make a diagnosis at this stage is to do a magnetic resonance imaging (MRI) of the pelvic organs, which will give a reliable result. 
However, ultrasound diagnosis is prescribed if such a diagnosis is suspected in the vast majority of cases. This is due to the hormone-dependent nature of the process. It develops with an increased content of estrogen, as a result of which active tissue growth begins, as cells divide excessively quickly. Against this background, various other pathologies and neoplasms may arise. Therefore, even if signs of endometriosis are not visible on ultrasound, it allows you to diagnose the presence of other neoplasms.
Preparation
No special preparation is required for this process. The only peculiarity is that it must be done strictly with a full bladder. Thanks to this, a position of the organs is achieved in which maximum information content of the study is possible. To achieve this effect, it is recommended to drink half a liter of liquid a few hours before the test and not empty your bladder until you leave the doctor’s office.
Time spending
Since the endometrium is hormone-dependent, its thickness and features change throughout the menstrual cycle. Therefore, it is very important to conduct gynecological ultrasound examinations on the very day of the cycle that the specialist prescribes. In the case of endometriosis, the most favorable days of the cycle are considered to be from the fifth to the seventh, if you count from the first day of menstruation.
It is very important to carry out diagnostics at this time. Therefore, it is necessary to do it, even if residual menstrual bleeding is still present. It should not be carried out during this period only if the bleeding is still severe.
However, sometimes doctors recommend doing several repeated studies in a row in the following cycles. Only in this case will it be possible to accurately confirm or refute the pathology. There is no need to be afraid of this, since ultrasound is a relatively safe procedure that does not have a negative effect on the body. If any treatment was prescribed, then at certain stages of it, studies are also necessary to assess the effectiveness of therapy.
The course of diagnosis and its essence
The operating principle of an ultrasound machine is that different tissues have different permeability to ultrasound. Based on this, one can get an idea of the arrangement of several types of tissues and their nature. Thus, an image of the patient’s internal organs is built on the screen of the ultrasound machine.
To make a diagnosis of endometriosis, it is necessary to place the sensor as close as possible to the area being examined. Therefore, the study is carried out mainly in a transvaginal manner. That is, a sensor located on the handle is inserted into the vagina. The transabdominal method, when the sensor is moved along the peritoneum, is almost completely uninformative in this case, due to its remote position from the study area.
In a doctor's office, a woman undresses to the waist and sits down in a chair. During the procedure, a sensor is inserted into the vagina, and the doctor displays an image of the internal organ on the screen of an ultrasound machine. He examines him and, based on this, makes a conclusion about the presence of endometriosis. The procedure itself takes 10-15 minutes, and the entire stay in the doctor’s office usually takes no more than half an hour.
It is worth remembering that it is impossible to determine endometriosis, especially when it is chronic, with absolute accuracy. But during the study, it is possible to detect other neoplasms, the presence of which is undesirable.
Signs on ultrasound
Is endometriosis visible on ultrasound? As mentioned above, this is not always possible. What exactly does this research show?
- Irregularities and thickening of the endometrium in cases where they are significant enough;
- The vagueness of this layer, for which there can be many reasons;
- Presence of nodes, cysts, neoplasms, etc.;
- Violation of the symmetry of organ walls.
What are the signs of endometriosis on ultrasound? At the first stage of the disease, signs are almost completely absent, with rare exceptions. On the second you can already notice them, on the third and higher, the picture of endometriosis is clear, as in the photo. What are the signs of the process?
- Fine-pointed tissue structure locally, in several areas, or throughout the entire organ;
- Heterogeneous structure of uterine tissue;
- Small focal neoplasms are also present in some cases;
- Sometimes thickening of the endometrium is visible visually, but this is not a typical sign.
Can endometriosis be seen on ultrasound? It all depends on the stage and nature of the disease. But this study is recommended to be carried out regularly for preventive purposes. Therefore, it is worth doing it anyway. This method is one of the main diagnostic tools in gynecology.
Endometriosis of the uterine body is a disease characterized by the pathological process of growth of endometrioid tissue outside the uterine cavity.
Other names for the pathology are internal endometriosis, uterine endometriosis, etc.
Normally, the endometrium lines the inner cavity of the uterus. During fertilization, the function of endometrioid tissue is to retain the embryo in the uterus. If conception does not occur, the endometrium peels off and comes out along with menstrual flow every month.
During the pathological process, endometrial cells move to other pelvic organs, continuing to function there.
Endometriosis of the uterine body in some cases occurs in combination with other diseases - endometrial hyperplasia and.
Causes
The exact cause that contributes to the development of endometriosis has not been established. It is believed that the development of the disease in most cases is provoked by a hereditary factor, that is, a genetic predisposition to the development of endometriosis.
Other factors contributing to the occurrence of pathology:
- curettage of the uterus - according to indications or during artificial termination of pregnancy;
- long-term use of an intrauterine contraceptive device;
- disruption of the natural hormonal balance in the body;
- inflammatory and infectious diseases of the pelvic organs;
- decrease in the body's immune forces.
The following types of disease are distinguished:
- Diffuse (diagnosed in 80% of patients).
- Diffuse nodular (occurs in approximately 10% of women).
- Focal (diagnosed in 7% of cases).
- Nodular (this form occurs in a small proportion of patients - 3%).
Depending on the degree of damage, diffuse endometriosis is divided into stages:
- Stage 1. Adenomyosis affects the submucosa of the internal cavity of the uterus and the transition zone.
- Stage 2. The spread of pathological foci to the myometrium, but they do not reach the outer tissue of the uterus.
- Stage 3. Damage to the entire muscle tissue of the uterus, including damage to pathological cells of the serous membrane of the organ.
- Stage 4. Extension of endometriotic lesions outside the uterus. Localization of lesions on other organs and tissues of the pelvis.
Endometriosis of the uterine body and its symptoms
One of the symptoms of endometriosis of the uterine body is pain. Pain occurs in the lower abdomen, in the lower back. Its intensity depends on the day of the menstrual cycle. The most powerful sensations.
Other signs that may indicate the presence of endometriosis:
- pain during sexual intercourse;
- prolonged menstruation;
- spotting before and after menstruation;
- spontaneous termination of pregnancy in the early stages;
- impossibility of conception, i.e. infertility;
- bright – premenstrual syndrome.
Danger of disease
The danger of the disease is as follows:
- development of anemia due to heavy periods;
- infertility;
- malignancy of endometrioid foci;
- deterioration in general well-being, decreased quality of life.
Is pregnancy possible?
The presence of adenomyosis in most cases prevents natural conception. But there are also cases of pregnancy in the presence of endometriosis of the uterine body, but it is associated with a high risk.
Causes of infertility with endometriosis:
- disruption of the normal functioning of the endometrium in the uterine cavity (an obstacle to embryo implantation);
- inflammatory process in the uterine cavity;
- myometrial dysfunction;
- dysfunction of the ovaries due to hormonal imbalance.
The onset of pregnancy after completing a course of therapy is not a 100% guarantee. If a woman is also diagnosed with infertility after treatment, then IVF is indicated.
Diagnostic methods
Initially, an examination by a gynecologist is carried out. An enlarged uterus may indicate the presence of endometriosis.
However, for an accurate diagnosis, a more detailed examination is necessary:
- Ultrasound examination using the transvaginal method.
- Hysteroscopy and biopsy.
- Laparoscopy.
Treatment methods
Treatment is possible in two ways - medication and surgery.
In the first case, hormonal drugs are prescribed, the purpose of which is:
- elimination of symptoms of the disease;
- reduction of endometrioid lesions;
- normalizing hormonal balance;
- restoration of reproductive function.
Medicines used:
- Gestagens - Duphaston, Norkolut, Visanne.
- Combined oral contraceptives – .
- Gonadotropin-releasing hormone agonists (GnRH A) – , Diferelin.
- Progestogens – Depo-Provera.
- Hormonal IUD (intrauterine device) – .
- Antigonadotropins – Danoval, Danazol.
It should be borne in mind that the effect of drug treatment is often temporary. The disease is prone to relapse, and therefore there is a high probability that it will develop again over time.
This therapy is aimed primarily at women planning pregnancy in the near future.
In combination with hormones, painkillers and anti-inflammatory drugs, immunomodulators, and vitamins are prescribed.
If adenomyosis is asymptomatic and stage 1 or 2 is diagnosed, then a wait-and-see approach makes sense. The woman is under the supervision of a doctor, hormones are not prescribed, and physiotherapy, immunostimulating drugs, and anti-inflammatory drugs are prescribed to strengthen the body.
The duration of hormonal therapy is from three months to six months or more. If there is no effectiveness, surgery is indicated.
Watch the video about the treatment of endometriosis:
Surgical intervention
The method of the operation and its volume depend directly on the form and stage of endometriosis, and the woman’s desire to become a mother in the future.
Organ-conserving surgery is performed by laparoscopy. During the operation, endometriotic nodes are removed, as a result of which the walls of the uterus are restored. The disadvantage of this technique is the extremely high risk of relapse of the disease.
The last resort for surgical treatment is hysterectomy, that is, complete removal of the uterus. Indicated as a result of late diagnosis of adenomyosis and its advanced forms.
Indications for hysterectomy for endometriosis:
- lack of effectiveness of hormone treatment;
- intense pain;
- uterine bleeding, which causes severe anemia;
- the presence, in parallel with adenomyosis, of endometrial hyperplasia, uterine fibroids and other pathologies;
- the patient’s reluctance to give birth in the future;
- suspicion of the development of malignant cells.
Prevention measures
The following recommendations will help prevent the development of endometriosis of the uterine body or its relapses:
- using contraception to avoid the need for abortions;
- eliminating excess weight;
- prevention of stressful situations;
- increasing the body's immune forces;
- quitting smoking, alcohol;
- healthy eating.
Endometriosis of the uterine body or adenomyosis is not a death sentence. If you monitor your women's health and consult a doctor in a timely manner, you can identify pathology in the early stages, which will allow you to successfully complete a course of therapy. And, on the contrary, the neglect of the disease leads to its further development and bad consequences, which will only have to be eliminated surgically.
Endometrioid disease (endometriosis) is a pathological benign process of growth of tissue similar to the endometrium outside the cavity.
Uterine endometriosis or adenomyosis is the growth and proliferation of endometrial-like tissue in various parts of the muscular layer of the uterine wall.
With adenomyosis, endometrioid “implants”, similar to the glandular and stromal components of the basal layer of the mucosa, are embedded in the myometrium to varying depths, causing deformation and inflammation of the surrounding tissues.
Internal endometriosis Endometriosis of the uterine body - what is it?
Endometriosis of the uterine body, adenomyosis, internal endometriosis, endometriosis of the uterus - all this is the same disease.
Recently, endometriosis of the uterine body is considered as a special, independent variant of endometrioid disease.
Endometriosis of the uterus in the structure of endometriosis.
Adenomyosis in the classification of endometriosis Endometriosis of the uterus: code according to ICD-10
N80.0 Endometriosis of the uterus (adenomyosis)
Causes of the disease
There is still no single point of view on the causes of uterine endometriosis. Since the end of the twentieth century, a significant role has been assigned to genetic factors, i.e. congenital predisposition to the development of the disease.
The key link and trigger of adenomyosis today is considered mechanical damage to the myometrial transition zone(Junctional Zone, JZ).
The transition zone (JZ) or subendometrial myometrium is the border layer of the myometrium located directly under the uterine mucosa. Normally, the thickness of the JZ in women of childbearing age does not exceed 2-8 mm.
It has been proven that during abortions, especially those performed using curettage (curettage), when taking an endometrial biopsy or other gynecological and surgical procedures, the boundary between the endo- and myometrium can be destroyed. This makes it easier for endometrial components to enter and survive in new conditions.
However, further formation and progressive growth of endometriotic foci in the muscular layer of the uterus is possible only against the background of weakening immune control and disruption of the woman’s hormonal status. Endometriosis of the uterus is a complex, multifactorial pathological process.
Mechanism of development of uterine endometriosis
Pathological circle of adenomyosis Risk factors for uterine endometriosis
- Genetic predisposition (“familial” form of endometriosis).
- Curettage of the uterus.
- Long-term use of a contraceptive intrauterine device (IUD).
- Inflammatory processes of the uterine mucosa.
- Immunity impairment: local and/or general.
- Local hormonal imbalance: increased regional synthesis of estrogens (local hyperestrogenism), decreased sensitivity to progesterone in the area of endometriosis.
- Unfavorable environmental and social factors.
- Chronic stress.
There are several types (forms) of adenomyosis:
- Diffuse (up to 80% of cases).
- Diffuse nodular (approximately 10%).
- Focal (up to 7%).
- (until 3%).
When endometrioid cavities form in the myometrium, they speak of cystic endometriosis.
Types of adenomyosis
According to the modern classification (L. V. Adamyan), internal diffuse endometriosis, depending on the depth of the lesion, is divided into 4 degrees (stages):
- Ι degree (stage) of adenomyosis - the pathological process is limited to the submucosa and the transition zone.
- ΙΙ degree (stage) - the process extends to the myometrium, but does not reach the outer (serous) lining of the uterus.
- ΙΙΙ degree (stage) - the entire myometrium is involved in the painful process, right down to the serous membrane of the uterus.
- ΙV degree (stage) - the pathological process extends beyond the uterus, affecting other organs and tissues.
The combination of adenomyosis with external genital endometriosis is observed in 70% of cases.
Stages of adenomyosis Why is endometriosis of the uterus dangerous?
- Decreased quality of life and ability to work.
- Development of severe, life-threatening secondary anemia.
- Infertility.
- Malignancy (malignancy).
The ability of endometrioid lesions to “filter” (infiltrate) into the surrounding tissues, the tendency of their growth in distant organs, the absence of a connective tissue capsule around pathological areas - all this brings uterine endometriosis closer to a tumor process.
The disease is distinguished from a true tumor by the absence of pronounced cellular atypia and the dependence of the clinical manifestations of the disease on menstrual function. Wherein the possibility of malignant degeneration of endometriosis is undoubted.
- Pain in the pelvic area and lower back. In most cases, the intensity of pain is associated with the menstrual cycle: during menstruation it is maximum.
- Painful menstruation (algomenorrhea).
- Painful sexual intercourse (dyspareunia).
- Scanty, brown-chocolate-colored bleeding from the uterus a few days before and after menstruation.
- Prolonged heavy menstruation, up to cyclic uterine bleeding (hyperpolymenorrhea) with the occurrence of secondary anemia.
- Miscarriages in early pregnancy.
- Infertility (primary and/or secondary).
- PMS: nervousness, headaches, increased body temperature, sleep disturbances, vegetative-vascular disorders.
Unlike sometimes occurring (periodic) “menstrual” pain, pain with endometriosis of the uterus during menstruation always occurs and is observed regularly for 6 or more months in a row.
Nature of pain:
- pulling, stabbing, cutting... variable; lower abdomen, lower back;
— constant: from weak-moderate to intense.
- worsens on the eve of menstruation;
- pain during menstruation may resemble a picture of an acute abdomen, accompanied by bloating and flatulence.
Clinical symptoms of uterine endometriosis One of the common signs of the disease and the only reason for a patient to see a doctor is infertility. Miscarriage (spontaneous termination of pregnancy, miscarriage) often precedes the development of typical (pain, “chocolate daub,” heavy periods) clinical symptoms of endometriosis.
Pain, although a frequent, but subjective sign of the disease - each woman assesses the intensity and/or significance of the pain syndrome differently.
Sometimes the first sign by which adenomyosis can be suspected is heavy and prolonged periods(hyperpolymenorrhea).
Signs of internal endometriosis Diagnosis of uterine endometriosis
1. Gynecological examinationDuring a bimanual gynecological examination, a clinical sign of adenomyosis may be an increase in the size of the uterus, especially pronounced on the eve of menstruation.
A spherical uterus is a sign of diffuse adenomyosis.
A tuberous uterus is a sign of a nodular form of adenomyosis.
Small forms of adenomyosis (endometrioid lesions
The patient's complaints and routine gynecological examination can only suggest the presence of uterine endometriosis. To make an accurate diagnosis, instrumental studies are needed.
2.Transvaginal ultrasoundEchography (ultrasound) today remains the most accessible and fairly informative method for diagnosing adenomyosis.
When performing an ultrasound using a vaginal sensor in the second half of the menstrual cycle, endometriosis of the uterus is detected
in 90-95% of cases
Optimal timing of ultrasound if adenomyosis is suspected:
- in the second phase of the menstrual cycle, preferably on the eve of menstruation.
- control ultrasound is performed immediately after the end of menstruation.
Clinical ultrasound signs of uterine endometriosis:
Adenomyosis grade 1(minor forms of endometriosis):
- Anechoic tubular zones, up to 1.0 cm in size, located from the endometrium to the myometrium.
- Small, up to 0.2 cm hypo- and anechoic oval-shaped structures in the basal layer of the endometrium.
- Unevenness, jaggedness, ruggedness of the basal layer of the endometrium; other endometrial defects.
- Small (up to 0.3 cm) areas of increased echogenicity in the transition zone of the myometrium.
- Uterine wall thickness: normal, close to normal.
Adenomyosis ΙΙ degree:
- In the subendometrial layer of the myometrium there are zones of increased heterogeneous echogenicity of various sizes containing round anechoic inclusions with a diameter of 0.2-0.5 cm.
- The thickness of the uterine wall is slightly higher than the upper limit of normal.
- The walls of the uterus are thickened unequally, with a difference of up to 0.4 cm or more in relation to each other.
Adenomyosis ΙΙΙ degree:
- The uterus is enlarged.
- The walls of the uterus are thickened unevenly.
- In the myometrium: a zone of increased heterogeneous echogenicity, occupying more than half the thickness of the uterine wall. Bands of high and medium echogenicity.
- In areas of increased echogenicity there are many anechoic inclusions and cavities of various shapes, 2.0 - 4.0 cm in diameter.
- Significant reduction in endometrial thickness.
Nodular, focal adenomyosis:
- A rounded zone of increased echogenicity with small (0.2-0.4 cm) anechoic inclusions or cavities is determined in the uterine wall.
- M-echo deformation (with submucosal location of endometrioid nodes).
- Changes in the size of the uterus and the thickness of the uterine wall depend on the size and number of nodules.
Additional methods for diagnosing uterine endometriosis
CT, hysterosalpingoscopy (graphy) and laparoscopy are not the methods of choice for diagnosing adeomyosis. These studies are carried out according to individual indications.
1.Magnetic resonance imagingMRI is the most accurate method for diagnosing endometrioid disease. But in the case of adenomyosis, the significance of MRI is comparable to transvaginal ultrasound performed on the eve of menstruation.
MRI is prescribed according to individual indications, to exclude/confirm the combination of adenomyosis with various forms of external genital and/or extragenital endometriosis, other types of benign and/or malignant proliferative diseases. Using MRI, the exact localization of endometriotic lesions is determined.
2.CDC – color Doppler mapping.This is a study of the speed of blood flow in the uterus.
Endometrioid heterotopias are avascular formations; no zones of growth of new vessels are detected in them. The resistance index in foci of endometriosis increases as the pathological process becomes more severe.
Allows you to visualize signs of adenomyosis and make a targeted biopsy of suspicious areas.
Hysteroscopic signs of uterine endometriosis:- The uterine cavity is deformed.
- On the pale pink mucosa, dark red crypts are visible - the mouths of endometrioid “passages” of various sizes. They may ooze dark red blood.
Separate diagnostic curettage of the endometrium with further histological examination of the removed tissue to determine uterine endometriosis does not have much diagnostic value (after all, endometriotic lesions are located in the thickness of the myometrium). Curettage under hysteroscopy control is done to identify/exclude the combination of adenomyosis with uterine cancer. This is important for choosing the right tactics for further treatment.
Instrumental diagnosis of uterine endometriosis 4. Surgical hysteroscopy and histology.
Histological verification of adenomyosis is carried out after hysteroresectoscopy. During a minimally invasive endoscopic operation performed through a vaginal approach, endometrial tissue is removed along with a portion of the myometrium. Then the removed tissue is examined under a microscope (histological examination) and an accurate diagnosis is made.
5.Laparoscopy.The “gold standard” for diagnosing external forms of endometriosis
at stage 4 of adenomyosis, laparoscopy remains. This therapeutic and diagnostic operation is carried out by introducing endoscopic equipment into the abdominal cavity through punctures in the abdominal wall.
How to treat uterine endometriosis
Treatment of adenomyosis remains a complex, ambiguous problem, purely individual for each patient, for each specific case of the disease.
Treatment of internal endometriosis Hormonal treatment of uterine endometriosis
Speaking about the effectiveness of hormonal treatment, you need to know that none of the drug therapy regimens leads to a complete cure or eliminates the possibility of relapse of endometriosis.
The effect of hormonal treatment is temporary - after stopping the drugs, the disease may gradually return.
In cases of asymptomatic uterine endometriosis, ultrasound signs of the disease are not an indication for hormonal therapy.
For asymptomatic adenomyosis of 1-2 degrees, a “wait-and-see tactic” is advisable, i.e. the patient does not receive hormonal treatment, but is under close dynamic monitoring. According to indications, restorative and physical therapy, immunocorrection, antioxidant and anti-inflammatory therapy may be prescribed (see below).
Objectives of hormonal therapy:
- Reducing the size of endometriosis lesions.
- Reducing the severity of symptoms of the disease.
- Reducing the risk of surgical and/or repeated surgical intervention.
- Fighting hyperestrogenism, stabilizing hormonal levels.
- Prevention of progression and recurrence of the disease.
- Preservation of fertility (childbearing function).
Drug therapy for uterine endometriosis is primarily aimed at patients interested in future pregnancy.
Hormonal therapy is based on the significant role of endocrine factors in the development of endometrioid disease. It is carried out in the absence of contraindications and side effects. Initially, treatment is prescribed for 3 months. Then its effectiveness is assessed and, if successful, extended for 6-9 months. In case of unsatisfactory results, drug replacement or surgical treatment is indicated.
First-stage hormonal drugs for uterine endometriosis1.Oral progestogens.
Monotherapy with progesterone-like drugs is considered quite effective with adenomyosis. Progestogens are prescribed continuously, in fairly high doses, for 3-6 or more months. Their incidence of side effects is significantly lower than that of GnRH A (see below).
Tablets for endometriosis of the uterus
2.COCs – combined oral contraceptives.
They are used to reduce pain (relief of pelvic pain) associated with uterine endometriosis in women who are not interested in pregnancy. For dysmenorrhea (hyperpolymenorrhea), COCs are prescribed continuously. The effectiveness of these drugs in the treatment of endometriosis is low. More often they are prescribed as maintenance postoperative therapy to prevent relapse of the disease.
The drug of choice for the treatment of endometriosis is considered to be.
COC drugs are contraindicated in women with adenomyosis and migraines.
Second-stage hormonal drugs for uterine endometriosis1. Gonadotropin-releasing hormone agonists (GnRH A)
/consultation with a doctor is required/
| Name A-GnRH | Reception scheme (a course of treatment up to 6 months) | Possible side effects |
| Goserelin (Zoladex) | 3.6 mg each subcutaneously Once every 28 days | Hot flashes, sweating, vaginal dryness, headache, mood lability, osteoporosis, negative impact on the cardiovascular system, liver. |
| Leuprorelin (Lucrine depot) | 3.75 mg each intramuscularly Once every 28 days |
Same |
| Buserelin | 3.75 mg each intramuscularly Once every 28 days. Or 150 mcg each, injection into each nostril 3 times a day. |
Same |
| Triptorelin (Diferelin, Decapeptyl depot) | 3.75 mg each intramuscularly Once every 28 days. |
Same |
Treatment with GnRH A drugs is considered the “gold standard” of drug therapy for endometriosis.
GnRH A is used to treat severe forms of uterine endometriosis. While taking these medications, women stop menstruation (a “medical pseudomenopause” occurs). After discontinuation of the drug, the menstrual cycle is restored on its own. The recurrence rate of endometriosis 5 years after completion of the GnRH A course reaches approximately 50%.
Long-term (more than 6 months) therapy with GnRH A is possible, but always under the guise of “return” hormone replacement therapy (HRT) with estrogen and progesterone. This method of treating endometriosis is considered quite effective.
2. Parenteral progestogens.
- Depot medroxyprogesterone acetate (Depo-Provera) – 104 mg injected subcutaneously every 12 weeks.
The effectiveness of parenteral progestogens is comparable to GnRH A. But long-term use of both is undesirable due to the negative impact on bone mineral density (risk of osteoporosis).
A significant drawback of treatment with progestogens is breakthrough bleeding (dysfunctional uterine bleeding that occurs in response to progesterone stimulation of the endometrium). Therefore, it is more advisable to introduce therapeutic agents directly into the uterus, in the form of an IUD.
3. Hormonal intrauterine device LNG-IUD Mirena:
The levonorgestrel-releasing intrauterine system is recommended for the treatment of adenomyosis in women who are not interested in pregnancy.
High efficiency of Mirena proven by the agency of the Ministry of Health and Social Affairs. USFDA services.
Duration of use is 5 years.
4. Antigonadotropins for the treatment of endometriosis:
- Gestrinone (Nemestran)
- Danazol (Danol, Danoval)
These drugs are currently rarely used due to frequent side effects caused by androgenic influence (acne, seborrhea, male pattern hair growth, weight gain, change in voice tone, shrinkage of mammary glands, etc.)
Ultrasound of the pelvic organs - uterus and ovaries
Ultrasound examination of the uterus
The uterus is pear-shaped. It distinguishes between the neck, body and bottom. The uterus may be deviated from the median plane or rotated along the longitudinal axis.
Dimensions of the uterine body (mm) in women of reproductive age, depending on previous pregnancies and childbirth:
group of patients length of p.s.r. width
no pregnancies 45 ± 3 34 ± 1 46 ± 4
those who were pregnant but did not give birth 51 ± 3 37 ± 1 50 ± 5
those who gave birth 58 ± 3 40 ± 2 54 ± 6
Biometry of the uterus includes determining three dimensions of the uterine body: length, anteroposterior size and width. If necessary, measure the length of the cervix.
The size of the uterus in women of reproductive age varies widely and depends on previous pregnancies and births. In addition, changes in the size of the uterus were revealed depending on the phase of the menstrual cycle.
In clinical practice, it is generally accepted that the upper limit of normal values for the size of the uterine body in women of reproductive age is. length - 70; width - 60; anterior-posterior size - 42 mm. However, exceeding these dimensions should not automatically be considered pathological. In this case, fibroids, internal endometriosis, malformations, pregnancy, or erroneous inclusion of ovarian tissue in the measurement should be excluded.
An ultrasound examination of the endometrium evaluates its thickness, structure and compliance with the phase of the menstrual cycle.
Measurement of M-echo thickness should be carried out with a longitudinal scan of the uterus with simultaneous visualization of the cervical canal. The maximum value of the anteroposterior dimension of the M-echo is taken as the thickness of the endometrium.
The thickness and structure of the endometrium undergoes significant changes throughout the menstrual cycle (the duration of the cycle is conventionally taken as 28 days).
During the first two days of menstruation (the desquamation stage of the bleeding phase), the M-echo is visualized in the form of a heterogeneous structure of reduced echogenicity, slightly increased sound conductivity, and a thickness of 0.5 - 0.9 cm. A clear layered structure of the endometrium is not observed during this period.
On the 3-4 day of menstruation (the stage of regeneration of the bleeding phase), the M-echo is presented in the form of a formation of increased echogenicity, a small thickness of 0.3 - 0.5 cm.
On days 5-7 of the menstrual cycle (early stage of the proliferation phase), there is a slight thickening of the M-echo up to 0.6 - 0.9 cm, a decrease in echogenicity and an increase in its sound conductivity. During this period, an echo-negative rim with a thickness of about 0.1 cm appears along the periphery of the M-echo.
On days 8-10 of the menstrual cycle (the middle stage of the proliferation phase), a clear hyperechoic structure in the center of the endometrium, about 0.1 cm thick, begins to be determined for the first time, which persists almost until the end of the menstrual cycle. Directly above and below this formation, zones of average echogenicity and sound conductivity, about 0.3 cm thick, are detected. All of these structures are surrounded by a thin (0.1 cm) echo-negative rim. The thickness of the endometrium during this period, including the echo-negative rim, is 0.8 - 1.0 cm.
On days 11-14 of the menstrual cycle (late stage of the proliferation phase), the echographic picture is similar to the previous one, however, between the zone of medium echogenicity and the echo-negative rim, a thin echo-positive structure appears, about 0.1 cm thick. The thickness of the entire endometrium in this phase of the menstrual cycle is 0. 9 - 1.3 cm.
During all subsequent stages of the secretion phase, the M-echo has a similar structure, only a slight thickening is noted.
Thus, on days 15-18 of the menstrual cycle (early stage of the secretion phase), the thickness of the endometrium is 1.0 - 1.6 cm, and on days 19-23 of the menstrual cycle (middle stage of the secretion phase) it reaches maximum values of 1.0 - 2 .1 cm. On days 24-27 (late stage of the secretion phase), the thickness of the endometrium decreases to 1.0 - 1.8 cm.
The identification of individual endometrial structures is currently not yet clear enough. It can be assumed that during the desquamation stage of the bleeding phase, the appearance of the M-echo in the form of a heterogeneous structure is due to some expansion of the uterine cavity, the presence of blood and endometrial fragments in it.
Dynamics of changes in the structure and thickness (cm) of the endometrium during the menstrual cycle:
cycle days thickness
bleeding phase 1 - 2 (desquamation stage) 0.5 - 0.9
3 - 4 (regeneration stage) 0.3 - 0.5
proliferation phase 5 - 7 (early stage) 0.6 - 0.9
8 - 10 (middle stage) 0.8 - 1.0
11 - 14 (late stage) 0.9 - 1.3
secretion phase 15 - 18 (early stage) 1.0 - 1.6
19 - 23 (middle stage) 1.0 - 2
24 - 27 (late stage) 1.0 - 1.8
During the regeneration stage of the bleeding phase, the M-echo is represented only by the walls of the uterine cavity.
An echo-negative rim, which appears on days 5–7 of the menstrual cycle (early stage of the proliferation phase), usually persists until the end of the menstrual cycle. This is probably how the transitional part of the myometrium into the basal layer and the adjacent area of the functional layer of the endometrium are visualized.
From 8 to 10 days of the menstrual cycle, a hyperechoic structure appears in the center of the endometrium. It seems to divide it into two mirror-like equal parts. This acoustic phenomenon occurs as a result of the contact of the surfaces of the layers of the anterior and posterior walls of the endometrium.
On the 11th - 14th day of the menstrual cycle, a thin echopositive structure appears between the zone of medium echogenicity and the echo-negative rim. This way the spongy part of the functional layer of the endometrium adjacent to the basal layer can be visualized.
It should be noted that in some cases, throughout the entire menstrual cycle, the functional layer of the endometrium on the echogram may not be visualized as layered, but have a fairly uniform structure. Apparently, this is due to the individual characteristics of the structure of the endometrium and the quality of the resulting image.
When studying the endometrium in postmenopausal women, special attention should be paid to measuring its thickness. An increase in the thickness of the M-echo of more than 5 mm is considered pathological.
In approximately 10% of cases, a small amount of fluid is found in the uterine cavity, the volume of which is 1 ml. This is due to stenosis of the cervical canal.
Ultrasound examination of the ovaries
Usually, the ovaries are identified quite easily, however, in cases where the search for some reason is difficult, it is necessary to find their landmark - the internal iliac vein.
In reproductive age, the echographic dimensions of the ovaries are on average 30 mm in length, 25 mm in width, 15 mm in thickness. The volume of the ovary normally does not exceed 8 cm3.
However, depending on the phase of the menstrual cycle, their sizes may vary. The largest ovarian sizes are observed in women in the age group from 30 to 49 years.
In the early follicular phase, 10 to 20 primordial follicles begin their development. The bulk of them soon undergoes atretic changes. On average, 5 follicles of them reach the Graafian vesicle stage. From 8 to 12 days it is possible to identify the dominant follicle, which exceeds 15 mm during this period. The development of the remaining follicles stops during this period.
The dominant follicle continues to grow by an average of 2 - 3 mm per day and by the time of ovulation its diameter reaches 18 - 24 mm.
In postmenopause, due to the decline of reproductive function, the size of the ovaries decreases.
Due to the gradual decline of the hormonal function of the ovaries, the presence of single small follicles during the first five years of postmenopause should not be regarded as a pathological process.
After 5 years of menopause, follicles are not detected, and their persistence should cause some concern.
When forming a conclusion, it is necessary to indicate the position and size of the uterus, describe the structure of the myometrium, the thickness and structure of the M-echo; the location and size of the ovaries, their structure and the size of the dominant follicle.
Norms for endometrial thickness
1 - 2 days of the cycle - 0.5 - 0.9 cm
3 - 4 days of the cycle - 0.3 - 0.5 cm
5 - 7 days of the cycle - 0.6 - 0.9 cm
8 - 10 days of the cycle - 0.8 - 1.0 cm
11 - 14 days of the cycle - 0.9 - 1.3 cm
Endometriosis
I had aspiration done, endometrial polyps were removed, and after that I was examined by ultrasound. Histological analysis showed an endometrial character, and the ultrasound result was as follows:
The body of the uterus is spherical, cellular, and normal in size. At the bottom of the uterus there is a subserous myomatous node d=2.5 cm. The thickness of the endometrium is 1.2 cm. Pronounced multiple endometrioid foci are identified in the cervical canal. The right ovary is 3.0x2.8 cm, the left is 3.0x3.0 cm with the presence of cystic inclusions. The analysis was done before menstruation on the 31st day of the cycle. Please explain to me what a cellular uterus is and do I have a chance of getting pregnant with such tests?
The spherical shape of the uterus and the cellular structure of the myometrium (the muscular layer of the uterus) are signs of internal endometriosis of the uterine body (adenomyosis). Sometimes with this disease pregnancy occurs on its own, sometimes it causes infertility, then it must be treated. The main manifestations of adenomyosis are heavy, painful menstruation, bleeding between menstruation. Subserous uterine fibroids will not prevent you from becoming pregnant, although they will increase during pregnancy, which will require constant monitoring.
My doctor prescribed me a sedative and vitamins Aevi T for two months. Is this treatment adequate for breast fibroadenosis?
2. My mother, who is 52 years old, had her uterus and appendages removed (due to endometriosis), and now she has discovered endometriosis of the cervical stump, which is accompanied by pain and sometimes dark discharge (although she has not had her period for a long time).
a) Tell me what needs to be done for non-operative treatment?
b) Is duphaston suitable for treatment?
1. If we are talking about fibroadenoma, then this is a nodular form of mastopathy, and it requires removal.
If you have ordinary mastopathy with a predominance of the fibrous component, then you have been prescribed the correct treatment.
2. Duphaston can help. It is better to try the stronger drug Norkolut in continuous mode. Or even stronger ones: danazol, gestrinone. But! These drugs are effective only when the ovaries are preserved, since the mechanism of their therapeutic action is to suppress ovulation. And if the ovaries are removed (specify), then hormonal therapy cannot help. Only surgery.
1. With endometriosis of the cervical stump, is it possible to do without surgery for the presence of one ovary (removed: appendages, uterus, one ovary)?
2. If possible, what drugs should be used for treatment?
1. The choice of treatment method depends on the complaints. If they continue to bother you, removal of the stump is indicated. If not, the fact of endometriosis itself is not an indication for surgery.
2. Medicines must be prescribed by the attending physician. The drugs are “harsh” and cause manifestations of menopausal syndrome.
I am 46 years old, on February 19 of this year I had an operation: Laparotomy. Panhysterectomy. The operation was performed urgently based on the results of ultrasound: infarction of the fibroid node with malnutrition.
Diagnosis: Ademiosis. Endometriosis of the uterosacral ligaments. Chr. endometritis Chr. bilateral adnexitis. Endometrial polyp.
Histological examination: Glandular-cystic hyperplasia, uterine fibroids with areas
ademiosis. Ovary - sclerosis and hyamentosis of the walls of blood vessels and corpus luteum, follicular cysts,
Corpus luteum cysts. Pipe - wall sclerosis. Cervix - Nabothian cysts.
Based on the histology results, I was prescribed Norkolut for 3 months according to the regimen.
Almost immediately after the operation, I started having hot flashes (within an hour or more).
With any physical and emotional stress, severe sweating. After a shower, relief comes, but not for long. I've been taking Remens for a month, but I don't feel any improvement.
About two weeks ago pain in the rectum appeared. Can endometriosis develop again?
The pain is similar to that before surgery. An appointment is scheduled in a month. They don’t spend more than 5 minutes during an appointment.
Tell me how I can alleviate my condition, reduce hot flashes, avoid complications such as osteoporosis, etc. For what purpose am I prescribed a hormonal drug?
Can hot flashes go away on their own? If not, please advise what can be taken with the least side effect. Is it possible for me to go to a resort in half a year and take mud on my lower back? When can you start exercising to strengthen your abdominal muscles? The incision is made along the white line. What kind of physical activity can there be?
95% of the strength of the suture of the anterior abdominal wall is restored 3 months after surgery. Light loads can be started now.
Pain in the rectum may be a manifestation of retrocervical endometriosis. It is diagnosed with a routine examination and ultrasound. Also, after panhysterectomy, endometrioid lesions could remain on the pelvic peritoneum, giving complaints characteristic of endometriosis, as before the operation.
Norkolut is prescribed to you so that endometriosis does not progress. But apparently it doesn't help. It would be ideal to do a control laparoscopy and coagulation of foci of endometriosis in the peritoneum. But in any case, given the removed ovaries, endometriosis will not progress; on the contrary, it will gradually go away. But hot flashes and other signs of hormonal deficiency (osteoporosis, etc.) will increase. You are not contraindicated in taking hormone replacement therapy, since the doses and medications contained in modern medications will not affect the course of endometriosis, and will restore your health. After checking the condition of the mammary glands (mammography), blood biochemistry (lipids) and blood clotting, it is possible to prescribe continuous hormone replacement therapy with drugs such as Cliogest, Livial.
In January, the ovary was removed laparoscopically due to an endometrioid cyst, and extensive external endometriosis of grade 3 was discovered. Different doctors recommend different hormonal therapy, some Nemestran, others Danoval. I still have to give birth and I don’t know which drug to choose.
For endometriosis, stage 3. The main method of treatment is laparoscopic coagulation of endometriotic lesions. After this, hormonal therapy is prescribed, which temporarily turns off ovulation so that endometriosis does not progress. Taking into account the fact that you are interested in restoring ovulation, you would prefer “softer drugs”: danol (danazol, danoval), gestrinone (nemestran). Drugs such as Zoladex and Decapeptyl are more effective, but they suppress the ovulatory function of the ovaries more strongly. The choice of drug should be up to the attending physician who operated on you and knows about the prevalence of the process.
I am 29 years old. After the second birth for 3 years, on the first day of menstruation the temperature rises to 37.5 - 37.8, severe pain, cycle irregularities - delays of up to 10 days. Ultrasound showed: adenomyosis of the uterine body (nodular form), ovarian endometriosis, retrocervical endometriosis, uterine dimensions 77-48-52, endometrium 11 mm. There is a large number of leukocytes in the smear. The result for chlamydia is negative. The attending physician's diagnosis coincided with the ultrasound diagnosis plus chronic endometritis. Hormonal medications were recommended for the treatment of adenomyosis and endometriosis, but with the permission of a mammologist, because Immediately before this, I was operated on for fibroadenoma of the mammary gland. The mammologist explained that since I still have pronounced manifestations of diffuse mastopathy and taking into account my heredity (close female relatives have breast cancer at a young age), hormonal drugs are indicated for me only as a last resort. I consulted with several other gynecologists, their recommendations were different: some believed that hormonal treatment was required, others that it was not required. Moreover, different hormonal drugs were prescribed: microgenon, norkolut, duphaston, depo-provera. As a result, my doctor and I decided to treat only endometritis. After the course of treatment, the temperature during menstruation became lower - 37.2 and the leukocytes in the smear returned to normal. This happened for 5 months after treatment. In the sixth month, the temperature again on the first day of menstruation rose to 37.8 and the smear showed leukocytosis again. A repeat ultrasound (one year after the first) showed that the size of the uterus and endometrium remained the same, but there were more endometriosis lesions. After another 2 months, a 6 cm cyst on the right ovary was discovered. I was again prescribed hormone therapy, and if it does not disappear in a month, then surgery. Moreover, they offer me to remove the entire right ovary. Please tell me,
1) Should I decide on hormone therapy and which drug is best for me (prolactin and progesterone are normal, but estradinol is not determined in our city). Do I need any more research and do I have time for this, or should I start hormone therapy immediately?
2) Are there types of operations that allow you to remove a cyst without an ovary, which ones exactly?
3) Are there treatments for endometriosis and adenomyosis other than hormone therapy? Including surgical ones?
1. The drugs that you listed are all drugs of the same group (gestagens). And they are absolutely not contraindicated for mastopathy, even if relatives had malignant tumors. Caution requires the use of estradiol, and gestagens, on the contrary, are indicated for mastopathy.
On the other hand, with such progressive endometriosis, gestagens are too mild a treatment method. It is advisable to start with surgery, remove the ovarian cyst, cauterize the endometriotic lesions, and in the postoperative period prescribe hormonal treatment to reduce lesions in the uterus and retrocervical endometriosis (temperature during menstruation is most likely caused by it). And these are hormonal drugs of other groups: nemestran, gestrinone, danazol, zoladex. They give more side effects, but are more effective against endometriosis
2. Laparoscopic surgery. Technically, it can sometimes be difficult to remove a cyst; this depends on the qualifications of the surgeon and is decided during the operation itself.
3. See paragraph 1. But uterine endometriosis can be surgically cured only by removing the uterus
Please tell us about a new drug for the treatment of endometriosis - "DUFASTON", because... I don't have information about him. Question: What are the new treatments for endometriosis?
Endometriosis is a hormonal-dependent disease associated with an absolute or relative increase in estrogen levels. "Duphaston" is an analogue of progesterone, the hormone of the second phase of the menstrual cycle, which balances the effect of estrogens. With its deficiency or with excessively elevated estrogen levels, endometriosis develops. "Duphaston" compensates for the lack of its own progesterone, and thereby suppresses endometriosis. There are other analogues of progesterone, but Duphaston is by far one of the best representatives of this group of drugs. To treat endometriosis, drugs are used that turn off the function of the ovaries, creating a kind of artificial menopause (menopause), which also contributes to the regression of endometriosis foci. After discontinuation of these drugs in women of reproductive age (up to 40 years), ovarian function is restored; in women of late age, it may turn off completely. Surgical treatment of endometriosis is effective. In this case, its foci are removed from the surface of the fallopian tubes and peritoneum; in the case of endometriotic ovarian cysts, part or all of the ovary is removed along with the cyst; in severe forms of endometriosis of the uterus, the organ is removed.
Please tell me what are the obvious symptoms of endometriosis. My friend was diagnosed with this, but she only has pain in the lumbar region, a regular monthly cycle, the only thing is that a rash began to appear on her face on the day her period began and then it disappeared within a few hours. Are these symptoms sufficient to make a diagnosis of endometriosis?
No, the symptoms you listed are not criteria for endometriosis. This diagnosis is finally made after a histological (under a microscope) examination of a tissue sample obtained surgically. Presumable symptoms of endometriosis are severe pain that intensifies or appears before menstruation and disappears on the first day, spotting before and/or after menstruation, pain during sexual intercourse, during bowel movements, infertility of unknown cause - these are the complaints. Some forms of endometriosis, for example, retrocervical, endometriosis of the uterine body, endometrioid ovarian cysts, can be diagnosed using ultrasound, some - with a two-handed examination. With endometriosis, there is always ovulation, the cycle is regular, the temperature is biphasic, the egg matures.
On an ultrasound scan dated July 31, 2000, a longitudinal section of the uterus shows a more homogeneous and “dense” structure of the uterus over time, which confirms the conclusion of ENDOMETRIOSIS. there is a small amount of liquid inclusion in the uterine cavity. Ultrasound dated 02/09/2001 shows ENDOMETRIC POLYP. Nodular uterine fibroids up to 7 weeks.
Question: Is surgical intervention required for removal, that’s what is not clear?
Question: What kind of medicine is OXYPROGYSTERONE CAPRONATE?
A repeat ultrasound is done after menstruation (if any). If the polyp remains, then it needs to be removed using curettage (preferably hysteroscopic).
The question of removing fibroids is decided depending on the complaints (you don’t write a word about what worries your mother, and this is the most important thing), the growth rate of the node, and its location. Submucosal nodes (growing into the uterine cavity), which grow rapidly, cannot be treated with hormones, and cause complaints of pain and bleeding, are removed.
Oxyprogesterone capronate is a drug of progesterone, a female sex hormone, the lack of which in the body can lead to the development of endometriosis and uterine fibroids. But it is not always effective in these situations. There are more modern, effective drugs, but they are much more expensive, they are not available everywhere, and they cause more adverse reactions. They cannot be appointed in absentia. But according to the description, the fibroid is small, it is enough to monitor it (if it does not bother you subjectively) and do not use potent drugs. There is not enough data to diagnose endometriosis: the size of the uterus and endometrium are not indicated, there are no complaints. By the way, there are no sizes of the fibroid node (on ultrasound, sizes are measured in centimeters, not in weeks).
Much also depends on the age of the mother and the nature of the menstrual cycle. and most importantly - complaints.
I am 48 years old. In 1999, I was diagnosed with endometriosis. After diagnostic curettage, treatment with DANAVAL was prescribed for 6 months. Naturally, there was no menstruation. After this period, an ultrasound was performed and the conclusion was made - atrophy of endometriosis. There was no limit to the joy. However, a year later, my periods came again and were heavy for 8 days. They did an ultrasound again. Conclusion - the picture corresponds to internal endometriosis, multiple endocervical cysts, synechylosis (septum) in the uterine cavity. Endometrium 1.0 cm. I can’t vouch for the spelling, because it’s not clearly written. Curettage again. Diagnosis: adenomyosis with hemorrhoids syndrome. After 20 days there was bleeding again. Urgently prescribe DANAVAL 400 ml. in a day. The bleeding does not stop; on the contrary, it increases. I go to the appointment - Danoval was canceled and they prescribed OPK 17, 4 ampoules. For 2 weeks all discharge disappears, then appears again. I'm panicking. What should I do - will I really not be cured and this will continue indefinitely?
Unfortunately, the symptoms of endometriosis rarely disappear permanently with treatment. They usually reappear after treatment is stopped. You need, after consulting with your doctor, or use a drug like Zoladex, which creates an artificial menopause (with all its unpleasant symptoms) for 6 months. As a rule, after stopping Zoladex, endometriosis does not recur, but it is impossible to promise; or decide to have the uterus removed. However, curettage against the background of endometriosis is not necessary, they only intensify its manifestations.
I am 39 years old. They had surgery to remove two tubes and an ovary, as well as a cyst on the ovary. Diagnosis: endometriosis. There is a small cystic formation in the breast, the thyroid gland is enlarged and there is also a lump in it. Treatment with Nemestran was prescribed. What do you recommend? How effective is treatment with this drug? What are his side effects? What else can you take to reduce them? What is my treatment period?
Since pregnancy is apparently not in question, the goal of treatment is to prevent the recurrence of endometriosis and its characteristic pain complaints. Nemestran is an effective remedy that leads to atrophy of both endometrioid formations and the endometrium itself. You can read about side effects in the instructions for the drug (they are caused by a decrease in the level of female sex hormones in the body and an increase in male hormones, reminiscent of the signs of menopausal syndrome); they more often occur when the dose is exceeded. The normal dose is 2.5 mg 2 times a week. Usually the duration of the course is about 6 months, but the specific one must be decided by the attending physician. If, while taking it, menopausal complaints begin to torment you, you can take homeopathic medicines: Klimaktoplan, Klimadinon, Remens. Normally, after menopause, endometriosis goes away on its own, so the therapeutic effect of Nemestran is to create an artificial menopause.
But the thyroid and mammary glands must be examined by specialists. The formations in them are in no way related to endometriosis and will not disappear with its treatment.
In October, I had an operation (laparoscopy), a dermoid cyst was removed from the right ovary (about 7 cm in size, histology showed that it was a mature teratoma), a corpus luteum cyst from the left ovary, and a paravarial cyst (I don’t know if I wrote the name correctly). During the operation, endometriosis of the peritoneum was discovered, the foci of which were coagulated. Before the operation, the uterus was shifted to the left, as I was told, due to a dermoid cyst, which was located on the right. After the operation, I underwent a course of physical therapy, and I have another one to go. But the position of the uterus has not changed; it is still shifted to the left. The first day of your period is still just as painful. Please tell me, is the first day of menstruation as painful (as before the operation)? And why did the uterus remain shifted to the left?
1. Painful menstruation may be caused by the fact that not all foci of endometriosis are coagulated. Small lesions that were not noticeable during the operation could remain. Perhaps there is also internal endometriosis (body of the uterus), which cannot be removed by laparoscopy. Usually, after laparoscopic coagulation of endometriotic lesions, a course of hormone therapy is prescribed to prevent recurrence of the disease. Consult the gynecologist who operated on you, maybe he will prescribe you a suitable hormonal drug. Painful menstruation may also not be associated with endometriosis, but may be caused by chronic endometritis (inflammation of the uterine lining). This condition is difficult to treat; the main method is physiotherapy.
2. Displacement of the uterus is caused by the tension of adhesions formed as a result of chronic inflammation of the appendages, intestines (dysentery in childhood) or due to endometriosis. Adhesions cannot always be eliminated during menstruation, so they continue to hold the uterus. This circumstance should not bother you; it does not interfere with pregnancy and does not cause pain.
In the regional hospital, a diagnosis was made: endometriosis of the uterine body, PMS (severe course - dizziness, attacks of paroxysmal tachycardia). Prescribed Depo-Provera 200 mg IM 2 times per month for 6 months. At the place of residence, doctors refused to carry out the recommended treatment. Contraindications: Gilbert's syndrome, chronic cholecystitis, chronic gastrointestinal and kidney diseases. Frequent exacerbations. Is it possible to do without hormonal drugs? If not, then what should I do?
There is a drug "Utrozhestan" containing natural progesterone. These are capsules inserted into the vagina. Therefore, the hormone does not pass through the liver, as when taken orally. It is effective in doses of 2-3 capsules per day, and is quite expensive. It should be taken continuously for 6 months in case of severe complaints. If you write how premenstrual syndrome is expressed other than dizziness, perhaps it will be possible to choose a non-hormonal treatment for it. But endometriosis of the uterine body, if it bothers you and you are planning a pregnancy (?), needs to be treated with hormones.
Please tell me, I’m 31 years old, I have fibroids and endometriosis, at first I took duphaston, but there was bleeding against it, now Buserelin from the first day of the cycle, now it’s the seventh day, menstruation is not heavy. but it does not stop, and on the seventh day there is bright red discharge. Please tell me what other medications I can take, I will, of course, consult with my doctor, but I would like to have complete information on this issue, maybe hormonal treatment will not help me at all.
Against the background of buserelin, menstruation should stop completely. This drug creates, as it were, an artificial menopause, temporarily turning off the function of the ovaries, which creates conditions for the reverse development of your diseases. You should take a drug such as buserelin for at least 3 months in order to detect its effectiveness. However, the presence of heavy bleeding on the 7th day of the cycle is alarming; be sure to consult a doctor. Curettage may be necessary, or if possible, aspiration biopsy. Non-hormonal treatment of your diseases is surgery.
After hysteroscopy, the result was c/c polyp, endometrial polyposis, endometriosis along all ducts of the walls, glandular hyperplasia with foci of weak adenomatosis, adenomyosis. (I apologize if there are medical errors). Now they are reviewing the glass in MGOD. I have 3 questions
1.If the diagnosis is confirmed, what are the chances of a cure?
2.What do you know about Zolotex treatment?
3. Do you know the results of treatment with VISION drugs (Detox, Antiox, Lifepack, Women's complex.). Are they not dangerous because they have not undergone clinical trials and are dietary supplements?
The diseases you listed are quite serious, especially when they are combined, and serious complications are possible. So treatment must be approached with all seriousness. Zoladex is a drug that is used to treat such conditions. Its action is based on the suppression of ovarian function, which causes artificial menopause. In this case, these diseases regress (decrease or disappear). If you are near menopausal age, then after stopping the drug, menstruation may not return. A side effect of Zoladex is manifestations of menopausal syndrome. However, in this situation, this is an alternative to surgical treatment. In such a situation, I do not recommend relying on dietary supplements.
Can the contraceptive drug Regulon be used to treat symptoms of focal endometriosis? Is it normal to increase the duration of menstruation and have brown discharge before and after it? Can Regulon be used for cystic fibrous mastopathy? How can you distinguish endometritis from focal endometriosis if there are no abnormalities according to ultrasound results?
Hormonal contraceptives suppress ovarian function, and regression of hormonally active diseases such as endometriosis and fibrocystic mastopathy is noted. Indeed, endometriosis of the uterine body and endometritis have similar symptoms. On ultrasound, endometriosis is more clearly visible 2-3 days before the onset of menstruation. However, this is only an indirect method. A more accurate diagnosis can be made with hysteroscopy.
Using an ultrasound, the doctor diagnosed endometriosis. (A repeat ultrasound in another location confirmed this diagnosis). The gynecologist does not confirm this diagnosis. I am 40 years old. I have been using Marvelon for the last 3 years. No complaints. Should I do anything now?
If you have no other manifestations of the disease other than ultrasound data (heavy menstruation causing anemia, endometrial hyperplasia, severe pain on the eve of menstruation, pain and discomfort during sexual intercourse...), then therapy is not required. In addition, oral contraceptives suppress ovarian function, which leads to endometrial atrophy. And this is just one of the methods of treating endometriosis. If there are symptoms of the disease that threaten your health and reduce your quality of life, you should discuss treatment with your doctor.
I am 28 years old, got married at 26. Two years ago I had a resection of both ovaries due to endometroid cysts. After that, I took Danol for half a year, and then tried to get pregnant, but to no avail. Ultrasound results in April 2000 on the 10th day of the cycle: the uterus is located in the midline. saddle-shaped, the cavity is not expanded, not deformed, the length of the neck is 30 mm of normal structure, there is no free fluid in the pelvis; endometrium 7 mm, the contour is not deformed, the structure corresponds to the proliferation phase; the size of the left ovary is 23x15mm, the structure of the “old” corpus luteum is D=13mm, the right one is 24x19mm of the usual structure.
Questions: 1. In October 1999, I had an ultrasound, but the uterus was normal, what does “saddle-shaped” mean and what does this mean?
2. Is it possible to determine whether ovulation has occurred or not based on the results of an ultrasound?
3.What is the proliferation phase and is it possible that I do not have endometriosis?
4. In what phase of the cycle is it better to perform metrosalpingography, can it have any negative consequences.
5. Do I have any hope of getting pregnant and what measures should I take?
1. “Saddle uterus” is a form that is an intermediate option between a normal uterus and a bicornuate uterus. This feature does not affect reproductive function.
2. Ultrasound examination can detect indirect signs of ovulation: the presence of a dominant follicle, fluid in the retrouterine space, corpus luteum.
3. The proliferation phase is the 1st phase of the menstrual cycle. According to the ultrasound you described, there is no endometriosis.
4. Hysterosalpingography is performed on days 7-8 of the menstrual cycle, in the absence of an inflammatory process.
5. You need to see a doctor for further examination.
The disease endometriosis, what it is, methods of treatment.
Endometriosis is a disease in which endometrial-like tissue grows outside of its normal location. Mechanical trauma to the genital organs, for example, during abortion, may play some role in the occurrence of endometriosis. diagnostic curettage of the uterine mucosa, caesarean section, etc. as a result, conditions are created for implantation of the endometrium in different parts of the reproductive system. The main signs of endometriosis are progressive pain before and during menstruation, menstrual irregularities, and infertility. Treatment of the patient is carried out depending on the patient’s age, localization and extent of spread of the pathological process. Hormonal, surgical, symptomatic and physiotherapeutic treatment is possible.
I am diagnosed with uterine endometriosis. How to treat it, how serious is it and what consequences can there be? I have been taking Mercilon for the second year on the recommendation of a doctor.
Endometriosis is a hormonal-dependent disease, which is manifested by the penetration of tissue similar to the mucous membrane of the uterine body into the muscle of the uterus. Moreover, during menstruation, foci of endometriosis also menstruate, which leads to the development of inflammation. Symptoms of adenomyosis (endometriosis of the uterus) are heavy and painful menstruation, bleeding, spotting before and after menstruation. Endometriosis is often accompanied by infertility and miscarriage. Oral contraceptives promote regression of endometriosis lesions.
Last December I had laparoscopic surgery to remove an endomethroid cyst. After the operation, a diagnosis was made of endometriosis and uterine fibroids. My nodules are small - 2 nodules of 2.5 cm each. The doctors insisted on hormone therapy without explaining why and how this could affect my body. Now I have been using the drug "Nemestran" for two months. I don’t know what benefit it has, but it has a negative effect. There were pains in the chest, the menstrual cycle was disrupted and very often there was bloody discharge. Please tell us about the effect of this drug on the treatment of endometriosis and how taking this drug can affect future pregnancy. How to stop using this drug correctly.
Nemestran is a drug for the treatment of endometriosis, including those complicated by infertility. It is a synthetic analogue of the female sex hormone progesterone, the absolute or relative deficiency of which leads to the development of this disease. When using Nemestran, symptoms similar to menopausal syndrome develop. However, all manifestations disappear after discontinuation of the drug. The drug is contraindicated for use during pregnancy. However, it is used to treat infertility caused by endometriosis.
Please tell me what are the external manifestations of external ovarian endometriosis (is there fever, pain, etc. on which organs does endometriosis occur?
Ovarian endometriosis most often manifests itself in the form of endometrioid cysts, which are fused with surrounding tissues and have chocolate-colored contents. Clinical manifestations of ovarian endometriosis are infertility and pain. The pain is usually constant, intensifies the day before and during menstruation, and radiates to the lumbar region and rectum. A sharp increase in pain is sometimes accompanied by vomiting. The adhesive process in the pelvis causes constipation. bloating, etc. and may serve as an additional cause of infertility. The localization of endometriosis can be different: - genital (uterus, ovaries, tubes, cervix, uterine ligaments, etc.) - extragenital (bladder, intestines, kidneys, lungs, conjunctiva, postoperative scars, etc.)
I have ovarian endometriosis, only Nemestran is prescribed, but my friend says that Nemestran “damages” the liver, and that you need to take Essentiale along with it. Is it so? and why didn't my doctor tell me about this?
The drug "Nemestran" is contraindicated for liver diseases. If you do not suffer from diseases of the hepato-biliary system, then for prophylactic purposes it is possible to take the drug Essentiale Forte in parallel.
For 3 months I treated endometriosis with Nemestran. After a course of treatment, I had the following problem: before menstruation, my breasts hurt and swell, the lower part of the breast is tight and hurts a little when pressed. The gynecologist said that this was mastopathy that developed due to taking Nemestran. I heard that mastopathy can go away on its own, especially since the “blow” to hormones lasted only 3 months. Is this really true? Or is it better to contact a mammologist? If yes, is there a mammologist at your institute? Or maybe you can recommend me some treatment? Just not hormonal.
The symptoms you describe are characteristic of mastodynia. This is a dyshormonal disease of the mammary glands, which may be associated with taking Nemestran. A painful lump in the lower part of the chest is alarming, so it is better to consult a specialist.
According to the results of the ultrasound, I discovered two endometriotic cysts in the right ovary (1.5 cm and 1.6 cm), a teratoma 5.0x3.5x4.6 cm, consisting of a dense component in diameter. 3.6 cm and liquid fat in the left ovary, as well as an endometrial polyp dia. 0.7 along the anterior wall of the uterus. Is non-operative treatment possible? How is a teratoma different from a cyst?
There can be no two opinions: non-operative treatment is impossible. In your case, surgery using endoscopic methods (laparoscopy, hysteroscopy) is possible. Teratoma is a tumor consisting of germinal tissue. Most often it is benign, but only histological examination can give an accurate answer. A cyst is a hollow formation with contents. Endometrioid cysts are a manifestation of ovarian endometriosis. Endometriosis does not respond well to conservative treatment, although it may regress slightly under the influence of hormonal drugs.
I am 33 years old. In 1992 I had surgery for endometriosis. The left ovary was removed and the right one was resected. 5 years after the first operation, resection was performed again - a corpus luteum cyst. And now, 3 years later. I have uterine fibroids of 15 mm. ovarian cyst 30-40 mm and a cyst in the breast. Can this be dealt with without surgery? And what should be done for this? If I remove both the uterus and ovaries, what does this mean for me?
Typically, such problems develop against the background of “disturbed” functioning of the neurohumoral and hormonal systems, so patients are treated either by neuroendocrinologists or gynecological endocrinologists. The main task of doctors in such situations is to try to normalize neuro-hormonal relationships in a variety of ways - from physiotherapy to hormone therapy, and not to surgically remove the affected organ (the problem does not go away, but begins to manifest itself in other organs and systems). What to do exactly in your case can only be said after a detailed examination.
44 years old. Diagnosis: adenomyosis, left ovarian cyst, paraovarian cyst, cystic changes in the right ovary. Possible treatments? Can laparoscopy be used? If yes, where?
We do not advise you to consult “by phone” - the range of diagnoses is quite serious. Apparently, in this case we are talking about a choice between hormonal and surgical treatment, and perhaps a combination of both. Without seeing the patient, without knowing the medical history, it is impossible to even say whether laparoscopic treatment is possible and whether it is necessary.
/ Continuation/ A surgical operation is scheduled, but, as I was told, rehabilitation will take 2 months. Therefore, I would like to consult about laparoscopy and, of course, not by telephone. Please help me find out the phone numbers of organizations where such operations are performed.
Both during “conventional” and during laparoscopic surgery, the volumes are the same, but with laparoscopy, access to the operation site is made not through an incision in the abdominal wall, but through a puncture, so this operation is easier to tolerate. For example, discharge after a “regular” operation is 10-14 days, and after laparoscopy - 5-8. Laparoscopic operations are longer, they have a whole list of female contraindications, for example, adhesions. Rehabilitation after laparoscopic surgery is just as necessary as after conventional surgery, because... tissue healing occurs within the same time frame. Laparoscopic equipment in Moscow is available in many scientific centers and hospitals, both commercial and urban. These are 1 city clinical hospital, 15 city clinical hospital, 7 city clinical hospital, mother and child center on Oparin street 4, MONIIAG on Chernyshevsky street, departments of medical institutes. Prices and conditions are different everywhere, so we advise you to “arm yourself” with a directory and call as many places as possible.
I had a laparoscopy: they “blown out” the tubes, removed the adhesions, discovered external endometriosis - they cauterized it. Doctors say that now I can get pregnant, but first I need to treat endometriosis (they prescribed Nemestran). Please answer why I can’t get pregnant right away, and what could happen if I suddenly get pregnant without treating endometriosis?
Unfortunately, against the background of endometriosis, pregnancy occurs very rarely - the disease is characterized by infertility. Pregnancy is one of the best “medicines” against endometriosis; against its background, it undergoes a reverse development.
I am 23 years old. My husband and I have been trying to conceive a child for a year now. The doctor suspects endometriosis. Recommends laparoscopy and sperm preparation for intrauterine insemination. Could you advise what to do first and whether there may be complications after laparoscopy and what they are.
Infertility examination is multi-stage. You probably took smears for special infections and microflora, measured your basal temperature for at least 3 months, did a semen analysis, ultrasound of the pelvic organs, etc. Laparoscopy with checking the patency of the tubes and, if necessary, surgical treatment (dissection of adhesions, etc.) is one of the stages (by no means the first) of the examination. It provides a lot of information, especially for minor forms of endometriosis. Laparoscopy is an operation and complications can occur, as with any operation: an allergic reaction to painkillers, infections, complications, the development of adhesions.
