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Adenomyosis

Signs and symptoms

Some women with Adenomyosis do not experience any symptoms, while others may have severe, debilitating symptoms. The Endometrial implants that grow into the wall of the uterus bleed during menstruation, (the same as endometrial tissue bleeds) is discharged vaginally as menstrual bleeding. The vaginal pressure can be severe enough to feel like the uterus is trying to push out through the vagina, like the last stage of labor when the baby's head pushes into the cervix. Other symptoms include;

  • Intense debilitating pain all the time and/or
  • Acute & increasing pain at menstration and ovulation
  • Strong 'contraction' feel of uterus
  • Abdominal cramps
  • A 'bearing' down feeling
  • Pressure on bladder
  • Dragging sensation down thighs and legs
  • Heavy bleeding and flooding
  • Large blood clots
  • Prolonged bleeding i.e.; up to 8–14 days

Location and classification

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Adenomyosis (pronounced A - den - oh - my - oh - sis) is a medical condition characterized by the presence of ectopic glandular tissue found in muscle. The term adenomyosis is derived from the terms adeno- (meaning gland), myo- (meaning muscle), and -osis (meaning condition). Previously named as endometriosis interna, adenomyosis actually differs from endometriosis and these two disease entities are found together in only 10% of the cases.

It usually refers to ectopic endometrial tissue (the inner lining of the uterus) within the myometrium (the thick, muscular layer of the uterus). The term "adenomyometritis" specifically implies involvement of the uterus.The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have painful and/or profuse menses (dysmenorrhea & menorrhagia, respectively). However, because the endometrial glands can be trapped in the myometrium, it is possible to have increased pain without increased blood. (This can be used to distinguish adenomyosis from endometrial hyperplasia; in the latter condition, increased bleeding is more common.)

In adenomyosis, basal endometrium penetrates into hyperplastic myometrial fibers. Therefore, unlike functional layer, basal layer does not undergo typical cyclic changes with menstrual cycle.Adenomyosis may involve the uterus focally, creating an adenomyoma. With diffuse involvement, the uterus becomes bulky and heavier.

Treatment

Treatment options range from use of Natural Progesterone Cream, NSAIDs, hormonal suppression, anti inflammatory pain killers and IUD Coil for short term symptomatic relief (although IUD may cause further irritation of the uterus). Women with adenomyosis fail endometrial ablation because the ablation only affects the surface endometrial tissue, not the tissue that has grown into the muscle lining. This remaining tissue is still viable and will continue to cause pain.

Those that believe an excess of estrogen (Estrogen Dominance) is the cause of Adenomyosis, or that it aggravates the symptoms, recommend avoiding products with xenoestrogens and/or recommend taking Natural Progesterone Cream which may help balance the hormone levels.

Chinese herbal supplements DIM and Myomin are claimed to reduce excess estrogen, shrink fibroids and reduce significantly the adenomyosis symptoms.[citation needed] DIM is a blend of cruciferous vegetable extracts including broccoli, cauliflower, cabbage and brussel sprouts. Research shows it helps metabolize unhealthy circulating estrogens (estrone, estradiol) into the good form (estriol).

Myomin is an all natural formula of Chinese herbs that has been shown to help metabolize unhealthy estrogens and promote proper hormonal balance. Studies show that it also inhibits aromatase, an enzyme that converts androgens (testosterone) into estrogen. In addition to that, it competes with estradiol at the estrogen receptors of target cells. This is why Myomin is so effective for estrogen-dominant conditions such as cysts and fibroids (International Journal of Integrative Oncology. Mar 2008; 2(1):7-15)

Hysterectomy should only be considered as a very last form of treatment option for this condition once full understanding of the long term effects have been read and understood

See Hysterectomy Education Resources and Services (HERS) website which explains the longer term after effects to having the uterus, cervix and/or ovaries removed.

Medication

A number of medications are in use to control symptoms caused by fibroids. NSAIDs can be used to reduce painful menses. Oral contraceptive pills are prescribed to reduce uterine bleeding and cramps. Anemia may have to be treated with iron supplementation. Levonorgestrel intrauterine devices are highly effective in limiting menstrual blood flow and improving other symptoms. Side effects are typically very moderate because the levonorgestrel (a progestin) is released in low concentration locally. There is now substantial evidence that Levongestrel-IUDs provide good symptomatic relief for women with fibroids. While most Levongestrel-IUD studies concentrated on treatment of women without fibroids a few reported very good results specifically for women with fibroids including a substantial regression of fibroids.

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