Endometriosis of the uterine body - what it is in simple terms and what you need to know about this pathology. Endometriosis of the uterus: symptoms and treatment

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Endometriosis is a functioning endometrium outside its normal location. Internal endometriosis (adenomyosis) includes fragments of the endometrium in the thickness of the myometrium, and external endometriosis includes lesions in the ovaries, utero-rectal space, uterosacral ligaments, rectum, bladder, ureters, vagina, etc.

Click on pictures to enlarge.

Endometriomas can be nodules, infiltrates and cysts, ranging in size from 1 to 40 mm. Under the influence of hormones, cyclic changes occur in them, just like in the uterus. Perifocal inflammation is a constant companion of all types of endometriosis, which leads to the formation of small adhesions around. Often the adhesive component predominates over the endometriotic component. Over time, this leads to the formation of an endometroid-scar nodule, which, having reached a certain size (3-5 mm), becomes visible on ultrasound. Visualization of “fresh” and very small formations is not possible.

Drawing. Pathomorphology of adenomyosis: in the thickness of the myometrium, endometrial glands are visible surrounded by stroma with a scar-lymphoplasmacytic reaction.

With endometriosis, the main complaint is painful, heavy and prolonged periods. Retrocervical endometriosis has the most aggressive course. Characterized by severe pain during sexual intercourse and, to a lesser extent, during bowel movements; constant aching, and during menstruation, sharp shooting pains in the lower abdomen, radiating to the sacrum, rectum, vagina, and thigh.

Diffuse form of endometriosis of the uterine body (adenomyosis) on ultrasound

A 3.5-7 MHz convex sensor is used. Position the patient lying on his back. Bladder of varying degrees of filling. Smoothly reduce the intensity of the echo-positive component of the image: many elements of the picture disappear, but high-density pathological details of the image are highlighted against a general dark background. Repeated performance of this technique from different angles ensures reliable visualization of heterotopias whose dimensions exceed 3-4 mm.

On ultrasound, the uterus is diffusely enlarged, spherical in shape, with a clear and even contour. Compared to the cervix, the echogenicity of the uterine body is increased, the myometrium is heterogeneous due to many hyperechoic point and linear inclusions, and blood flow is often diffusely increased. With TV-ultrasound, tortuous dilated vessels are often visible in the peripheral parts of the uterine wall. In half of the cases, the endometrium is thicker than expected. In young patients, the echogenicity and echostructure of the uterus is often normal, but the uterus is always spherical in shape.

"God is in the details"

The size of the uterus can be increased in tall women, in those who have given birth many times, before menstruation, and in the presence of an intrauterine contraceptive. In contrast to endometriosis, the uterus retains an oval or pear-shaped shape, and the density of the myometrium is regarded as low.

With a pronounced bend, the size of the uterus may be larger than normal, and the shape may approach spherical. In such cases, the absence of a diffuse increase in the echogenicity of the myometrium, endometrial hyperplasia and complaints is important.

Before menstruation, the echogenicity of the uterus may decrease due to vasodilation and edema.

Diffuse fibrous changes in the myometrium during adenomyosis are often mistakenly regarded as diffuse fibromatosis of the uterus.

Table. Difference between adenomyosis and diffuse form of uterine fibroid.

	Adenomyosis	Diffuse uterine fibroma
Complaints	Algomenorrhea	More often, asymptomatic
Uterus size	Increased	Increased
Nodes	No	No
Form	Regular spherical	Irregular oval or pear-shaped
Circuit	Smooth	Wavy or finely lumpy
Myometrium	Diffusely heterogeneous due to point and linear hyperechoic inclusions	Multiple hypoechoic zones with unclear contour
Echogenicity	Diffusely increased	Hypoechoic areas
Endometrium	Often hyperplasia	Usually not changed

Local form of endometriosis of the uterine body on ultrasound

In the myometrium, individual bright hyperechoic inclusions without an acoustic shadow, irregular round, oval or blocky shape, size 2-6 mm, are found. These are areas of fibrosis around one or more endometriomas in the thickness of the myometrium. While cyclic processes occur in the foci, they can increase in size and take on the appearance of small, clearly defined nodes of irregular shape. In the local form of endometriosis, the uterus is of normal size and typical shape, the endometrium is not changed.

In almost all such cases, there is a habitual overdiagnosis of intramural fibromatous nodes with a predominance of fibrosis and calcification. Please note that the clear dependence of the lesion on the phase of the cycle indicates local fibronodular endometriosis.

Endometriosis of the cervix on ultrasound

Endometriosis of the cervix is rare and does not cause pronounced manifestations. The only complaints may be bleeding before and after menstruation.

On ultrasound, cysts are detected in the myometrium of the cervix or the area of the cervix is thickened compared to the intact sections. The outer contour in this place is clear, smooth or wavy. The echogenicity of the cyst-free myometrium is not changed. The configuration of the neck is club-shaped, pear-shaped or fusiform. Cysts are round in shape, the wall is hyperechoic, thin, the effect of enhancement is behind, the contents are homogeneous or finely dispersed, size 4-15 mm. It is especially visible with a TV sensor.

Nabothian cysts are found in the cervix much more often than endometroid cysts. With long-term glandular pseudo-erosion, the stratified squamous epithelium of the vaginal part of the cervix covers the mouths of the glands, which leads to the formation of thin-walled cavities. Nabothian cysts are asymptomatic, very slowly increase in size to 15-20 mm, and then empty; contents are colorless, sterile, cell-free liquid. On ultrasound, Nabothian cysts are located superficially, without wall thickening and contour deformation; long-existing cysts are immersed in the myometrium.

Ovarian endometriosis on ultrasound

Ovarian endometriosis comes in two forms: endometrioid cysts and superficial endometriosis.

Endometrioid cysts can reach large sizes (up to 10-15 cm in diameter). On the smooth inner surface, compactions are found, which, upon microscopic examination, turn out to be areas of the endometrium; chocolate-colored contents. Ultrasound reveals a round formation with a double contour, the capsule in 30% of cases contains hyperechoic foci; there are no dense inclusions in the lumen, the contents are hypoechoic, homogeneous, and there is no internal blood flow. The echo structure does not change at different periods of the menstrual cycle.

Ultrasound for superficial endometriosis reveals a small (2-9 mm) hyperechoic formation of a round, oval or lumpy shape on the ovarian capsule; the contour is clear, smooth or spicule-shaped due to single short fibrous cords. The structure is homogeneous, the echogenicity is high or very high. In the affected area there is some retraction of the ovarian contour; the endometrioma is partially immersed in the ovarian tissue, but is always clearly limited from it by a thickened and compacted capsule. With purely adhesive changes paraovarian, the most typical are multiple linear hyperechoic inclusions along the edge of the ovary without retraction of the contour.

Most of these patients are observed and treated for adnexitis, and the possibility of endometrioid damage to the ovarian capsule is not taken into account. Long-term, untreated ovarian endometriosis often leads to adhesions in the pelvis, creating conditions for chronic salpingitis. It is necessary to look for hydrosalpinx/hematosalpinx and peritoneal cysts - indirect signs of adhesions in the pelvis.

Drawing. Diffuse paraovarian fibrosis as a consequence of external endometriosis.

Drawing. Under the influence of hormone therapy, the lesions shrink and can even resolve.

Endometriosis of the fallopian tubes, outer wall, round and broad ligaments of the uterus is not visible on ultrasound.

Endometriosis of the ovarian ligaments on ultrasound

TA-ultrasound is optimal with a full bladder, then the ovaries are pushed upward, the ligaments are stretched and fully included in the image. During TV-ultrasound on an empty bladder, the ovaries descend, the ligaments hang and occupy an almost vertical position in relation to the vaginal vaults, the image includes transverse and oblique sections of the ligaments, which merge with the surrounding tissues.

On ultrasound, endometriosis of the ovarian ligaments is a hyperechoic nodule or a large linear adhesion up to 30-32 mm that covers the ligament in a muff-like manner.

Deep infiltrating endometriosis on ultrasound

TV-ultrasound has a clear advantage over TA-ultrasound. During examination, the bladder is slightly full. It is necessary to determine the number, position, size (in three planes) of endometriomas, and echostructure.

Four stages of TV-ultrasound for suspected deep infiltrating endometriosis:

Examination of the uterus and ovaries. Assess the mobility of the uterus - normal, decreased, fixed (“question mark”);
Indirect signs of endometriosis: local pain and fixed ovaries increase the likelihood of endometriosis and adhesions. By applying pressure between the uterus and ovary, it can be assessed if the ovary is attached to the uterus medially, to the side wall of the pelvis laterally, or to ligaments.
Assess the pouch of Douglas using the “sliding sign” during dynamic TV-ultrasound. When the uterus is in anteversion, gentle pressure on the cervix using a transvaginal sensor is established as the rectum slides freely along the posterior surface of the cervix (retrocervical region) and the posterior wall of the vagina. One hand is then placed on the anterior abdominal wall to move the uterus between the palpating hand and the transvaginal probe to assess how the anterior bowel wall slides over the posterior surface of the upper uterus and fundus. When the sliding sign is considered positive in both of these anatomical regions (retrocervix and posterior wall of the uterus), it is recorded that the pouch of Douglas is not obliterated.
Assess the anterior and posterior cervical space.

The nodular form is a hyperechoic, compactly located heterotopia fused to each other in the space between the posterior surface of the cervix (or isthmus) and the anterior wall of the rectum. The shape of the lesion is irregular oval, less often irregular round or blocky. The contours are uneven (lumpy) and heavy. The heaviness of the contours is a consequence of adhesions and local infiltrative spread of endometriosis. The size of the lesion is from 3 to 30 mm. Retrocervical endometriosis is characterized by very high density, often with an acoustic shadow.

Drawing. Heterotopia group

The scar-infiltrative form is characterized by a significant predominance of the connective tissue component. In other words, a minor endometrioid lesion initiates the development of a pronounced adhesive process. The distribution of changes occurs along the posterior wall of the cervix: the vaginal vault, the uterosacral ligaments, the peritoneum covering the body of the uterus, the broad uterine ligament and the wall of the uterus, the anterior wall of the rectum, bladder and ureters. Ultrasound shows a hyperechoic, heterogeneous compaction of an elongated shape - a scar cord - spreading along the posterior wall of the cervix, the anatomical and topographical features of which determine the position and shape of the changed area. The pathological focus forms a flat platform - straightening of the cervix at the level of the retrocervical lesion. The contours are heavy. Heaviness (spiculosity) is a reliable indicator of locally invasive growth.

Drawing. Perifocal inflammation appears before menstruation or immediately after its end - a hyperechoic focus is outlined by a hypoechoic rim. Perifocal inflammation is a constant companion of all types of endometriosis, but only with retrointestinal localization can it be seen with TV-ultrasound.

One of the objects of spread of retrocervical endometriosis is the uterosacral ligaments - from the posterolateral surfaces of the cervix and isthmus, cover the rectum in an arcuate manner, and are attached to the pelvic fascia of the sacrum. Isolated lesions are rare, more often secondary lesions due to ingrowth from the retroisthmus-uterorectal recess. On ultrasound, the uterosacral ligaments are not visible. A survey ultrasound is used with a weakly filled bladder, vigorous compression of the anterior abdominal wall, the beam is directed towards the intended focus - a round hyperechoic formation in one of the parametric areas at the level of the isthmus. In such patients, scar-infiltrative changes often spread to the posterior wall of the bladder, sometimes to one of the ureters - narrowing, ureterectosis, hydronephrosis.

Indirect signs of endometriosis invasion into the rectum are large size of the node, pronounced heaviness of the lower edge + pain during defecation, intensifying during menstruation, admixture of blood in the stool during menstruation.

The “kissing” sign of the ovaries indicates the presence of serious pelvic adhesions. Endometriosis of the intestine and fallopian tube is significantly more common in women with kissing ovaries versus those without kissing ovaries.

Anterior cervical space on ultrasound

Assess the anterior cervical space, where the bladder, anterior wall of the uterus and ureters are located.

We must not forget that TA-ultrasound and TV-ultrasound are complementary techniques; in the form of a two-stage study, they are a powerful diagnostic tool for diagnosing endometriosis.

It is best to scan the bladder if it contains a small amount of urine. Four zones of the bladder on ultrasound:

(I) in the trigonal zone, which is within 3 cm of the urethral opening, the smooth triangular area is divided into two ureteral openings and the internal urethral opening;
(ii) at the base of the bladder, which faces back and down and lies next to both the vagina and the supravaginal uterus;
(III) the bladder dome, which lies superior to the base and is intra-abdominal;
(IV) extra-abdominal bladder.

Bladder endometriosis is more common in the base and dome of the bladder than on the peritoneal surface of the bladder. On ultrasound, endometriosis in the anterior compartment can be variable, including hypoechoic linear or spherical lesions, with or without clear contours involving muscle (most often) or (sub)mucosa of the bladder. Bladder endometriosis is diagnosed only when the muscles of the bladder wall are affected; lesions involving only the serosa represent superficial disease.

Drawing. The four zones of the bladder are: the trigone, the base of the bladder, the dome of the bladder, and the extra-abdominal bladder. The point of demarcation between the base and the dome of the bladder is the uterine bursa.

Obliteration of the uterovesical region can be assessed using the “sliding” sign, i.e., a transvaginal probe is placed in the anterior fornix and the uterus moves between the probe and one hand of the operator placed in the suprapubic region. If the posterior wall of the bladder slides freely on the anterior wall of the uterus, then the uterine region is not obliterated. If the bladder does not slide freely along the anterior wall of the uterus, one can think about obliteration of the uterovesical area with adhesions. Adhesions in the anterior pelvis are present in almost a third of women following a cesarean section and are not necessarily a sign of endometriosis.

The distal ureters should be examined. The ureter can be found by identifying the urethra in the sagittal plane and moving the probe to the lateral wall of the pelvis. The intravesical segment of the ureter is identified and follows its course to where it exits the bladder and further to the lateral wall of the pelvis and to the level of the bifurcation of the common iliac artery. This is useful to see how peristalsis occurs and confirms the patency of the ureters.

On ultrasound, the ureters usually appear as long tubular hypoechoic structures, with a thick hyperechoic wall extending from the lateral surface of the bladder, from the base to the common iliac vessels. Ureteral dilatation due to endometriosis is caused by a stricture (either external compression or internal penetration) and the distance from the distal ureteral opening to the stricture should be measured. All women with deep endometriosis have their kidneys examined to rule out hydronephrosis as a consequence of obstruction by endometriosis.

Posterior cervical space on ultrasound

The most common posterior sites of endometriosis are the uterosacral ligaments, posterior vaginal vault, anterior rectal wall/anterior rectosigmoid junction and sigmoid colon, rectovaginal septum. On ultrasound, endometriosis in the posterior cervical space appears as hypoechoic thickening of the intestinal or vaginal wall, or as hypoechoic solid nodules that can vary in size and have smooth or irregular contours. Hypoechoic nodules may be homogeneous or heterogeneous with or without large cystic areas, or there may be no cystic areas adjacent to the nodules.

Deep endometriosis of the rectovaginal septum (the hyperechoic layer between the vagina and rectum) is confirmed by TV-ultrasound. Isolated endometriosis of the RV septum is rare, most often spreading into the vagina and/or rectum. On TV-ultrasound, the lesion is visible in the RV space under the line running along the lower border of the posterior lip of the cervix (under the peritoneum).

Drawing. Retrofrontal implants (65%) are usually a small lesion that develops from the posterior chest to, but not through, the rectovaginal septum. Hourglass-shaped implants (25%) larger lesions (>3 cm) that originate from the retrofarnital position and extend toward the anterior rectal wall. AND rectavaginal septal implants (10%) usually a small lesion separated from the cervix, located under the peritoneal fold of the cul-de-sac of Douglas.

Involvement of the posterior wall of the vaginal vault and/or lateral vaginal vault should be suspected when a nodule is visible on TV-ultrasound in the rectum in the space below the line running along the caudal end of the peritoneum of the lower edge of the rectum (the pouch of Douglas) and above the line running along the lower borders of the posterior lip of the cervix (under the peritoneum). Posterior vaginal vault or vault endometriosis is suspected if the posterior vaginal vault thickens or if hypoechoic layers of the vaginal wall are identified.

Douglas pouch obliteration can be graded as partial or complete depending on whether one side (left or right) or both sides, respectively, exhibit a negative sliding sign.

Normal uterosacral ligaments are usually not visible on ultrasound. Endometriosis of the uterosacral ligaments can be seen in a midsagittal section of the uterus. However, this is best seen by placing a transvaginal probe in the posterior vaginal fornix along the midline in the sagittal plane and then moving the probe. On ultrasound, hypoechoic thickening with clear or unclear boundaries is seen as abdominal fat around the uterosacral ligaments. The lesion may be isolated or may be part of a large nodule extending into the vagina or other surrounding structures.

Deep endometriosis involving the intestine involves the anterior wall of the rectum, rectosigmoid junction, and/or sigmoid colon, which can be visualized using TV-ultrasound. Mott take the form of an isolated lesion or may be multifocal (multiple lesions of one segment) and/or multicentric (multiple lesions affecting several segments of the intestine, i.e. small intestine, colon, cecum, ileocecal junction and/or appendix).

Histologically, intestinal endometriosis is defined as the presence of endometrial glands and stroma in the intestinal wall, reaching at least the muscular layer, where it invariably causes smooth muscle hyperplasia and fibrosis. This leads to thickening of the intestinal wall and some narrowing of the intestinal lumen. Normal layers of the wall can be visualized on TV-ultrasound: the rectal serosa is visible as a thin hyperechoic line, the muscular plate is hypoechoic, with longitudinal smooth muscle (external) and circular smooth muscle (internal) separated by a subtle thin hyperechoic line; the submucosa is hyperechoic; and the mucosa is hypoechoic.

Intestinal endometriosis is seen as a thickened, hypoechoic muscle wall or as hypoechoic nodules, with or without hyperechoic lesions with blurred edges. The size of these lesions may vary.

Intestinal lesions may be described according to the segment of the rectum or colon in which they occur. Lesions located below the level of the insertion of USLs on the cervix are designated as the lower (retroperitoneal) anterior rectum, above this level are designated as the upper (visible by laparoscopy) anterior wall of the intestine, at the level of the uterine fundus are designated as rectal lesions, and those above the level of the uterine fundus are designated as lesions of the anterior sigmoid. The distance between the inferior edge of the most caudal lesion and the anal verge should be measured. It is possible to measure the distance from the anus to the intestinal lesion using transrectal sonography.

Hourglass-shaped nodules occur when damage to the posterior vaginal vault expands and extends into the anterior wall of the rectum. On ultrasound, the portion of the DIE lesion located along the anterior rectal wall is the same size as the portion located in the posterior vaginal fornix. There is a small but easily visible connection between the two parts of the lesion. These lesions are located below the peritoneum and pouch of Douglas and are usually large (3 cm on average).

Endometriomas may undergo decidualization during pregnancy, in which case they may be confused with ovarian malignancies on ultrasound. The simultaneous presence of other endometriotic lesions may facilitate the correct diagnosis of endometrioma during pregnancy and minimize the risk of unnecessary surgery.

Take care of yourself Your Diagnosticer!

The third most common gynecological disease is internal endometriosis of the uterus or adenomyosis. It begins when the overgrown endometrium extends beyond the organ cavity. The disease is dangerous and hormonally dependent.

Signs of internal endometriosis of the uterus

Pain in the lower abdomen - a symptom

In most cases, there are no clear symptoms, so problems arise with diagnosing the disease. The following signs of internal endometriosis or adenomyosis are noted.

Pain in the pelvic area. Discomfort is felt all the time, but is especially acute before menstruation.
Bloody, spotting discharge a few days before the start of the cycle and after sexual intercourse.
Frequent urge to urinate, appearance of blood.
Menstrual flow with internal endometriosis is heavy and lasts longer than usual.
Constant miscarriages. The situation often appears against the background of endometriosis, since the specifics of the disease prevent the embryo from developing.
Infertility. With adenomyosis, the egg cannot enter the fallopian tube due to adhesions in the pelvic area.
Feeling unwell. The girl feels weak, constantly wants to sleep, and is shivering.

Against the background of severe blood loss with adenomyosis, a severe form of anemia can develop. During internal endometriosis, severe pain occurs. Especially on the first day of the cycle.

When the uterine angles are affected, discomfort occurs in the groin. If the neck of the organ is damaged, the rectal area hurts.

Sonographic signs of internal endometriosis of the uterus

Depending on the condition of the organ, during diagnosis it will be possible to identify the disease and determine its degree. The most accurate method is ultrasound examination with a transvaginal sensor.

When performing an ultrasound, eco-signs are visible confirming the development of endometriosis.

The basal layer of the endometrium is atypically thick or thin and jagged. There is no pronounced transition from the myometrium.
One of the uterine walls with adenomyosis is very thickened.
Hyperechoic areas and dense, closely spaced stripes form on the muscle layer of the organ.
With internal endometriosis, the uterus becomes round.
Large cysts with fine suspension appear.

How to treat internal endometriosis of the uterus

Prescribed Marvelon

Drug and surgical treatment of the disease is carried out. The first option is chosen if internal endometriosis does not show clear signs, and the girl is young and wants to preserve reproductive functions.

Treatment of adenomyosis is carried out using hormonal agents:

combined estrogen-progestogen;
gonadotropin releasing hormone agonists;
antigonadotropic;
gestagens.

Among the effective combination drugs are Marvelon, Silest, Nonovlon. They are relatively mild and are prescribed at the first stage of adenomyosis. The products contain gestagens that interfere with the synthesis of estrogens.

Triptorelin and goserelin are used as agonists for adenomyosis. They prevent the increase in the number of endometriotic lesions. Medicines reduce estrogen levels.

To normalize gestagens, Norkolut, Utrozhestan, Nemestran, Duphaston are taken, which are prescribed at all stages of the disease. Antigonatory drugs include Danazol, Danogen, Danol. Treatment of internal endometriosis is long and takes at least six months.

Norkolut, if there are problems with gestagens

When pills do not help, surgery is performed. It is indicated if the foci of inflammation due to adenomyosis are more than 3 cm, there are problems with the functioning of the intestines and excretory system, and ovarian tumors have appeared. The laparoscopic method is used.

During the operation, the surgeon cuts through adhesions, removes cysts and heterotopia particles from the organs. Laparoscopy for adenomyosis is a gentle method. Such a surgical intervention makes it possible to carry and give birth to a child in the future.

Endometriosis is successfully treated with a laser beam, which penetrates shallowly into the tissue and therefore does not contribute to the formation of scars and adhesions. The effectiveness of therapy is 95%. Under the influence of the beam, the overgrown endometrium evaporates from the surface of the organs.

Treatment with folk remedies for internal endometriosis of the uterus

Alternative medicine helps eliminate the disease. But therapy for adenomyosis should be comprehensive and carried out only on the recommendation of a doctor. Homemade remedies are aimed at eliminating symptoms and reducing pain.

Borovaya uterus with disease

Tincture from boron uterus relieves inflammation in internal endometriosis and normalizes hormonal levels. Take:

2 tbsp. l. dry raw materials;
0.5 l of alcohol.

Preparation and use.

Mix the ingredients and leave for 2 weeks in a dark place.
Dilute 35 drops of the finished product with water and take 3 times a day before meals.

To reduce inflammation and pain in internal endometriosis, tampons with a decoction of celandine are used. To prepare the product you will need:

1 tbsp. l. dry grass;
0.2 boiling water.

Preparation and use.

Mix the ingredients.
Leave for 3 hours, strain.
Soak a gauze swab in the liquid and insert it into the vagina for 30-60 minutes. Carry out the procedure daily for a month.

Use the gifts of bees

For complex therapy of adenomyosis, you can make tampons with bee products. You need to mix a small piece of propolis and half a teaspoon of honey. Then put the ingredients in a gauze tampon and insert it into the vagina for 9 hours. It is recommended to do at least 10-12 procedures.

The effect of endometrial polyps on internal endometriosis of the uterus

The situation may be aggravated by concomitant diseases. For example, the appearance of endometrial polyps. These are neoplasms that form from the tissue covering the uterus.

The more polyps, the more severe the endometriosis. It is aggravated by symptoms of concomitant illness. The formations are benign, but if left untreated they can degenerate into pathogenic ones.

Forms of the disease

Endometriosis can be diffuse, focal, or nodular. These forms are characterized by the degree of tissue proliferation. The first one is the most common.

Diffuse form of internal endometriosis of the uterus

This pathology is characterized by a large amount of endometrium, which covers the entire organ and penetrates deep into the muscle tissue. Pathology goes through 4 stages. First, the myometrium suffers, and if there is no treatment, the disease affects neighboring organs.

Description of the disease

Focal internal endometriosis of the uterus

Limited areas of the muscular layer of the uterus are affected. Cysts filled with fluid appear. They are increasing in size every month.

Nodular endometriosis of the uterus

This form is characterized by damage to the muscle layer of the organ. A large number of dense nodes appear on it. Their cavity is filled with blood, and connective tissue forms around them.

Pathology affects the size of the uterus. It begins to increase, and during diagnosis, doctors often confuse endometriosis with fibroids. But in this case, the nodes are formed from glandular tissue.

Nodular lesions

Degree of development of intrauterine endometriosis

There are four stages of the disease, with 3 and 4 the most dangerous. If the third degree of internal endometriosis is not easy to treat, then the latter is even more difficult to cope with. They differ in the area of damage to internal organs.

1st degree

Fragments of the endometrium grow only on the muscle layer. There are very few pathogenic tissues, and they affect the organ superficially.

2nd degree

Heterotopias extend deeper into the tissue. The endometrium penetrates the muscular layer of the uterus. Its number is starting to grow.

3rd degree

Adenomyosis extends to the serosa. Single or multiple cysts form on the ovaries. An adhesive process appears in the abdominal cavity.

4th degree

Pathogenic tissues extend beyond the uterus. The peritoneum is affected, fistulas are formed, and the disease affects the vagina and rectum. Bilateral polycystic ovary syndrome is often diagnosed.

Initial degree

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, endometriotic “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%).
(up to 3%).

When endometriotic 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, up 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. At the same time 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.

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.

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.

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 examination

During 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 ultrasound

Echography (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.

Ultrasound cannot reliably distinguish fibroid nodes from the nodular form of uterine endometriosis.

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 imaging

MRI 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.

With 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 endometriotic 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 endometriosis

1.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 endometriosis of the uterus 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 endometriosis

1. Gonadotropin-releasing hormone agonists (GnRH A)
/consultation with a doctor is required/

Name A-GnRH	Reception scheme (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.)

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:

internal - a sign of internal endometriosis is the penetration of cells into the muscular layer of the uterus;

external - pathology extends to the pelvic peritoneum and ovaries.

Extragenital develops outside the reproductive system and has varieties:

peritoneal;

extraperitoneal.

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:

pain and increased duration of menstruation;

Also, the first sign of endometriosis is the appearance of spotting before and after menstruation;

Indirect signs of endometriosis include periodic pain in the pelvic area and lower back;

pain during sex;

general weakness, fatigue, drowsiness, irritability can also be peculiar signs of uterine endometriosis, although such symptoms also indicate a number of other diseases that have nothing to do with the reproductive system;

if the disease is in an advanced form, and endometrial cells have reached the bladder or rectum, then pain occurs during urination and defecation.

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:

enlarged uterus, also called a “round uterus”;

thickening of some walls;

Among the echographic signs of internal endometriosis is increased echogenicity of the myometrium;

open cysts before the onset of menstruation.

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 restoring it can be much more difficult. 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 uterine endometriosis. 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 growth 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 sexual 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 prevent a woman 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 enter 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 is 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 must 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

Echosigns 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 gives multiple magnification when examining the cervix.

Echosigns of uterine adenomyosis One of the most widespread and most effective and efficient types of echography in gynecology is the transvaginal ultrasound method.

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 skullcap - 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 completely stopped, 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 myoma 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, maybe 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. Of 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 hour. 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 is 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 home monitoring 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 really hope 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, Broom, 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 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. Prepare 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. About a year ago, acne appeared 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 focusing on the maximum echopriseaki on 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 hillock Scutellaria baicalensis or Fireweed angustifolia echo signs. Hello, I beg you, please answer the question. What viruses and bacteria can cause a temperature of a little over 37?

So far we have found Klebsiella 10 to 7 degree and Acinetobacter baumania 10 to 8 degree in the intestines. Cytomegalovirus was detected 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 a haircut for thin and oily hair, go through the hills and, based on the results, switch to a stronger tincture of Aconite Djungarian or a less powerful 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 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 cooled.

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.

The echo signs of internal endometriosis did not agree to the operation at that time; 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

The importance and functionality of the uterus in the process of conceiving and bearing a child is well known. However, there are a number of diseases that limit its capabilities. One of them is adenomyosis. We will talk about what it is - internal endometriosis - how to recognize it and cure it, and whether it is possible to bear a healthy child with such a disease.

Normally, the inside of the uterus is covered with a mucous layer, known medically as the endometrium. Its function is to create the most favorable conditions for:

implantation of a fertilized egg into the uterus,
securing it there
supplying the fetus with nutrients and oxygen during pregnancy.

Therefore, a woman’s ability to become pregnant and bear a healthy child directly depends on the condition of the mucous membrane of this most important reproductive organ. But sometimes the endometrium grows into the muscles of the uterus, and also grows in its cervix and canal. This pathology of the uterine body is called internal genital endometriosis (adenomyosis).

There are four stages of the disease. The least dangerous is the 1st degree of internal genital endometriosis, a characteristic feature of which is the germination of the endometrium to a shallow depth. If the disease is not detected in time and appropriate measures are not taken, internal endometriosis will progress to the 2nd, more serious stage.

At this stage, new growths increase in size, cover a larger area and grow in new places. The pain begins to bother me.

The third stage of the disease is characterized by:

ingrowth of the endometrium into the serous layer,
infection of the fallopian tubes and peritoneum,
the appearance of cysts on the ovaries,
formation of a large number of adhesions.

With the fourth degree of internal endometriosis, the pelvic area, excretory and reproductive systems are completely affected. There are frequent cases of organ fusion.

Echosigns of internal endometriosis

As you know, a disease is simpler, easier and cheaper to prevent than to treat it later. This is especially true for diseases of the genital organs. After all, here we are often talking not only about your health, but also about the ability to get pregnant and bear a healthy baby. Therefore, even if nothing bothers you, it is necessary, first of all, to undergo regular preventive examinations.

Well, if there are pains, disruptions in the menstrual cycle and other unpleasant things, you should under no circumstances put off going to the gynecologist. The main symptoms of internal endometriosis include the following ailments:

pain in the lower abdomen,
irregularity of the menstrual cycle,
painful heavy periods,
bleeding during the intermenstrual period.

But since similar symptoms are characteristic of some other diseases, the gynecologist will definitely refer you for an ultrasound examination. Based on its results, it is impossible to establish an accurate diagnosis, however, certain echo signs will make it possible with a high degree of probability to assume the presence of internal endometriosis.

Internal endometriosis of the uterus: treatment

Treatment of internal genital endometriosis of the uterus involves the use of one of two methods:

conservative (with the help of medications);
surgical (operating room).

Sometimes a combined method of getting rid of the disease is used. Drug therapy is not limited to just taking pills. The doctor also prescribes:

a high-calorie diet with limited salt and spices in dishes,
prolonged stay in the fresh air,
limiting not only physical, but also mental stress.

The treatment method depends on the degree of the disease, age and general condition of the patient and is prescribed individually.

Statistics show that the risk of endometriosis is lower among women who smoke and those who take hormonal contraceptives.

Internal endometriosis and pregnancy

Endometriosis ranks second on the list of causes of infertility. If this is internal endometriosis, the inability to get pregnant can be caused either by the development of adhesive processes, or by changes in hormonal levels that do not allow the egg to mature and leave the follicle.