Chronic pain in the groin, lower abdomen and waist ... Intense and prolonged menstrual bleeding, intermittent bleeding ... Severe anemia ... Pain in sexual intercourse and sexual reluctance that develops as a result ... Worse, its ability to prevent pregnancy can lead to miscarriage one after another even if pregnancy occurs. can lead! The name of this disease, which can sometimes take years to be diagnosed, because it has common symptoms with other diseases and the problems experienced during the menstrual period are considered as usual and the doctor is not consulted; adenomyosis.
The endometrium tissue lining the inner space of the uterus is removed from the body with menstrual bleeding every month. The growth of this tissue in the uterine wall muscle due to various factors is called 'adenomyosis'. Although there is no clear data on the incidence of adenomyosis, which affects women of reproductive age and ends in menopause because it is dependent on estrogen, it is stated to be a very common health problem. Acıbadem University Atakent Hospital Gynecology and Obstetrics Specialist Assoc. Dr. Müberra Namlı Pen, Drawing attention to the fact that the most important problem in adenomyosis, which can significantly reduce the quality of life of women, is the delay in treatment, he said, “Showing common symptoms with other diseases makes it difficult to diagnose. In addition, patients may not need to consult a physician, considering that heavy menstrual bleeding and pain in the groin area are normal. They have to suffer from these pains for years, and even worse, they cannot achieve the dream of motherhood. Therefore, especially in cases of groin pain and heavy bleeding, a physician should be consulted, and annual gynecological examinations should never be neglected even if there is no complaint ”.
The reason is not yet known
Although the exact cause of adenomyosis is unknown, various theories have been put forward. Although it has not been scientifically explained yet, the frequent family history in adenomyosis patients suggests that the genetic factor is also effective. In addition, it is stated that the presence of endometrial foci in the uterine muscle from birth, surgical procedures such as cesarean section and birth traumas that cause damage between the inner wall of the uterus and the middle muscle layer, infections and stem cells placed in the uterine wall may be the cause of many factors.
If there is even one of these symptoms ...
Adenomyosis may not show any symptoms or progress with very mild complaints in 35 percent of patients. Assoc. Dr. Müberra Namlı Pen By listing the most common symptoms, this He warns that if there is even one of the complaints, it is necessary to consult a doctor:
- Excessive and prolonged menstrual bleeding: Menstrual bleeding should not last more than 7 days. The number of pads used daily should not exceed 2-4.
- Intermediate bleeding that develops outside of menstruation.
- Severe cramps or sharp, stabbing lower abdominal pain during menstruation with no other cause.
- Chronic groin and low back pain, feeling of fullness in the pelvis.
- Pain in sexual intercourse and the resulting lack of sexual desire.
- Miscarriages whose cause cannot be determined.
- Infertility
- Anemia caused by heavy menstrual bleeding: The result of this picture is the development of chronic fatigue, unhappiness, decrease in energy, anxiety or depression.
Can prevent motherhood
Another important problem caused by adenomyosis is that it causes infertility and increases the risk of miscarriage one after another even if you become pregnant. Assoc. Dr. Müberra Namlı Kalem stated that adenomyosis affects pregnancy in 2 ways and continues as follows: “The first effect is that it disrupts the uterine wall structure and blocks the passage of sperm through the tubes. Second, when the pregnancy occurs, the embryo prevents adherence by creating high pressure in the environment where it will settle. " Assoc. Dr. Müberra Namlı Kalem emphasized that the risk of miscarriage is doubled in adenomyosis cases and said, “If adenomyosis is not detected, the chance of the patient to become pregnant or to continue it if pregnancy occurs gradually decreases. If endometriosis is accompanied by involvement of the ovaries, tubes and peritoneum, the risk increases further. If the diagnosis is made, thanks to the IVF method and the more intensive application of preventive measures against the risk of miscarriage, the chance of the patient to become a mother is quite high.
Regular inspection is very important
Regular gynecological examinations and informing the physician about the menstruation are of great importance in early diagnosis. Gynecology and Obstetrics Specialist Assoc. Dr. Müberra Kalem warned that annual checks should be started at a very early age, especially for those with a family history, saying, “Whether or not there is this disease in the family, gynecological examination should be performed in the first period, ie 13-14 years of age. Then, up to the age of 20, examination every 3-4 years will be sufficient. Annual checks should not be neglected starting from the 20s. " says. Having a larger uterus is seen as an important clue for diagnosis. Diagnosis can be made by ultrasonography, but MRI (magnetic resonance imaging) method may be needed in suspicious cases.
Solution can be provided with treatment
Treatment in adenomyosis is arranged according to the patient's age, complaints and whether he / she wants to have a child. For example, if the menstrual bleeding is very intense, hormone supplements to reduce bleeding and pain medications to relieve pain are used if there is pain. Adenomyosis foci, which can cause severe pain and intense bleeding or are thought to prevent pregnancy, can be reduced with medication or removed with appropriate surgical techniques. If the symptoms are very severe and the patient has completed their reproductive age, the uterus may be recommended for a definitive solution. Emphasizing, however, that drugs that control pain and bleeding are beneficial as long as they are used, problems start again when they are stopped. Dr. Müberra Namlı Pen, “Our other option besides drug therapy is spirals that secrete progesterone. The spirals that we apply in suitable patients can significantly reduce the complaints of bleeding and pain for 5 years and stop the progression of the disease. With this method, the patient can avoid surgery. " says.
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