Adenomyosis is caused by uterine cavity operation (including abortion, cesarean section, hysteroscopy), estrogen stimulation, heredity, and other factors.
Dysmenorrhea is the typical symptom of adenomyosis. The pain is mild in the first few years and gradually aggravated in the next few years. Dysmenorrhea accounts for about 70% of women. Generally, the menstrual volume increases suddenly after 4 ~ 5 years of onset, which can easily lead to anemia for a long time.
Due to the different location of the focus, some women will have sex pain. Adenomyosis, popularly speaking, is like the poor quality of the house where the fetus lives, so adenomyosis can cause infertility. Even some patients will get pregnant naturally, but the risk of spontaneous abortion is also greater.
Therefore, women need to treat adenomyosis actively. It mainly has three treatment methods.
1. Chemical medicine treatment: Patients with mild symptoms of adenomyosis can take some nonsteroidal anti-inflammatory drugs such as Fenbid during dysmenorrhea. If the patient does not want to have children, for the time being, oral contraceptives or progesterone can be used to treat the disease. They can also use a contraceptive device containing high-efficiency progesterone to treat adenomyosis through its continuous release of progesterone in the uterus.
2. TCM treatment: TCM believes that this disease is related to the congestion in the patient's body, so it will adopt the principle of promoting blood circulation and removing blood stasis. Taking Fuyan Pill, a herbal patent medicine, can relieve patients' pain and other symptoms. And it can also improve the chance of natural pregnancy.
3. Surgical treatment: Surgical treatment is divided into radical operation and conservative operation. Radical surgery is suitable for patients with severe symptoms, directly removing the uterus for treatment. This method is ideal for women who no longer have children in the future. If women still want to have children, conservative surgery will be used for treatment. Adopt conventional surgery to achieve the therapeutic effect by removing adenomyoma, endometrium, and myometrium.
Adenomyosis is called "immortal cancer" by the medical community. That is, the endometrium grows in the myometrium like cancer cells, causing pain to women. Unlike cancer, it is benign hyperplasia. However, this does not mean that adenomyosis is absolutely benign. There are also very few patients who may become cancerous.
Doctors speculate that cancer may occur due to the following reasons:
1. For patients with adenomyosis, uterine enlargement, and abdominal pain, the pain time is not limited to the menstrual period but also intermittent lower abdominal pain in the non-menstrual period. The degree of pain is also worse than before. If the nature of dysmenorrhea changes, especially in patients with irregular lower abdominal pain in the non-menstrual period, women should pay great attention to it and guard against the possibility of malignant lesions;
2. Some studies believe that 23% of malignant transformation of adenomyosis patients show abdominal pain and space-occupying the uterine cavity. In addition, a few patients have no clinical symptoms, only show abnormal cervical smears, but there is no endometrial thickening, and early metastasis is not easy to find. However, when it is clearly diagnosed, it is often in the late stage of the disease, with a high risk of recurrence and poor prognosis.
Therefore, women should not take it lightly for postmenopausal unexplained lower abdominal pain. Postmenopausal patients without uterine atrophy cannot be explained by simple adenomyosis. They should be vigilant against other diseases, such as Serous papillary endometrial carcinoma or uterine sarcoma, and do not blindly use drugs for conservative treatment;
3. Malignant transformation of adenomyosis is rare, most of which are case reports. According to foreign data, there are about 40 cases of adenomyosis and ectopic endometrium, including 33 cases of endometrioid adenocarcinoma, 2 cases of poorly differentiated adenocarcinoma and 2 cases of clear cell carcinoma, 1 case of serous papillary carcinoma, 1 case of papillary adenocarcinoma containing thyroid gland and 1 case of adenosquamous carcinoma.
There are few malignant cases of adenomyosis. The symptoms and signs of early instances are similar to adenomyosis, so the diagnosis is often delayed. Therefore, if the uterus increases rapidly in a short time for patients with adenomyosis, or the nature of dysmenorrhea changes, they should be alert to the possibility of malignant transformation.
In conclusion, for patients with adenomyosis, especially women over 40 years old, if the nature of dysmenorrhea changes, or postmenopausal women have unexplained lower abdominal pain, even if there is no irregular vaginal bleeding or postmenopausal bleeding, they should also be alert to the possibility of malignant transformation of eutopic or ectopic endometrium. And pay attention to the characteristics of various particular types of endometrial cancer.
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