Adenomyosis is a common benign gynecological disease characterized by the ectopic growth of endometrial glands and stroma into the myometrium. In recent years, its incidence has been increasing year by year, and the age of onset has shown a younger trend, which is closely related to factors such as uterine injury, abnormal sex hormone levels, and genetic factors. Most patients with adenomyosis have obvious clinical symptoms, such as progressive dysmenorrhea, menorrhagia, prolonged menstrual periods, and lower abdominal distension, but a small number of patients have no obvious discomfort and are accidentally found during gynecological examinations. Early detection and accurate diagnosis through scientific examinations are crucial for the formulation of treatment plans and the improvement of the quality of life of patients. It is reported that adenomyosis affects about 10% to 15% of women of childbearing age, and the incidence is higher in women who have given birth or have a history of uterine surgery.
Prevention of Adenomyosis
The prevention of adenomyosis should focus on avoiding uterine injury and regulating hormone levels, and the specific measures are as follows:
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Undergo regular gynecological examinations and pelvic ultrasound. Women of childbearing age, especially those who have given birth, had abortion operations, or have a family history of adenomyosis, should have a gynecological examination and B-ultrasound every year to detect potential lesions in a timely manner.
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If abnormal symptoms such as dysmenorrhea, menorrhagia, or irregular menstruation occur, go to the hospital for examination in time. B-ultrasound can be done first to observe the thickness of the myometrium, the distribution of ectopic lesions, and the size of the uterus; if necessary, further examinations such as magnetic resonance imaging (MRI) or blood tests can be performed to confirm the diagnosis.
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Pay attention to protecting the uterus and avoid unnecessary uterine operations, such as induced abortion and curettage, which can easily damage the uterine wall and increase the risk of adenomyosis. For women who need to undergo uterine surgery, choose a regular hospital and an experienced doctor to reduce the risk of surgical injury.
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Maintain a healthy lifestyle, avoid long-term mental stress, excessive fatigue, and irregular work and rest, which can help regulate the balance of sex hormones in the body and reduce the incidence of adenomyosis. At the same time, avoid long-term intake of foods with high estrogen content.
Common Examinations for Adenomyosis
The diagnosis of adenomyosis requires a combination of clinical symptoms, gynecological examinations, and auxiliary examinations. Dr. David Carter, a gynecologist specializing in adenomyosis diagnosis and treatment, points out that a single examination is often not enough to confirm the diagnosis, and a comprehensive evaluation is needed to improve the accuracy of diagnosis. The following are the common examinations for adenomyosis:
Gynecological Examination
Gynecological examination is the most basic examination method. The doctor can feel the size, shape, and texture of the uterus through bimanual examination. Patients with adenomyosis usually have an enlarged uterus, which is uniform or uneven, and the texture is hard. When pressing, there may be tenderness, especially before or during menstruation, the tenderness is more obvious. In addition, the doctor can also check the cervix, vagina, and adnexa to rule out other gynecological diseases.
B-Ultrasound Examination
B-ultrasound is the preferred auxiliary examination method for adenomyosis, which is non-invasive, convenient, and low-cost. Through B-ultrasound, the doctor can clearly observe the thickness of the uterine myometrium, the distribution of ectopic endometrial lesions, and the size and shape of the uterus. The typical ultrasonic manifestation of adenomyosis is that the uterine myometrium is thickened unevenly, and there are scattered hypoechoic areas or cystic dark areas in the myometrium, which are not clearly separated from the surrounding normal myometrium. B-ultrasound can also help distinguish adenomyosis from uterine fibroids, ovarian cysts, and other diseases.
Magnetic Resonance Imaging (MRI)
MRI is a more accurate examination method, which is suitable for cases where B-ultrasound cannot confirm the diagnosis or needs to further clarify the scope of lesions. MRI can clearly show the distribution, size, and depth of ectopic lesions in the uterine myometrium, and can accurately distinguish adenomyosis from uterine fibroids, especially for patients with multiple lesions or unclear lesion boundaries. However, due to the high cost of MRI, it is not used as a routine examination, but as a supplementary examination for difficult cases.
Blood Test (CA125 Detection)
CA125 is a tumor marker, which is often used in the auxiliary diagnosis and follow-up of gynecological diseases. The level of CA125 in patients with adenomyosis is often slightly or moderately increased, generally between 100 U/ml and 200 U/ml. However, CA125 is not specific. The level of CA125 can also be increased in patients with endometriosis, ovarian cancer, pelvic inflammation, and other diseases. Therefore, CA125 detection can only be used as an auxiliary diagnosis method, and cannot be used alone to confirm adenomyosis. It is often used in combination with B-ultrasound and other examinations to improve the accuracy of diagnosis.
Hysteroscopy and Laparoscopy
Hysteroscopy can directly observe the internal condition of the uterine cavity, check whether there are submucosal ectopic lesions, and take living tissue for pathological examination if necessary, which is helpful for the differential diagnosis of adenomyosis and other uterine cavity diseases. Laparoscopy can directly observe the appearance of the uterus, ovaries, and pelvic cavity, and can perform biopsy of suspicious lesions, which is suitable for cases where the diagnosis is difficult or other gynecological diseases need to be ruled out. However, both hysteroscopy and laparoscopy are invasive examinations, and they are generally not used as routine examinations, but as supplementary examinations and treatment methods.
Common Symptoms of Adenomyosis
Understanding the common symptoms of adenomyosis is helpful for women to detect the disease early and seek medical treatment in time. The main clinical symptoms of adenomyosis include the following aspects:
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Progressive Dysmenorrhea: This is the most typical symptom of adenomyosis, which usually starts 1-2 days before menstruation and lasts until the end of menstruation. The pain is mainly lower abdominal pain, which can radiate to the lumbosacral region and inner thighs, and the pain will gradually worsen with the progress of the disease.
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Menorrhagia and Prolonged Menstrual Period: Due to the enlargement of the uterine cavity and the increase of endometrial area, patients often have increased menstrual volume, prolonged menstrual period, or irregular vaginal bleeding after menstruation.
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Lower Abdominal Distension and Discomfort: Some patients will have lower abdominal distension, falling pain, or lumbosacral soreness in non-menstrual periods, which is related to the congestion and edema of the uterine myometrium caused by ectopic lesions.
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Infertility: Adenomyosis can affect the implantation of fertilized eggs and the peristalsis of the uterus, leading to infertility. The infertility rate of patients with adenomyosis is about 20% to 30%.
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Enlarged Uterus: Most patients have an enlarged uterus, which can be felt as a hard mass in the lower abdomen in severe cases.