Endometriosis of the body of the uterus - what is it in an accessible language and what you need to know about this pathology. Hormone therapy and its features. Causes and mechanisms

If some time ago the disease bothered patients aged 30-55, then today, after 20 years, girls are diagnosed with this disease. In the initial stages, there may not even be any pain during menstruation, during sex, or severe irritability, or extramenstrual bleeding. This is due to the fact that the endometrium has not yet grown deep into the organs. The only sign is heavy periods, although not everyone attaches great importance to this and rarely decide to undergo a diagnosis.

Internal endometriosis of the 1st degree is very important to diagnose already at this stage of development. In this case, a complete cure is possible. This is especially true for those who are planning to get pregnant. Because the degree of the disease directly determines the risk of infertility. The initial stages, for example, the 1st will not prevent a woman from conceiving and giving birth to a child. But more on that below.

Diffuse or nodular

What is internal endometriosis 1-2 degrees? The disease can develop as follows.

Diffuse pathology. With it, the uterus is not affected deeper than the submucosal layer. There are small but multiple endometrioid lesions.
Pathology of the nodular form. Endometrium - with one or two endometrioid small nodes that do not reach the muscle layer.

Diagnostics

Endometriosis of the uterine body of the 1st degree is not easy to detect. Pathology develops hidden:

there are no clear manifestations of endometrioid disease;
menstrual function is normal;
sometimes at the beginning of menstruation, a woman feels pain in the lower abdomen, but the problem is usually explained simply by the onset of menstruation;
the uterus is practically unchanged, therefore, even on ultrasound, typical symptoms are not always visible;
with endometriosis of the 1st degree, you can become pregnant if you do not use contraceptives, and in fact, usually, patients come to the gynecologist for a complete examination and treatment when they cannot conceive.

As a rule, endometriosis is detected by chance when an operation is performed on the ovaries (for cystic tumors) or the uterus is affected by fibroids, intervention is required.

It happens that endometriosis is detected during a diagnostic laparoscopy, which is performed to find out the causes of pain. Or during hysteroscopy, when the uterus (her body) is affected by a polyp.

To understand that this is grade 1 or 2 endometriosis, an ultrasound scan is performed. Moreover, it is advisable to carry out ultrasound twice: before critical days and after the end of menstruation.

Symptoms

The initial stage of pathology is recognized by a number of signs:

uterus - its inner layer - uneven;
the walls of the uterine organ are not the same, that is, the uterus does not just change in size, but becomes asymmetric;
there are areas of different echogenicity - increased, decreased;
small liquid cavities are found;
vascular blood flow is changed in suspicious areas.

The initial degree of pathology requires the most thorough diagnosis. To confirm the diagnosis, the doctor will refer to other methods of research:

blood test - a study for a tumor marker (Ca-125),
hysteroscopy (diagnostic procedure),
taking the endometrium for biopsy.

It is important to realize that the first stage of endometriosis is just dangerous because no technique is guaranteed to confirm the diagnosis. How to treat endometriosis of the 1st degree in this case and is it worth taking any measures? An urgent issue that worries many women who care about their health and are planning a pregnancy in the future, perhaps even more than one.

Treatment of endometriosis of the 1st degree in this case will be preventive.

How is endometriosis grade 1-2 treated?

Usually the initial degree of pathology involves the choice of hormonal therapy. If you strictly follow the recommendations of a good doctor, then thoughtful treatment will not only prevent the development of complicated forms of the disease, but also provide all the conditions for pregnancy.

You can treat endometriosis with Janine, Silhouette, Byzanne, Yarina, Duphaston, Utrozhestan. But it is important not to independently prescribe coursework for yourself, but to take the drug recommended by the doctor, taking into account the clinical picture, individual characteristics, etc.

The initial degree of the disease rarely involves the use of strong drugs that have a long-term effect. But sometimes, according to indications, endometriosis can be treated:

injections - the drug Buserelin-Depot is injected,
Mirena - under the supervision of a specialist, a hormonal coil is introduced.

The initial degree is not treated surgically! Therefore, do not be afraid to come for a consultation, do not be afraid to hear this diagnosis. The sooner treatment is given, the better.

Endometriosis 1 degree and desired pregnancy

Even the initial degree of endometriosis, when the pathology is not so deeply affected, can nevertheless create certain problems. What are the risks:

fading pregnancy,
spontaneous miscarriage at the initial stage,
threat of interruption in the first and second trimesters,
problems with placental blood flow,
placenta pathology,
early birth,
in the postpartum period - bleeding.

The initial degree of endometriosis is not a reason to get upset and say goodbye to the dream of long-awaited motherhood. Also, do not wait for the listed risks. If treated correctly, then the pregnancy will pass without complications.

The most effective prevention

An attentive attitude to the slightest deviations of the cycle, pain and discomfort, mood swings is the key to women's health.

What is uterine endometriosis? This is a very common disease, so it is useful for every woman to know about it. Endometriosis (adenomyosis) is characterized by the growth of the lining of the uterus beyond its normal location. In this case, endometrial cells grow between the fibers of the muscular layer (myometrium) of the uterus. The danger of endometriosis is that its development can lead to female infertility.

Development process and types of disease

Separate areas are affected, the pathological process often covers the anterior and posterior walls of the uterus. With the nodular type of the disease, seals in the form of nodules form in the places of germination.

Internal endometriosis of the body of the uterus can have a diffuse appearance, characterized by a uniform germination of the endometrium throughout the internal region of the reproductive organ and the defeat of all muscle layers. Such adenomyosis is very difficult to cure. Any type of adenomyosis is accompanied by an increase in the size of the uterus.

The development of the disease leads to malfunctions in the functioning of the uterus, to a violation of the process of hormone production. Overgrown endometrioid cells cause hemorrhages in the area of the affected area, which is the cause of the development of inflammatory processes. With a disease, the inner layer of the mucous membrane becomes loose, so it is difficult for the embryo to gain a foothold on it. As a result of these processes, infertility can occur.

Conditions for the occurrence and symptoms of adenomyosis

The disease in the early stages often proceeds without external manifestations, the following symptoms can serve:

various menstrual irregularities;
the appearance of pain in the pelvic area;
pain that begins 2-3 days before the onset of menstruation;
change in the size and shape of the uterus.

Under normal conditions, the cyclic development of the endometrium occurs, it thickens at the beginning and is rejected at the end of the cycle. Moreover, growth (unlike adenomyosis) occurs only inside the uterine cavity, without affecting the muscle layer.

The following reasons can lead to the development of endometriosis:

physical overload and stress;
surgical operations performed in the uterine cavity;
abuse of sunbathing;
hereditary predisposition;
hormonal disorders;
retrograde menstruation, accompanied by the reflux of blood cells and endometrium into the region of the ovaries and fallopian tubes;
immune disorders.

These phenomena cause damage to the membrane that protects the muscle layer, and contribute to the engraftment and growth of endometrial cells.

Methods of diagnosis and treatment

A gynecologist diagnoses a disease based on the results of a survey and examination of the patient, as well as using data obtained during laboratory tests and diagnostic studies. The doctor may prescribe studies such as hysteroscopy, transvaginal ultrasound, MRI, biopsy.

The examination helps not only to identify the signs of the disease, but also to determine the stage of its progression. In the initial stage, the endometrium grows into the muscle layer to a depth of 1 cm. In stage 2, painful sensations appear and the depth of germination is half the thickness of the walls of the uterus. At stage 3, the pathological process affects the entire depth of the uterine body and can pass to the ovaries and tubes.

Treatment of pathology can be conservative, surgical or combined.

If there are no pronounced symptoms, then hormone therapy can be used using estrogen-progestin drugs (for example, Anovlar) and agents that have an antigonadotropic (suppressing the production of gonadotropic hormones) effect. The duration of treatment and dosage of drugs are determined by the doctor. With conservative treatment, physiotherapy can be used. Medications stop the growth of the endometrium and help cleanse muscle tissue.

To eliminate infertility, small lesions in the body of the uterus can be removed through conservative plastic surgery. After surgery, the likelihood of pregnancy increases dramatically. Pregnancy, which helps to restore the hormonal balance in the body, can naturally lead to the elimination of endometriosis. With a high degree of development of internal endometriosis of a diffuse or nodular form, extirpation (removal) of the uterus may be required.

Prevention of the disease consists in the elimination of stressful situations and excessive loads, the timely treatment of hormonal disorders and foci of inflammation. To preserve the integrity of the membrane that protects the muscle layer, it is necessary to prevent abortion (using contraceptives) and treat trauma to the birth canal. Regular visits to a gynecologist will help to detect and stop the development of endometriosis in time.

Endometriosis of the body of the uterus, what it is, excites many women. A disease when endometrial cells grow outside the uterine layer and affect the muscular layer of the organ.

This is an insidious pathology, because it is difficult to diagnose, it occurs either without any changes in the body, or the symptoms are similar to other gynecological diseases. The main complication of endometriosis is female infertility.

Pregnancy either does not occur at all or ends in premature termination - miscarriage.

Types and severity of the disease

Endometriosis of the uterus, medically known as adenomyosis.
Depending on the location and degree of damage, the disease is divided into three types:

Genital - the most common disease. It is divided into internal and external endometriosis.
Extragenital - observed outside the genitals: intestines, lungs, stitches after surgery.
Mixed - combines the previous types of pathology.

If you prescribe the wrong treatment, the disease can develop into a chronic form, then there is a sharp exacerbation of the symptoms of the disease.

Such endometriosis cannot be cured, the treatment consists in slowing down the growth of the pathology and relieving pain and other symptoms of the disease.

Endometriosis of the uterus is also divided into three forms:

Diffuse - cell germination is observed throughout the uterus, treatment is very problematic. Therefore, this form of pathology is considered the most dangerous.
Focal, when certain parts of the mucous membrane of the uterus are affected - the posterior or anterior walls.
The nodular form of endometriosis is characterized by the appearance of foci of germination with compaction, which causes the appearance of nodes. Such nodules lead to an increase in the size of the uterus.

Depending on the depth of penetration of endometrial tissues, there are four degrees of severity of the disease:

At the first degree, pathological foci grow to a shallow depth, without going beyond the muscle layer.
Second degree - half of the myometrium is affected.
Third degree - the endometrium affects all the walls of the uterus, to the serous cover.
At the fourth degree, the growth penetrates into the abdominal cavity. Such damage to organs leads to the appearance of fistulas in the uterus and other organs of the small pelvis.

Treatment should be timely in order to get rid of the disease at an early stage, in order to avoid more serious problems. This is especially true for girls who are planning a pregnancy.

After all, getting rid of such a disease is difficult, and sometimes completely impossible.

Causes of the disease

This disease is not fully understood, there are many theories of the development of pathological processes.

But there are a number of factors that provoke endometriosis of the uterine body:

During menstruation, endometrial cells can get outside the uterus, where they begin to grow, affecting other organs: the ovaries, fallopian tubes, and the abdominal cavity.
Hormonal disorder in the body. Studies have shown that high levels of estrogen, and low levels of progesterone in the blood, provoke the development of the disease.
genetic inheritance. There are many cases that endometriosis of the body of the uterus is transmitted through the female line. These girls are at risk.
Violation of the functioning of the immune system. High immunity protects the body from the growth of pathological tissues outside the normal location. With immune disorders, endometrial cells that fall outside the uterus are not destroyed, but begin to function.

There are a number of reasons that provoke the disease:

Mechanical damage to the uterus - regular abortions, gynecological curettage, other manipulations in which the mucous membrane is damaged, then the endometrial cells penetrate deep and begin to multiply.
Gynecological interventions - cauterization of erosion provokes the entry of cells into the vagina, which leads to the development of endometriosis. With a cesarean section, pathological tissues can enter the abdominal cavity, where they continue to function.
Infectious diseases that are sexually transmitted contribute to the development of the disease.
Inflammatory processes or chronic diseases of the genital organs cause endometriosis of the uterine body.
Incorrect use of hormonal drugs.
The use of an intrauterine device causes pathology in many women. In the place where the spiral is in contact with the mucous membrane, an inflammatory process may occur. Tissues lose their elasticity, during menstruation, cells can penetrate outside the uterus.
An important role is played by the environment, ecology, constant stressful situations, physical activity.

The most common symptom of gynecological diseases is menstrual irregularities. Menstruation with endometriosis can be regular, but with profuse bleeding or with uneven intensity and duration.

More often, patients complain of prolonged discharge, which is not amenable to conservative treatment. Abundant blood loss with clots can lead to anemia.

Also an important symptom is regular pain in the lower abdomen. A woman feels pain during sexual contact, urination.

When viewed on a gynecological chair, it is difficult to determine this disease. The doctor may feel an increase in the uterus. To make an accurate diagnosis, modern research and laboratory tests are needed.

Internal endometriosis of the body of the uterus is often combined with hyperplasia, and therefore requires additional research.

If there are no pronounced symptoms, the patient is prescribed hormonal treatment. It is aimed at eliminating the imbalance in the hormonal background. All medications, their dosage and duration of administration, should be discussed with your doctor.

In a severe form of the disease, all reproductive organs can be removed. But this takes into account the age of the woman, whether pregnancy is planned, the general condition of the patient.

The method of surgical intervention should be determined by the doctor, taking into account the individuality of the body of each patient. The most common and effective method of treatment is laparoscopy.

The main signs of endometriosis are the absence of pregnancy or miscarriage of a child.

With endometriosis, the functioning of reproductive functions is disrupted, caused by:

Ovarian damage.
The formation of adhesions in the pelvic area.
Violations in the area of the uterine wall.

Proper treatment will relieve the pathology, the long-awaited pregnancy will come in six months. But pregnancy will not get rid of the disease forever, so such women need to regularly visit a gynecologist.

When planning a pregnancy, it is important to undergo drug therapy in order to avoid complications in the future.

The degree of risk depends on the shape and location of pathological cells. To avoid premature birth, such women need to be constantly under the supervision of doctors. This will help prevent complications and endure a healthy baby.

After childbirth, it is necessary to continue the treatment of the disease, because pregnancy will not relieve the pathology.

It is better to diagnose the disease in a specialized clinic, which is equipped with modern research methods. Treatment should be prescribed by a qualified specialist, after examining the patient.

To identify the disease in the early stages, it is necessary to visit the gynecologist regularly, once every six months.

Endometriosis of the body of the uterus, or adenomyosis, is a gynecological disease in which an atypical proliferation of endometrial cells occurs inside and outside the organ. The pathological process in the early stages does not have pronounced symptoms, so the patient may not even be aware of the development of the disease. If treatment is not started on time, this can gradually lead to problems with conception. Endometriosis often causes female infertility.

What is uterine endometriosis? A distinctive feature of this pathology is the growth of the endometrium (the mucous layer of the uterus). As the disease worsens, atypical foci of growth can spread to the entire abdominal cavity, interfering with the normal functioning of vital organs.

The wall of the uterus has three layers:

endometrium - internal mucous membrane;
myometrium - a muscular layer;
perimetrium - serous tissue that envelops the organ from the outside.

The endometrium has a two-component structure. Its first layer is functional, falling off and being removed from the woman's body along with the blood during menstruation. The second is basal, involved in the restoration of the inner lining of the uterus at the beginning of a new cycle. See photo.

With the development of the disease, atypical cells, morphologically similar to endometrial tissues, grow outside the inner uterine layer. In the foci of the disease, the so-called endometrioid heterotopias, during each cycle, the same changes occur as in the functional endometrium.

Pathology negatively affects reproductive capabilities. Symptoms may vary depending on the rate of spread of lesions and the size of heterotopias.

Classification of uterine endometriosis

There are the following morphological varieties of adenomyosis:

Diffuse endometriosis of the body of the uterus - characterized by the introduction of endometrial cells into the muscular layer of the uterus. It proceeds without the formation of nodules or well-defined heterotopias.
Nodular endometriosis of the uterus - is accompanied by the appearance in the myometrium of single or numerous nodes that do not have capsules.
Focal endometriosis - is manifested by the defeat of clearly defined areas of the muscular layer of the uterus.

Important! The diffuse form of endometriosis is the most dangerous. With this pathology, the walls of the uterus thicken up to 5 cm, cystic formations with bloody contents are often formed.

Depending on the depth of penetration of endometrial cells into the myometrium, the following degrees of the disease are distinguished:

First, only the inner layer of the uterus is affected;
The second - the pathological process affects about half of the muscle layer of the organ;
Third - the entire middle uterine layer and peritoneal walls suffer;
Fourth - the perimetry and tissues of neighboring organs are affected.

Endometriosis of the body of the uterus of the 1st degree with timely treatment does not affect reproductive functions. With 1 and 2 degrees of the disease, women after hormone therapy safely become pregnant and give birth to children. In advanced forms of adenomyosis, serious complications are possible, up to the point that fistulous passages leading into the pelvic cavity may appear in the thickness of the uterine wall.

Causes of adenomyosis

One of the main questions that patients ask is: what is endometriosis of the uterine body? Scientists have not yet figured out why adenomyosis occurs. There are only hypotheses about how pathological foci appear:

are formed from metaplastic squamous single-layer epithelium of the serous uterine membrane;
appear from embryonic tissues that remained unclaimed during the formation of the reproductive system;
grow when endometrial cells are thrown into other organs during surgical interventions, injuries and menstrual bleeding.

It has also been found that the disease often develops with pathological narrowing of the cervical canal.

Among the factors that increase the likelihood of developing pathology include:

any injuries of the uterus, operations on the organs of the reproductive system;

inflammatory processes in the pelvic organs;

no pregnancies, late delivery, repeated abortions;

intrauterine device;

hormonal imbalance, endocrine pathologies, weak immunity;

infectious and venereal diseases;

malnutrition, overweight, alcohol abuse;

hereditary predisposition;

untimely start of menstruation;

stress.

Symptoms and first signs

Approximately half of patients with uterine endometriosis have no pronounced symptoms, so the disease is often discovered by chance during a routine gynecological examination.

The main signs of endometriosis of the body of the uterus are:

heavy painful menstruation;
sudden breakthrough bleeding;
spotting shortly before and after menstruation;
disruption of the menstrual cycle;
increased manifestations of premenstrual syndrome;
discomfort during sexual intercourse.

Also, the symptoms of the disease are expressed by the inability to conceive, due to changes in the structure of the uterus and (or) the appearance of adhesions in the pelvic organs. Signs of endometriosis of the uterus are clearly manifested only in the advanced stage of the disease.

Diagnostic methods

First, the doctor must collect an anamnesis and analyze the symptoms. Then a vaginal examination is performed on a gynecological chair. During the examination, the doctor may notice that the uterus has increased in size, acquired a spherical shape and partially lost mobility due to adhesive processes in the pelvic region. In patients with nodular endometriosis, the surface of the organ becomes bumpy.

At the initial stage, ultrasound diagnostics is prescribed. The main echo signs of endometriosis:

changes in the structure, shape, size of the uterus and appendages;
increased density and thickening of the walls of the organ;
cystic formations on the mucous membrane.

Laboratory and instrumental examination:

general and biochemical blood tests, blood tests for tumor markers;

cytological examination of smears from the vagina;

colposcopy to clarify the localization of lesions;

biopsy to study damaged tissues using histological examination;

computed tomography - determines the localization of foci;

magnetic resonance imaging (according to indications, when other methods are uninformative);

diagnostic laparoscopy.

If there is a suspicion of the spread of lesions outside the uterus, cystoscopy, excretory urography, sigmoidoscopy and other studies are performed. The results of these studies allow an accurate diagnosis to be made.

Treatment Methods

In the treatment of endometriosis, both conservative and surgical methods are used. When compiling a treatment program, gynecologists take into account several factors at once - the level of damage, comorbidities, the age of the patient, and the desire to have a child in the future.

In the standard scheme of conservative treatment, doctors usually include:

taking hormonal drugs (estrogen-progestin drugs, gonadotropin-releasing hormone agonists, progestogens, antiestrogen, antiprogestins);
according to indications, taking painkillers and sedatives;
various vitamin and immunomodulatory complexes are prescribed.

If drug therapy fails, surgery is performed. Most often, a minimally invasive operation is used for this purpose, the medical name is curettage (curettage). This type of surgery is performed under general intravenous anesthesia. The operation lasts only 20 minutes, the rehabilitation period passes without complications.

Indications for surgical intervention are focal and nodular form of endometriosis. With a diffuse form, the operation is not performed, since the foci are too large, and the pathology proceeds with various complications.

In especially severe cases, a laparotomy is performed, during which the entire organ is most often completely removed. But a radical operation is prescribed extremely rarely, doctors try to preserve women's health to the last. After surgical treatment, it is recommended to take courses of physiotherapy (electrophoresis, magnetotherapy, ultrasound).

Can you get pregnant with endometriosis

Endometriosis of the uterus is the most common cause of female infertility.

The inability to conceive a child with this disease is associated with the following factors:

obstruction of the fallopian tubes;

hormonal disbalance;

inflammation of the myometrium, which increases the risk of miscarriage;

autoimmune reactions that prevent the introduction of the egg into the endometrium;

pain during sex complicates sexual activity.

With endometriosis of the uterus, treatment in most cases is long and complicated. It is possible to fully restore reproductive functions only with timely therapy. If a woman has not treated the disease for more than three years, then the chances of getting pregnant naturally are significantly reduced.

Unfortunately, there is no way to get rid of endometriosis forever. In 20% of women after hormonal treatment, relapses occur. The period of remission increases with menopause and after undergoing a course of combined treatment, which includes minimally invasive surgery and drug therapy. At the first symptoms, you should immediately contact a gynecologist, this will help to quickly cope with the disease.

Endometriosis of the uterus has another name - adenomyosis. This is a disease in which endometrial tissue (the inner layer of the uterus) grows outside its cavity, where this tissue should be normal. Based on this, characteristic clinical manifestations of the disease develop. Gradually, the process is steadily progressing, which further aggravates the condition of the woman. Therefore, the further prognosis depends on how timely the diagnosis is carried out and treatment is started. This is especially true when you consider that some women can become disabled on the background of this pathology. The development of disability (limitation of opportunities) is due to the fact that a persistent pain syndrome is formed, and nearby organs are involved in the process. All this dictates the need for early diagnosis and treatment of this pathological process.

Reasons for the development of the disease

Internal endometriosis of the body of the uterus develops for unknown reasons, which are still not fully understood. Therefore, various etiopathogenetic theories are proposed that try to explain the origin of this disease. The following reasons are currently accepted:

implantation theory;
metaplastic theory;
retrograde casting theory;
immunological theory;
combined theory.

But none of these theories explain the specific causes of endometriosis, so they remain only at the hypothesis stage. Moreover, if one theory explains one process, then it finds a contradiction in another. In this regard, the so-called modern concept of the development of endometriosis dominates in modern gynecology. It is a combined reflection of all existing theories in relation to this type of disease.

What does she look like? According to this concept, during menstruation, menstrual blood does flow to the peritoneum. However, the pathological process does not always develop. The reasons for its development are that there must be certain violations of the immune system and favorable conditions for the implantation of endometrial tissue on a particular organ. Thus, endometriosis develops if there are predisposing and contributing factors.

Classification

Endometriosis of the body of the uterus can be classified based on various features. One of the classifications involves the division of this disease according to severity. There are mild, moderate and severe degrees. The main criteria underlying this division are:

severity of pain syndrome;
the prevalence of endometriotic lesions;
general condition of the patient;
violation of the ovarian-menstrual cycle;
development of infertility.

Another classification takes into account the causes of the development of this pathological process, namely the background processes, that is, comorbidity. Perhaps she determined the development of endometriosis of the body of the uterus. The reasons that probably became the background for the development of this pathology are also subject to treatment in the process of complex therapy of this disease.

Clinical picture

Symptoms of uterine endometriosis can vary in severity. They include the following manifestations:

pain;
violations of the ovarian-menstrual cycle;
involvement in the pathological process of adjacent organs;
violation of reproductive function;
various neurovegetative manifestations.

Let's talk about each of them in more detail. With regard to reproductive function, a separate section has been written - adenomyosis and infertility.

Pain is usually associated with the onset of menstruation. At this time they appear, and then gradually increase. Therefore, with the progression of the disease, pain can accompany the entire menstruation, and also persist for several days after it. These pains lead to severe asthenization of the patient. This means that she becomes irritable, nervous. As a result, this condition negatively affects the social adaptation of women. A reasonable question arises - is it possible to cope with this? Yes, you can, if the diagnosis of the disease is timely, and the treatment is correct and adequate.

If the pathological process progresses against the background of the absence of treatment, then endometriosis leads to damage to nearby organs. This means that the bladder and rectum are involved. As a result, this is clinically manifested by a violation of the act of urination, an admixture of blood in the urine or feces (its appearance is associated with the menstrual cycle), constipation and other manifestations.

Symptoms of an ovarian-menstrual cycle disorder can be as follows:

intermenstrual spotting;
heavy menstruation;
long delays in menstruation (hypomenstrual syndrome - oligo- or opsomenorrhea, depending on the duration of the delay).

Neurovegetative symptoms include:

increased irritability;
nervousness;
hot flashes and palpitations;
headache and dizziness;
frequent mood swings, etc.

As a result, all of the above symptoms over time lead to the fact that the general condition of the woman is sharply disturbed. She cannot live and work normally, she is assigned a disability group.

Diagnostics

Symptoms of endometriosis of the uterus are not pathognomonic (specific), therefore, without the use of additional research methods, it is very problematic to determine a specific diagnosis. Therefore, the following methods are used:

hysteroscopy - examination of the uterine cavity using endoscopic equipment;
ultrasound examination - with a certain degree of probability it suggests this disease (ultrasound signs of the disease are well detected on the eve of menstruation, so it is carried out a few days before the expected menstruation);
histological examination.

It should be noted that it is extremely difficult to determine the diagnostic signs in this disease. Therefore, it is very important to conduct a comprehensive assessment of all symptoms that are detected at the stage of an objective examination and at the stage of diagnostic search using additional examination methods.

Treatment

The body of the uterus needs to be timely and correct. This will allow you to influence the consequences of this disease. It has already been considered how dangerous adenomyosis is. Therefore, it is quite obvious that it is necessary to treat!

Treatment of endometriosis of the body of the uterus is divided into two main types:

conservative;
surgical treatment.

Conservative therapy is carried out in a complex. It involves the use of the following pharmacological preparations:

hormonal (there are different classes of hormonal drugs that are used for this disease);
immunocorrective (their appointment is carried out taking into account the identified violations in the immune status);
painkillers (preference is given to drugs from the group of non-steroidal anti-inflammatory drugs, since the balance of prostaglandins is disturbed, which leads to pain);
psychotropic, which are prescribed taking into account disorders in the nervous system.

Hormone therapy is carried out on the basis of whether a woman wants to have children later. If the answer to this question is yes, then you can use:

combined oral contraceptives;
pure gestagens.

If a woman does not plan more pregnancy, then you can also apply:

antiestrogen;
analogues of gonadoliberin;
antigonadotropins.

These three groups of drugs can lead to a state of artificial menopause, so it is desirable to use them in older women. Given the possibility of estrogen-deficient conditions, they are treated intermittently (3 months of admission combined with 3 months of break, etc.).

Surgical treatment is carried out according to strict indications, when conservative therapy is most likely doomed to success. Features of the operation is the observance of measures to prevent the spread of endometrioid cells in the peritoneum. This will prevent the recurrence of the disease. It is desirable to give preference to such operations that allow you to save the uterus as an organ. Radical operations are performed if the anatomy is disturbed and a pronounced adhesive process has developed, which has led to damage to neighboring organs.

After treatment, the woman should be under the supervision of an obstetrician-gynecologist. This will allow timely detection of recurrence of the disease. This situation is an indication for hormone therapy.

Fertile function against the background of adenomyosis

Violation of the reproductive (fertile) function, that is, the ability to bear children, is an integral clinical sign of this disease. The mechanism of development of infertility is associated with the following pathogenetic factors:

a violation in the balance of prostaglandins, which does not allow a fertilized egg to implant normally;
the development of anovulation, that is, the maturation of the egg is disturbed or does not occur at all, and the process of its release from the dominant follicle may also suffer;
immunological disorders that lead to immune mechanisms of infertility;
a pronounced adhesive process that disrupts the patency of the fallopian tubes.

Thus, infertility against the background of endometriosis is a complex problem. Can it be cured? Of course, if treatment is started in a timely manner, taking into account all possible pathogenetic factors. Therefore, in order to treat this condition, it is necessary to know the immune and hormonal status of the patient. After that, appropriate treatment is prescribed. Hormonal treatment is carried out in several stages:

correction of identified violations;
stimulation of ovulation;
support for the second phase of the menstrual cycle.

In conclusion, it should be noted that endometriosis of the uterine body is a serious disease that requires timely diagnosis and treatment. With a belated detection of a pathological process, it is possible to develop irreversible processes in the internal organs, which can lead to a woman's disability. Therefore, further prognosis depends on the timeliness of treatment.