Adenomyosis and endometriosis: what is the difference, main symptoms and treatment
Gynecological diseases, which are based on proliferative processes, are called adenomyosis and endometriosis. Both pathologies are referred to as precancerous processes. What distinguishes adenomyosis from endometriosis, can only answer an experienced specialist who knows the pathogenesis and morphology of each of these diseases. In some cases, these concepts are combined into one, since the difference between them is not very pronounced. This is not considered a mistake, but there are still differences.
Adenomyosis and endometriosis: what is the difference between concepts?
Hyperplastic diseases are often found in the practice of gynecologists. The proliferation of uterine tissue and appendages can occur at any age. All hyperplastic processes are considered potentially dangerous for the female body. They can lead to infertility, tumor development, etc.Adenomyosis and endometriosis belong to a similar group of pathologies. The differences between these diseases are not pronounced.
Endometriosis is a pathological condition in which normal endometrial cells intensively divide and spread throughout the body. They can appear in any organ, but are most often found in the pelvic cavity.
Adenomyosis is considered a similar disease. In this pathology, proliferation and distribution of the tissue of the uterine muscle layer also occurs. Therefore, patients often ask the question: adenomyosis and endometriosis - what is the difference? The difference between the two diseases lies in the localization of hyperplastic processes. Adenomyosis is characterized by the germination of endometrioid tissue in the body. As a result, the uterus increases in size.
Causes of endometriosis and adenomyosis
What causes adenomyosis and endometriosis, what is the difference between etiological factors? Although the pathologies are somewhat different from each other, both arise due to hyperplasia. Endometrial proliferation does not occur by itself. This process is associated with hormonal changes that occur constantly in the female body. Etiological factors of endometriosis and adenomyosis can be:
- Pathological conditions in the hypothalamus or pituitary gland. Hormonal status changes when benign tumors occur, and head injuries occur.
- Diseases of the female genital glands - the ovaries. As in the brain, there may be hormone-producing tumors.
- Pathology of the thyroid gland.
In diseases of all these organs, the hormonal status of the patient changes. Most often, endometrial tissue hyperplasia occurs with elevated estrogen levels.
Endocrine disorders occur in women at risk. The factors for the development of hyperestrogene include:
- Frequent pregnancy and childbirth.
- Abortion history in a patient.
- Lack of pregnancies for life.
- Severe obesity. In adipocytes, the formation of female sex hormones.
- Installing the intrauterine device for a long time.
- Chronic inflammatory and venereal diseases.
Differences in the mechanism of development of pathological processes
Adenomyosis and endometriosis: what is the difference in the mechanism of action? The basis of both diseases is tissue proliferation. As you know, this process is observed in normal women of childbearing age.In a normal menstrual cycle, the thickening of the endometrial wall due to enhanced cell growth occurs every month.
However, in adenomyosis, the process is more pronounced. In addition, areas of hyperplasia do not disappear during the progesterone phase of the cycle. As a result, the uterine wall is constantly thickened and has a soft texture. Before menstruation, it reaches its maximum size, since during this period the production of estrogen increases.
The mechanism of endometriosis development is the same as in adenomyosis. The difference is that the overgrown foci of tissue of the muscular layer of the uterus are located outside the organ. They can be in the field of appendages, a cavity of a small basin, on ovaries, a peritoneum. In rare cases, endometriotic foci are located in the cavity of internal organs: lungs, intestines, joints, nasal cavities, etc. They all are amenable to hormonal regulation. That is, the activity of pathologically overgrown cells depends on the production of estrogen.
Clinical picture with endometriosis
The symptoms of endometriosis can be varied. First of all, it depends on the location of the hyperplastic process.Often the pathology proceeds without severe symptoms, since the endometrial foci are localized in the pelvis, intestine or appendages. During menstruation, the tissue lining the uterus is rejected. As a result, bleeding occurs, which is observed every month. The fact is that, regardless of the location of the endometriotic foci, during menstruation they are all active. Therefore, spotting may appear in the most unexpected places. If there is hyperplasia in the pelvic cavity (Douglas space, peritoneal pockets), then the clinical manifestations of the disease may not be observed.
In addition to bleeding, the symptoms of endometriosis include: abdominal pain, anemia, dysmenorrhea - a violation of the menstrual cycle. Sometimes the only sign of illness is the absence of pregnancy with non-compliance with contraceptive measures.
What are the symptoms of adenomyosis?
Adenomyosis and endometriosis - what is the difference in the clinical picture? Although the pathologies have the same developmental mechanism, the symptoms may differ. Unlike endometriosis, a pathological focus for adenomyosis cannot be common. Therefore, bleeding from other organs and cavities will not be observed.Adenomyosis is the proliferation of endometrial tissue in uterine tissue. Therefore, the main symptom of the disease is pain in the lower abdomen. Discomfort occurs due to the stretching of the ligaments of the uterus and increasing its size. Also characteristic symptom of adenomyosis is dysmenorrhea. The menstrual cycle is often shortened, and the period of blood flow is lengthened. During intercourse, there is pain due to an increase in the walls of the uterus. The intensity of menstrual bleeding increases. As a consequence, an anemic syndrome may develop.
Diagnosis of adenomyosis and endometriosis
To distinguish endometriosis from adenomyosis, several diagnostic procedures should be performed. In addition to the gynecological examination, instrumental methods of examination are required. Suspected adenomyosis can be on the clinical data: pain during intercourse and menstruation, profuse bleeding. Palpation of the uterus is marked by its increase. Thickening of the walls and foci of hyperplasia are diagnosed using ultrasound of the pelvic organs.
It is more difficult to identify endometriosis, since its localization is unknown. In addition, the pathology often has no symptoms.Most often, the disease is diagnosed during examination of a woman about the inability to conceive a child. Endometriotic foci can be located in the uterus (in adenomyosis - in the thickness of the organ wall) and prevent the attachment of the ovum. Hyperplasia is detected by ultrasound, hysteroscopy, laparotomy. Bleeding of unknown etiology can also be triggered by endometriosis. In this case, it is necessary to examine the entire body.
Adenomyosis and endometriosis: the difference in the treatment of diseases
Hyperplastic diseases are considered dangerous as they lead to serious consequences. Therefore, treatment is required for both processes. Help with pathologies adenomyosis and endometriosis - what's the difference? The treatment of both diseases can be conservative and surgical. Most often, drug therapy is carried out in cases of small foci of proliferation in women of fertile age. Since endometriosis and adenomyosis are considered hormonal pathologies, drugs from the COC group are prescribed. They contain estrogen and progesterone in the quantities necessary for a normal menstrual cycle.The combined oral contraceptives include the medicines “Yarin”, “Jess”, “Janine”, etc.
Surgical treatment is necessary in the absence of the effect of conservative therapy, as well as during menopause. For surgical interventions include:
- Laparoscopic removal of endometriotic focus or adenomyosis zone.
- Hysterectomy. With oncological history and heavy bleeding, the uterus is removed.
What is the prognosis for endometriosis?
Some women are interested in the question: adenomyosis and endometriosis - which is worse? In both cases, changes in the hormonal background are observed in the female body. Therefore, each of these pathologies is dangerous. Often the prognosis for endometriosis is favorable. However, the disease can recur in the presence of endocrine disorders.
What is the prognosis for adenomyosis?
Most often, after removal of adenomyosis, a woman can give birth to a child and also avoid the serious consequences of the disease. The exception is a common process that requires a hysterectomy. The operation reduces the risk of cancer, however, leads to infertility.