What is the cause of heavy menstrual bleeding in adenomyosis?

Adenomyosis is a diffuse or localized lesion formed by the invasion of endometrial glands and stroma into the myometrium. Like endometriosis, it is a common gynecological disease and a difficult disease. So, what is the menstrual bleeding of adenomyosis?

Adenomyosis mostly occurs in women aged 30 to 50, but can also be seen in young women who have not given birth, which may be related to the increase in various intrauterine surgeries. About 15% of patients suffer from endometriosis and about 50% suffer from uterine fibroids. This disease belongs to the category of "dysmenorrhea", "dysmenorrhea" and "infertility" in traditional Chinese medicine.

The patient had the following clinical manifestations:

1. Symptoms

1. Menstrual disorders in 40% to 50% of cases are mainly manifested by prolonged menstruation and increased menstrual volume. Some patients may also experience spotting before and after menstruation, and severe cases may lead to anemia.

2. Dysmenorrhea 25% is characterized by secondary progressive dysmenorrhea. It usually occurs one week before menstruation and is relieved at the end of menstruation. Taking painkillers can relieve dysmenorrhea in the early stage, but as the disease progresses, the dose of painkillers required for dysmenorrhea increases significantly, making it unbearable for patients.

3 The other approximately 35% of patients have no obvious symptoms.

2. Physical signs

Gynecological examination shows that the uterus is often uniformly enlarged and spherical, and adenomyoma may appear as a hard nodule. The uterus is generally not more than 12 weeks of gestation. The uterus is tender near the menstrual period; during the menstrual period, the uterus is enlarged, soft, and tenderness is more obvious than usual; after the menstrual period, the uterus shrinks. The uterus often adheres to the surrounding rectum, especially the posterior rectum, and has poor mobility. Endometriosis is combined in 15% to 40%, and uterine fibroids are combined in about half.

The disease can be treated with drug intervention or surgery, but it is difficult to cure. Only after menopause can adenomyosis gradually improve. The choice of clinical treatment options should be personalized according to the patient's age, symptoms and fertility requirements.