What are the diagnostic criteria for adenomyosis?

What are the diagnostic criteria for adenomyosis?

Adenomyosis can be initially diagnosed based on typical medical history and physical signs, combined with imaging examinations such as pelvic or vaginal B-ultrasound, MRI, CA125, etc. Confirmation requires surgery to obtain the diseased tissue for pathological examination.

Medical treatments for adenomyosis include:

1 Symptomatic treatment For those with mild symptoms who only require relief of dysmenorrhea, non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin or naproxen can be used for symptomatic treatment during dysmenorrhea.

2 Pseudopregnancy therapy is used for patients with mild symptoms, no fertility requirements, and those near menopause. Oral contraceptives or progestins can cause the ectopic endometrium to decidualize and atrophy, thereby controlling the development of adenomyosis.

3. For those who have heavy menstrual flow, dysmenorrhea, and no desire to have children, an intrauterine device containing highly effective progestin can be chosen. It continuously releases progestin locally in the uterus to control the development of ectopic lesions. It needs to be removed or replaced after five years.

4 Pseudomenopause therapy "drug-induced oophorectomy" or "drug-induced hypophysectomy" is a drug that shrinks the lesion before surgery and reduces recurrence after surgery. GnRHa injection allows the hormone level in the body to reach the state of menopause, thereby causing the ectopic endometrium to gradually shrink and play a therapeutic role. The application of GnRHa can significantly reduce the size of the uterus, and can be used as a preoperative medication for some patients with large lesions and difficult surgeries. The risk and difficulty of surgery will be significantly reduced after the uterus becomes smaller. Side effects may cause menopausal symptoms and even lead to serious cardiovascular and cerebrovascular complications and osteoporosis, so it is recommended to add estrogen in reverse after 3 months of GnRHa application to relieve complications. In addition, GnRHa is expensive, so it is not currently used as a long-term treatment option. Once the drug is stopped, the resumption of menstruation may lead to the re-progression of the lesion.