ADENOMYOSIS
Description
- Benign invasion of the endometrium into the myometrium due to hyperplasia of the endometrial basal layer producing a diffusely enlarged uterus (Endometriosis internal)
- Both glandular and stromal components of the endometrium are involved
- Associated with myometrial hypertrophy and may be either diffuse or focal
- Peak incidence at 35-50 years
Etiology
- The etiology is not known
- May be related to weakness of myometrial smooth muscles from repeated childbirths, vigorous curettage or excess of oestrogen effect
- More common in women having endometrial hyperplasia and fibroids
Types
- Dysmenorrhoea
- Heavy menstrual bleeding
- Prolonged bleeding cycles
- Chronic pelvic pain
- Severe and increasing abdominal pain throughout the month
- Back pain
- Dyspareunia
- Infertility
Investigation
- Clinical diagnosis
- Pelvic examination –reveals an enlarged, tender, and boggy uterus
- Ultrasonography (TVS) - Focal or diffuse myometrial bulkiness, typically of the posterior wall
- Myometrial Biopsy
- CA-125 (elevated in adenomyosis)
- MRI
Treatments
- Surgical
- Progestins or cyclic oestrogen and progestin
- Definitive treatment - Total hysterectomy, with or without ovarian conservation
Ayurvedic Treatment
Internal Medicines
- Varunadi Kashaya
- Kanchanara Guggulu
- Dhanwanthara Gutika
- Maha Narayana Taila
- Hingu Triguna Taila
- Avipathi Choorna
- Kalyana kshara + Gritha
Procedures
- Virechana
- Lekhana vasthi
- Yoni Pichu- Apamarga Kshara Taila, Dashamoola Taila
- Uttara Vasti - Apamarga Kshara Taila, Dashamoola Taila
Department
Prasoothi & Stree Roga
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