Adenomyosis

Endomyometritis or endometriosis interna are other names of

adenomyosis.

Introduction: the uterus is a muscular organ situated in the
female pelvis between the rectum and bladder.
When an egg is released from the ovaries and travels to the
uterus via a fallopian tube for fertilization.
The uterus is lined by an endometrial wall that gets thickened
every month as a protected layer for growing an embryo. But if
fertilization does not occur the layer breaks down and then
releases the egg from the uterus.
Adenomyosis is a condition where an endometrial layer of the
uterine wall grows inside the endometrium layer of the uterus.
The endometrium layer grows before menopause and stops
growing after menopause.
Adenomyosis can cause bloating and heavy feeling in the lower
abdomen.

Cause of adenomyosis:
1. An increased level of estrogen can be the reason for the
increased growth of endometrial tissues. It resolves after
menopause due to decreased levels of estrogen.
2. Uterine abrasion like D&C for termination of pregnancy by
surgical procedure.
3. History of cesarean delivery can cause the entering of
endometrial cells into the endometrium layer of the uterus.
4. increased level of prolactin can cause adenomyosis.
5. Autoimmune factors.
6. The study has concluded that hyper contraction of the
uterus can cause minute injury to the uterine wall that

increases the estrogen level to heal the injuries but at the
same time increased estrogen level increases uterine
contraction.

Symptoms of adenomyosis:

1. It can affect one particular area of the uterus or it can be
scattered involving a large area.
2. Uterine enlargement due to abnormal growth of
endometrial cells inwards the endometrium.

3. Thickened layer causes abnormal uterine bleeding.
4. Pain during sexual intercourse.
5. Severe pain in the lower abdomen during menses with the
tenderness of the abdomen.

6. Heaviness and bloating feeling in the lower abdomen.
7. Tired and weak feeling due to uterine hemorrhage.
8. Increased frequency of urination due to pressure over the
bladder.

9. In ultrasonography, certain symptoms of adenomyosis can
be seen like :

*Enlarged uterus.
* thickened uterine wall.
* Cystic spaces or lesions can be seen in USG.

Complications:
1. Infertility.
2. Preterm labor.
3. Abortion.
4. Menorrhagia/metrorrhagia causes weakness.
5. Anemia.

Diagnosis :
1. Transvaginal ultrasonography(TVS): the thickness of the
     junction between the endometrial and myometrial layer
     should be less than 8mm… increased thickness of the
     junction is an indication for adenomyosis.
2. MRI.

Management:
1. A healthy nutritional or iron-rich diet should be taken for
the correction of an anemic condition that is caused by
heavy bleeding during menses or abnormal uterine
bleeding.
2. Do exercise regularly.
3. Avoid stress.
4. Maintain a healthy weight.
5. Avoid tobacco smoking and alcohol.

Homeopathic management:

1. Sabina: Sabina is well marked in the condition where
menses are produced early. Hemorrhage is hot watery
bright red mixed with dark clots. Severe pain in the lower abdomen extends from sacrum to pubis relieved when
lying on the back. shooting type of pain inside the vagina.
Bleeding between periods.

2. Trillium pendulum: it is well marked in adenomyosis where
Uterine bleeding is profuse, severe pain in hips and back,
sensation as if body parts are falling in pieces. And
relieved by tight bandaging.
Heavy bleeding on least movements. Irregular menses
occurs every 2 weeks.

3. Hamamelis virginiana: hamamelis is well indicated in
heavy menses with dark bleeding or a sore feeling in the
abdomen. Abnormal uterine bleeding with bearing down
pain. The smallest movements can cause heavy bleeding.
pain in lower abdomen during menses. Bleeding only in the
daytime.

4. Secale cornutum: heavy menstrual bleeding or pain with
coldness and intolerance of heat. Menses are irregular,
heavy bleeding, dark continuous oozing of watery blood
until the next period. Burning sensation in the lower
abdomen.