Treatment of adenomyosis

Adenomyosis is a disease that is a particular case of endometriosis. In endometriosis, endometrial cells are found in tissues in which they should not be. In particular - in the muscular layer of the uterus, in the ovaries, in the fallopian tubes. The standard treatment regimen for adenomyosis involves the use of hormone therapy.

In particularly difficult cases, endometrial cells can be detected even in the organs of the abdominal cavity. In this case, such cells obey the laws of the menstrual cycle, that is, menstruate in a certain period. At the same time, there is no normal output for blood secretions, there is discomfort up to acute pain. Possible spotting in the intermenstrual period. If we are talking about adenomyosis, this is the case when the endometrial cells are found in unnatural places only in the side of the uterus. In adenomyosis, the ingrowth of the endometrial layer can be insignificant, and can completely penetrate muscle tissue, forming nodes and accumulations of bloody discharge in them.

Treatment regimen for adenomyosis

Depending on the degree of complexity of adenomyosis itself, as well as on the presence of concomitant diseases, a treatment regimen is chosen.

Hormone therapy with adenomyosis is used quite often, the effect of such treatment will be visible no earlier than 3-6 months after the start of taking hormonal drugs. Also, a course of anti-inflammatory and analgesic drugs is prescribed for symptomatic relief, which significantly affects the patient's way of life. In the case of severe ineffectiveness of hormonal therapy, surgical treatment of adenomyosis is resorted to. Surgical intervention can mean, like hysteroscopy (mechanical removal of the endometrial layer of the uterus), removal of endometrial cells from the muscle layer, and complete removal of the uterus (only the body of the uterus or the body and cervix).

But surgical treatment is very individual. It is possible to combine surgical and hormonal methods. For example, the removal of particularly complex formations by surgical means, and further pathologies to try to overcome with the help of drug treatment.

Alternative treatment of adenomyosis

Cases of adenomyosis have been known since quite a long time. This disease has always been a huge inconvenience to a woman, significantly lowered the quality of her life, very much interfered with the normal implementation of herself in social and moral terms. Therefore, since a long time, there were means and ways to combat this disease, designed to alleviate the condition of the patient. To date, there are many different approaches to the treatment of adenomyosis and the removal of its symptoms.

Modern medicine has stepped far ahead in the study of the causes and features of the development of this disease. But the alternative means that have come to us from the distant past have not lost their relevance. Many of them are time-tested. Also, to alternative means of treatment are patients who, for one reason or another, do not trust classical medicine. But not only this fact leaves alternative methods of treatment of adenomyosis topical. Sometimes the use of classical medicine is simply not available. Then the herbs, broths, leeches and other methods of alternative medicine come to the aid, we are well acquainted with them in the treatment of various other diseases.

When using alternative drugs, different methods are used, such as taking general drugs (drinking infusions, decoctions, extracts), and local (douching, compresses, applying leeches), even aromatherapy is applied. But it is important in this situation to understand that adenomyosis is a disease that requires struggle both with the clinical manifestations themselves, with profound violations of physiological processes, and with the very symptomatology of the disease. Alternative medicine has shown its effectiveness in combating the symptomatic manifestations of the disease, but in its complete cure. Therefore, alternative medicine can not be considered as the only method in the fight against adenomyosis.

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Treatment of adenomyosis with leeches

One of the popular methods of alternative medicine is hirudotherapy or treatment with leeches. This method of treatment is well known since very old times. Moreover, at one time it was one of the most important in the arsenal of classical doctors and was used for a very wide range of diseases. And this is not groundless. The main feature and distinguishing feature is the very instrument of treatment - the leech. In hirudotherapy, medical leeches are used. Their unique properties have long been noticed. The main thing is that when you bite a leech, a lot of useful substances get into the blood, which help reduce inflammation, increase the tone of the immune system, improve blood microcirculation in the bite site. Leeches are blood-sucking organisms. Therefore, albeit to an insignificant extent, they help with local application to reduce blood filling in the pelvic organs, which in adenomyosis greatly worsens the symptomatic manifestations of the disease.

In addition, when using hirudotherapy, the hormonal background of a woman is normalized, which significantly accelerates and increases the likelihood of recovery. It was also observed that the effect that is achieved with the use of medical leeches is fairly persistent in time.

Of course, leeches adenomyosis can not be completely cured, but this method is a very worthy part of complex treatment.

Treatment of adenomyosis with herbs

Herbal treatment or phytotherapy is one of the most common methods of both folk and traditional medicine. Treatment with herbs is known for a long time. With this method, the therapeutic effect does not occur soon, in comparison with the methods of pharmacotherapy, but nevertheless is not only fairly persistent, but also more sparing for the whole organism. The use of herbs in the treatment of adenomyosis can not be the only method, but nevertheless it significantly helps to combat symptomatic features, relieves pain syndrome, reduces bleeding.

If you use herbal medicine, you can buy herbs in pharmacies or specialized organizations, or you can collect them yourself. But with the independent collection of herbs, not only for the treatment of adenomyosis, but also for other purposes, it is necessary to understand well when collecting, what parts of the plant to collect, how then to process and prepare them (the need for grinding, drying and storage conditions) .

Popularity in the treatment of adenomyosis and its symptoms acquired such herbs as white willow, klopogon brush, sapelnik, plantain, tansy, air, celandine, anise, licorice, clover, sage, eucalyptus, fruits of currant and juniper. These components are combined into various fees, from which broths are prepared for drinking or syringing. It is important to understand that even the use of phytotherapy requires a rather deliberate approach. The use of these or those broths is possible not on an ongoing basis, but in certain periods of the menstrual cycle. There are a number of contraindications to the use of certain herbs and dues. For example, it is especially cautious to treat such treatment during pregnancy, breastfeeding, you need to take into account the patient's age.

It is also important to remember that phytotherapy is an effective tool in combination with drug treatment for adenomyosis and can not be an independent method to combat this disease.

Treatment of adenomyosis with a hamstring

A special role in the treatment of adenomyosis with alternative means, in particular in the treatment of herbs, has been taken by a plant such as the uterine Borova.

The hog or Ortilia is one-sided - a perennial herbaceous plant that is spread all over the globe in a temperate climate - in Asia, Europe, Japan, North America, Ukraine, Russia, Belarus, Mongolia, China, and the Caucasus. It grows in mixed forests, but you can meet it on meadows or bolts. For medicinal purposes, the ground part of the plant is used - leaves, stems, inflorescences.

The papilla is also called "female grass". Since its effectiveness in fighting various diseases of the female urinary system has long been known. To date, in several countries, the Uterus Borovaya has been officially recognized as a health system and is widely used in the fight against cystitis, algodismenosis, polycystosis, premenstrual syndrome, menopause symptoms and many other diseases. Disputable remains the use of the uterus of the hog with infertility, as a number of studies have revealed not only its ineffectiveness in such cases, but also the aggravation of the disease.

The bovine uterus has a pronounced anti-inflammatory, diuretic, analgesic effect, it also promotes the resorption of neoplasms, increases the body's immunity.

The uterine is used mainly in the form of alcohol or water infusions. The dosage is measured by the number of drops of the infusion. You can use both infusions of the uterus of the hog, and its combination with a number of other herbs.

Water infusions are more often used for douching, whereas alcohol is used for ingestion.

In the uterus of the hog, flavonoids and hydroquinone are contained, which have anti-inflammatory properties, arbutin, which has a diuretic effect, saponins, which have mucolytic, sedative and diuretic effects. But besides that, the coumarin contains the coumarin. It dilutes blood and can make bleeding longer, which is very dangerous for adenomyosis. Therefore, when using drugs from the uterus of the hog, be it pharmacy or cooked at home, you should consult your doctor both about the dosage and the method of preparation.

Treatment of adenomyosis with homeopathy

Among the various methods of alternative medicine for the treatment of adenomyosis is used and homeopathy.

Homeopathy is a principle of treatment that involves the use of drugs whose active substances are repeatedly diluted. The principle of selecting a drug is carried out mainly by focusing not on the disease, but on the person himself. Although the basis for the treatment with homeopathic preparations is the principle of "wedge kicking out", that is, for the treatment of a particular disease, a drug is selected that, when consumed by a healthy person, caused symptoms of the same disease, there is still a system for classifying patients according to different types, affects the choice of a homeopathic medicine.

It is important to note that of all methods of alternative medicine to homeopathy, the World Health Organization is the most skeptical, believing that the effect of homeopathic drugs is analogous to the placebo effect.

For the preparation of homeopathic preparations, extracts of various plants, trace elements are used, but their content in solution is very small. It can be as monopreparations, that is solutions, the content in itself of only one drug, and solutions, in which many different active substances are collected. There is no specific drug from a particular disease. Moreover, homoeopathic remedies are selected not only depending on the type of disease, but also adapting to the person's personality. But nevertheless, there are some general recommendations. In particular, in the fight against adenomyosis, Tui Western drugs are well established. To make preparations, young branches of branches are used, which have not yet become stiff. The drug has a similar name - Thuja. Also quite effective is the drug from Klopogona kistenosnogo. For the preparation is used only the underground part of the plant. Clapogon is generally considered "female grass" and is used for various diseases of the female reproductive system. Although as a homeopathic remedy it can be prescribed to men with various symptoms. The drug Klopogona for the treatment of adenomyosis - Actaea racemosa (Actaea racemosis). It is important when using homeopathy to remember that it is best if the drug is selected by a specialist in accordance with all the requirements, and not just bought at a pharmacy "by eye".

Treatment of adenomyosis of the uterus with drugs

Adenomyosis has grown significantly younger today. Previously, this disease was found in women giving birth at the age of 40 to 50 years. Adenomyosis is asymptomatic at the initial stages, therefore it was often studied only on the examples of queens that were removed in connection with other diseases. But today adenomyosis can be found in women aged 25 years, with such as those who give birth and are not nullified. At the same time, during this time, new progressive methods of research and surgical interventions appeared, which allow studying this disease in more detail.

Medical research is in step with pharmaceutical developments. Therefore, together with the study of endometriosis and adenomyosis in particular, specialized drugs have been developed, a number of them have undergone clinical studies and proved their effectiveness, some of them remain in doubt. But nevertheless today there is a wide spectrum of possibilities of medicamentous treatment of adenomyosis.

Adenomyosis is a hormone-dependent disease. Therefore, the main direction of drugs from adenomyosis in classical medicine are hormonal drugs. When choosing hormonal drugs, the age of the patient and the general condition, and the accompanying diseases play an important role. There are several groups of drugs that differ in the mechanism of action, side effects and sensitivity to them endometrial foci.

Hormonal treatment of adenomyosis

The main therapy for adenomyosis is the administration of hormonal drugs. The rest of the drugs, whether analgesic or anti-inflammatory, are designed to fight rather with the symptoms of the disease, which greatly reduce the quality of life of the patient. Hormonal drugs also directly affect the development of the disease itself, lead not only to a halt in the development of the disease, but also to regress right up to a complete cure.

Among the hormone-containing drugs that are used to treat adenomyosis, several major groups distinguish.

The first group includes oral contraceptives, which in their composition contain ethinyl estradiol. It is a synthetic analogue of the hormone estrogen. Do not think that contraceptives are used only to prevent unwanted pregnancies. In any case, it is hormone-containing drugs. In this case, these are those that contain not less than 0.03 mg of synthetic estrogen. These drugs suppress the foci of the endometrium. Sometimes their complete disappearance is achieved.

The second group of drugs are those that contain progestins. These are steroid hormones that are produced in the ovaries, in the placenta. In fact, they are responsible for the opportunity to become pregnant and endure this pregnancy. When exposed to such drugs in the endometrium, estrogen receptors are atrophied, and as a result, atypical foci of the endometrium are also atrophied (sometimes completely disappear).

The third group of drugs are those. Which contain analogs of gonadotropin-releasing hormone. This hormone affects the work of the genital organs, the production of gonadotropic hormones (most of the luteinizing hormone). Under the influence of such drugs, the growth of foci of adenomyosis slows down, the hormonal background is corrected.

The fourth group of drugs are those that contain androgens in their composition. This, roughly speaking, male sex hormones, which, nevertheless, are produced both in men and in women. When using this drug, old foci of adenomyosis stop growth, and new ones do not appear. The result of this therapy is quite persistent.

But it should be remembered that when taking hormonal drugs, there may be multiple side effects. Such as weight gain, amenorrhea, weakening of libido, liver damage, osteoporosis, weakened ovarian function. Often, the presence of these side effects causes patients to refuse to take hormonal drugs and resort to various methods of alternative treatment. This is a very dangerous approach, since precious time can be missed and there is no hope of therapeutic treatment. Therefore, you need to consult a doctor and, together with him, choose not only a suitable group of drugs, but the specific one that will be most appropriate in this situation for the patient. If there is a desire to use auxiliary non-traditional methods of treatment, then they should also be told to the doctor, as some infusions, procedures may go against medical treatment or not be suitable in any given situation.

Treatment of adenomyosis with dyufaston

To date, there are several popular drugs that are often recommended by doctors for the treatment of adenomyosis and a number of other diseases. One such drug is Duphaston.

Dufaston is a drug that contains an artificial analogue of natural progesterone (progestogen). Progesterone is a steroid hormone that is secreted by the yellow body of the ovary. The yellow body is formed in the ovary during ovulation and is a temporary gland of internal secretion (produces progesterone). There is a formation of the yellow body in the luteal phase of the cycle under the action of luteinizing hormone. The development of adenomyosis is often associated with a deficiency of these hormones, therefore the use of Dufaston gives support to the hormonal background. The results of such therapy are not only effective, but also quite persistent in time. Dufaston is a modern drug, the side effects of its use are minimized. Moreover, it is fashionable to take it during pregnancy. It is known that one of the most negative manifestations of adenomyosis is the very low probability of pregnancy and its bearing. Because Dufaston is used as before pregnancy for the balance of hormones, so sometimes in time it. Since adenomyosis may have a low level of development of the yellow body cyst of the progesterone hormone, which is very important at the initial stages of pregnancy, Dufaston's use can significantly reduce the risk of spontaneous abortion.

Treating adenomyosis with jam

Also to the most popular and effective drug in the treatment of adenomyosis is Jeanine. It is rather well known among women, since it is often used not as a therapeutic agent, but as a contraceptive.

Zhanin in its composition contains two groups of hormones. This is a low-dose drug that minimizes side effects when used as a contraceptive, and as a therapeutic agent for adenomyosis and a number of other diseases. Also positive quality is that Zhanin is absorbed by almost 85% because there is no need for large volumes of the drug.

In preparation Janine contains a gestagenic and estrogenic component.

As the progestogen acts active substance dienogest. Under its action, the growth of endometrial cells is inhibited. Thus, the pathological foci of growth of the endometrium decrease, until complete disappearance.

The estrogen component is the active substance. It promotes the growth and development of the ovarian follicle, ovulation.

In general, Zhanin balances hormonal metabolism in the first and second phases of the menstrual cycle, which helps prevent the development of new foci of adenomyosis and effectively combat existing ones.

Treatment of diffuse adenomyosis

There are several options for the development of adenomyosis. Diffuse adenomyosis is the most common. With this kind of disease, the endometrium grows into the muscular layer of the uterus, creating blind pockets, and sometimes penetrating through, creating fistulous exits. But with diffuse endometriosis, the endometrial tissue that penetrates the muscle does not expand. In this case, the muscular layer of the uterus is substantially thickened, reacting to penetration.

Any variant of development of adenomyosis can suggest both medical and surgical treatment.

In the case of diffuse adenomyosis, there is rarely a need for surgical intervention. The use of hormone therapy in the vast majority of cases is quite effective. Achieved not only a decrease in the growth of endometrial tissue that penetrates the mucosa, but the complete disappearance of foci of adenomyosis. Although the latter is observed in a rather small number of cases. But in addition to the treatment of the direct growth of the endometrial layer through the separation layer of the tissue, a muscular, therapeutic effect is also required regarding the remaining manifestations of diffuse adenomyosis.

With this disease, the symptoms are quite unpleasant for the patient. This and painful menstruation, pain during intercourse. At the same time the usual painkillers do not bring the former effect. Therefore, it is important to choose the right anesthetics, take vitamins, organize the regime of the day and exercise, which can ease the manifestation of these symptoms.

There may also be spotting outside of menstruation and heaviness in the lower abdomen. These symptoms, depending on their degree of severity, require intervention.

Treatment of the nodular form of adenomyosis

Another form of adenomyosis is nodular adenomyosis. In this case, endometrial tissue grows into the muscle as well as diffuse adenomyosis. But the main difference is that with nodal adenomyosis, endometrial tissue cells that have entered the muscle layer begin to expand. In this way nodes are formed. They are quite dense. Sometimes they are compared to benign tumors that have a capsule. This is due to the fact that both in these tumors and in the nodes of the endometrial tissue in adenomyosis, there is a sheath of connective tissue. But the main difference is that in tumors all the pathological cells are inside the capsule. And with adenomyosis, endometrial cells are located both inside the connective tissue capsule and behind its side-plates. As is known, with such a disease as adenomyosis, which is in the uncharacteristic places of the endometrium, it obeys all laws of the menstrual cycle. Including and periodically bleeds. But unlike diffuse endometriosis, in which the blood formed has a relative ability to escape, with the nodular form of this disease, all the blood remains inside the capsule near the node. Over time, it acquires a chocolate color.

Treatment of nodular adenomyosis is more complicated. Undoubtedly, medical methods are used. In any case, they are necessary, since the appearance of endometriosis of any form is associated with hormonal disorders. But the use of surgical methods in the case of the emergence of a nodular form of adenomyosis is most often inevitable. In especially critical cases, it is necessary to remove the affected organs - the uterus, the ovaries. This causes quite serious harm to the patient's overall health. Previously, only this method was used. But with the development of medicine and methods of treatment, it became possible to conduct organosaving operations. To do this, remove the nodes of the endometrial tissue from the muscle layer. Such formations are clearly visible when performing ultrasound diagnostics. When using such sparing surgical methods, it is also necessary to carry out hormone therapy, take anti-inflammatory drugs, lead a healthy lifestyle, and regularly conduct preventive examinations to avoid relapse of the disease.

Treatment of 1 degree of adenomyosis

There are several degrees of adenomyosis.

The first degree is characterized by very minor changes. In this case, the cells of the uterine endometrium grow, penetrating into the submucous layer of the uterus. But they do not pierce it through. This is the easiest form of adenomyosis. Its main danger is that it proceeds almost asymptomatically. Because often doctors deal with the treatment of adenomyosis of the following stages. If adenomyosis was detected at the first stage of development, then much depends on how the disease develops in this or that patient. At this stage of the disease development it is impossible to speak about its form of flow (diffuse, nodular, focal), as there is no germination in the muscle layer, the excess of endometrial cells is relatively small. But in this case, some patients may experience severe bleeding during menstruation. If this is the case, hysteroscopy is recommended. In this case, it gives an opportunity, how to solve the problem with excessive endometrium and stop bleeding, and get additional material for diagnosis. If there are no such complicated symptoms, then hormonal therapy is used, a complex of maintenance therapy is prescribed, such as vitamins, microelements. Such a state needs regular monitoring. With the right approach to the first stage of adenomyosis, the chances of a complete cure are very high, almost guaranteed.

Treatment of grade 2 adenomyosis

With the second degree of adenomyosis, the situation is already more serious. This stage is well defined by ultrasound. In addition, in the second stage the symptoms are much more pronounced, they give the patients discomfort. More severe pain during menstruation, bleeding is much more abundant. This state of affairs often makes one consult a doctor. Therefore, treatment of adenomyosis of the second degree is much more frequent, more studied and developed.

About adenomyosis of the second degree speak when the endometrial cells overcoming the submucosa, enter the muscular layer of the uterus, but does not reach its midpoint. In this case, the walls of the uterus thicken. At this stage, there may already be various options for further development of the disease - a diffuse form, nodular, mixed. Depending on this, choose the most optimal treatment tactics. In any case, it will be advisable to apply hormonal therapy. At this stage, surgical intervention is not desirable and is used in cases when other measures to combat the disease have already been carried out and did not give the desired result. Also, surgical intervention can be used in case the germination in the muscle layer occurs very quickly and causes fear.

Treatment of grade 3 adenomyosis

Adenomyosis of the third degree is a stage in the development of the disease, in which endometrial cells that sprouted into the muscular layer of the uterus not only reached the middle, but also advanced further. Sometimes those cases when germinated accumulations reach or even overcome the serous layer of the uterus (film on the outer surface of the uterus), is called the fourth stage of adenomyosis. But in most, even such a degree of complexity, can refer to the third.

As with any of the previous stages, hormone therapy is necessary and necessary. But there is no need to talk about the doubtfulness of the surgical approach at this stage of the disease. Operational intervention in such a situation is simply inevitable. At best, it is possible to remove foci of the disease. But, unfortunately, quite often at this stage of adenomyosis, we are talking about the removal of the uterus and, possibly, the appendages.

Quite often, adenomia develops with the uterine fibroids. And the last disease is also an indication for the removal of the uterus (not in all cases).

With adenomyosis of the third degree in the muscular layer of the uterus, both veins of endometrial cells and whole nodes can form. The walls of the uterus thicken significantly, reacting to the penetrating endometrium.

Surgical treatment of adenomyosis

With such a disease as adenomyosis, surgical intervention is considered an extreme measure, but sometimes inevitable. But for a surgical approach to solving such problems, there are many ways and approaches. This diversity is due to the progress in the study of this disease (and similar to it), and the development of new methods of instrumental medicine.

There are two main divisions of surgical intervention methods - open and so-called laparoscopic (endoscopic). The latter is a fairly new and actively developing method. Although the choice of how to conduct the operation is due to many factors. These include the severity of adenomyosis, and the presence of indications or contraindications relative to a particular method, the presence of concomitant diseases. Another important factor is the material and technical base of the medical institution in which such an operation is conducted. Although it should be noted that with adenomyosis it is extremely rare to meet operations of urgent unplanned nature. The very process of diagnosis is quite long and the need for a very accurate assessment of the situation for choosing the most sparing method of surgical treatment is necessary, if necessary. Because there is an opportunity and time for choosing such a clinic where it is possible to technically implement the most appropriate method of surgical intervention.

Surgical treatment for adenomycosis is used to remove nodes of endometrial cells in the thickness of the muscular layer of the uterus, to remove the thickening of the endometrium, which lead to bleeding. Also surgically, the material is taken for analysis, histological and cytological examination for the purpose of further diagnosis. In any case, in the surgical treatment of adenomyosis, all organs are trying to preserve. But much depends on the degree of defeat. The extreme case is amputation of the uterus and appendages if it is otherwise impossible to localize the disease.

Uterine removal in adenomyosis

A radical measure of the treatment of adenomyosis is the removal of the uterus. This procedure is called a hysterectomy. There are various options for such a process. Much depends on the concomitant diseases and lesions. Removal of the uterus can be accompanied by the removal of only the body of the uterus, and the body of the uterus along with the neck, the upper part of the vagina and the adjacent tissues that support these organs. In addition, the removal of the uterine tubes and the ovaries themselves can be subject to removal. Such operations can be performed using different access methods. One of these methods is removal of the uterus through vaginal access. With this operation, no external scars remain. In addition, with the development of medical equipment, it is possible to perform this operation under visual control by the introduction of a laparoscope. To perform a hysterectomy through vaginal access on the abdomen, a very small incision is made to insert a laparoscope, an incision is made in the vagina close to the uterus, through which the uterus will be removed. But there are a number of contraindications to this method of conducting an operation. Remove the uterus through vaginal access is possible only if its size is relatively small. And with adenomyosis of the last stages, in which most often this operation is required, the size of the uterus can be significantly worsened. This is due to the fact that even with a small penetration of endometrial cells into the muscular layer of the uterus, the latter thickens, resisting the pathological process. If the germination of the tissues is very extensive, a large number of nodes are formed, the endometrium itself is thickened, then the hysterectomy through vaginal access is impossible. In this case, use abdominal hysterectomy. This is such a method of carrying out the operation, when the cut for access to the uterus is done on the abdomen. Adenomyosis is often accompanied not only by an increase in the size of the uterus, but also by various neoplasms, the most common of which are fibroids. Therefore, with such a pattern, only abdominal access is possible.

With vaginal access, the patient recovered fairly quickly after surgery, but there is a risk of damage to the urinary tract. With abdominal access, the risk of concomitant damage is very low, but the recovery period is much longer and more difficult.

In addition to the difficulties that are directly related to the operation, there are a number of features with the consequences of hysterectomy. Much depends on whether this operation is done in the post-menopausal period or before it. In the event that the patient does not come at the time of the operation, and not only the uterus but also the ovaries are affected or to be removed, then hormone replacement therapy is necessary. If total hysterectomy was performed, that is, not only the uterus was removed, but also the cervix, as well as the upper part of the vagina, then there may be problems with sexual intercourse, which is especially important if there is no climax.

In any case, no matter what access is chosen, the psychological burden of patients undergoing hysterecoemia is also of great importance. Therefore, the treatment of adenomyosis by a surgical method should be carried out together with visits by a psychologist or group psychological help on this topic.