Diffuse changes in myometrium by type of adenomyosis, endometriosis, focal, nodal: what does it mean?

Such a conclusion of a gynecologist as a diffuse change in the myometrium does not give much promise to a young woman, because such a violation of women's health is often threatened by the fact that she can not become the mother of her own child. With the appearance of diffuse changes, the woman is most often diagnosed with "endometriosis", and this indicates that the chances of becoming pregnant and bearing a child are extremely low. So what is this disease that prevents the most noble and beautiful dream of every woman - the opportunity to give life to a new person?

What is the myometrium?

Before you start to consider the issue of diffuse and other changes in the tissues of a woman's body, you first need to understand what tissues in general there is a speech. One of the main organs of the female reproductive system is the uterus. It is in it during the first 7-9 months after conception that a little man is forming, growing and developing - a miniature copy of his dad and mother. It is thanks to the rhythmic contractions of the walls of the uterus that a son or daughter gets the opportunity to go outside the mother's body and see the world in due time.

The woman's uterus is a pear-shaped organ located in the center of the small pelvis. Its nearest neighbor with one side is the bladder, and on the other - the rectum. Depending on the fullness, they can slightly tilt the uterus forward or backward.

The uterus is considered a hollow organ, in which for the time being there is only an empty space. The body itself consists of three sections: the bottom, the body and the neck, which runs into the vaginal cavity.

The walls of the uterus also have 3 layers:

• the external or serous layer, identical with the cover of the bladder and considered to be its continuation, is called perimetry,
• the inner or muscular layer, which is the thickest and represents a combination of muscle and elastic fibers, as well as connective tissue, is called myometrium,
• an inner layer or mucosa, which consists of a basal and functional layer and is a layer of cylindrical epithelium attached to a connective tissue base, is called the endometrium.

Myometrium, whose diffuse changes we undertook to consider in this article, in turn is a multilayered tissue:

• the outer or subsurface layer is a thin fabric of longitudinal and some part of circular fibers tightly attached to the perimeter,
• the middle or vascular layer is the most sturdy and thick part of the myometrium, consisting of circular fibers and abundantly provided with blood vessels,
• the inner or submucosa layer is again a thin tissue, which is represented by longitudinal fibers and fits snugly to the endometrium.

When we talked about the fact that the uterus not only during pregnancy preserves the human fetus within itself, but also helps it to go outside when the baby's body is already capable of independent existence. Unfortunately, sometimes with certain violations of the fetus it is necessary to leave the mother's womb before the time when it is still unviable, and in this case they speak of miscarriage or premature birth.

How does the uterus help push the child out into the light? With the help of its inner layer - the myometrium. By rhythmically contracting, it promotes the movement of the baby by birth. It is clear that the condition of this layer largely depends on whether a woman will be able to endure pregnancy and give birth to a child on her own. And any changes in the muscular layer of the uterus can not but affect its functionality.

Normally, the myometrium lining the walls of the uterus with a uniform layer, i.e. Its thickness is approximately the same and inside the muscle shell there are no pathological seals or voids. This muscle layer functions normally. Its tangible contractions we feel during menstruation, as well as on the eve and at the time of birth.

But the endometrium during the menstrual cycle significantly changes its thickness: from 1-2 mm at the beginning of the cycle and up to 15 mm during menstrual bleeding. Both these layers are closely related, so the pathological changes in the endometrium often affect the inner layer of the uterus, disrupting its efficiency.

Diffuse changes in myometrium are diffuse disorders in the structure and functionality of the inner layer of the uterus, which affect the entire organ, and not its individual parts. And on how serious such changes are, women's health and the ability to become a mother depend.

Epidemiology

According to statistics, endometriosis is one of the most common pathologies of the reproductive system of women (although there are cases of such a disease in men who have pelvic organs). The number of women with this diagnosis persistently approaches the number of patients with inflammatory pathologies of the pelvic organs.

In practice, it was observed that half of the cases of development of adenomyosis (proliferation of epithelial cells inside the uterus) and endometriosis (germination of endometrial cells in other nearby organs) are combined with thyroid gland diseases (more often an autoimmune pathology called "thyroiditis" characterized by a chronic inflammatory process in the tissues of the thyroid gland, or disorders of the pituitary gland function). This allows you to suspect the data pathology in the involvement in the development of dysplastic processes in the uterus and surrounding tissues.

The percentage of women of reproductive age suffering from endometriosis to some extent, around the world is approaching 10-11%. Expressed and moderate diffuse changes in myometrium, which indicate the development of endometriosis, are detected in more than 30% of women who were diagnosed as "infertility." About 75% of women with dysplastic changes in uterine tissues can not have children.

[1], [2], [3], [4]

Causes of the diffuse changes in the uterine myometrium

If a woman in the results of ultrasound sees the words "heterogeneous myometrium," then, of course, she begins to worry about the question, what does it mean for her. The very notion of heterogeneity of the inner layer of the uterus is talking about diffuse changes in it. But these changes need to be considered in the age context.

In the postmenopausal period, the inhomogeneous myometrium is considered a variant of the norm. Changes in the hormonal background of a woman at this time dictate their own rules. In the reproductive age in the period of the monthly mucous layer of the uterus thickens, and when the climax comes, such changes are no longer observed. The endometrium is thinned, and since it is directly related to the myometrium, degenerative processes also encompass it.

For women over 45 years after the onset of menopause, diffuse changes in the myometrium do not carry danger. This is a natural physiological process of aging the body, caused by hormonal changes. Speech about pregnancy and the desire to have a child at this age is usually no longer worth, so the heterogeneity of the myometrium in the results of ultrasound can simply be ignored if it is not a question of suspicion of cancer processes.

But at a young age, when most women dream of becoming a mother, changes in the structure and functionality of the most powerful muscle layer of the uterus conceal a real threat to the woman's dream and her health. Normally, the endometrium of the uterus is tightly attached to the myometrium. If the cells of the mucous layer begin to penetrate into the muscle layer, they speak of the initial stage of endometriosis-adenomyosis. Deeper germination of the endometrium in the myometrium and perimeter is called endometriosis. When the process goes beyond the uterus, doctors diagnose "ectopic endometriosis".

If the endometrium germination does not occur in the muscle layer, and its thickness increases only due to the growth of cells in the uterine cavity, doctors talk about the boundary diagnosis of "endometrial dysplasia of the uterus" (more often dysplasia of the cervix, if the process affects not the entire organ, but only its final rounded part).

The mechanism of diffuse changes in the myometrium and endometrium has not yet been fully studied. Doctors have several theories of the development of the pathological process. Some experts are looking for reasons for changing the tissue of the uterine wall in the genetic predisposition, but directly the formation of the lesion focuses on hormonal changes in the body. Scientists believe that against the backdrop of impaired hormone production, the initial process at the DNA level is activated and endometrial cells begin to expand uncontrollably both inside the uterus and outward, damaging the structure of the muscle layer.

Hormonal theory is confirmed by changes in the thickness of the endometrium in different phases of the menstrual cycle, caused by changes in the hormonal background. In favor of this theory speaks and the fact that during pregnancy and menopause the process has the opposite direction, i.e. The thickness of the endometrium becomes smaller, as at the beginning of the menstrual cycle.

The second leading theory of development of dysplasia and endometriosis is implantation. According to her, the pathogenesis of the disease is based on the ability of rejected cells of the endometrium to form foci of diffuse changes in the form of tumor processes under certain unfavorable conditions.

[5], [6]

Risk factors

According to this theory, the risk factors for the appearance of diffuse and focal changes in myometrium are:

• past abortions and cleansing, in which the inner layer of the uterus is damaged (and the higher the frequency of abortions, the higher the risk of developing a pathological process),
• any other interventions in the uterus, including cesarean section, scraping in severe inflammatory processes, removal of cystic structures and polyps, surgical treatment of uterine fibroids, which is a benign tumor, surgical treatment of oncological diseases in the uterus,
• Infection of the tissues of the uterus (infection in the uterus, which often happens during menstrual bleeding, when the cervix is ajar, causes an inflammatory process in the endometrium, which already provokes dysplastic changes in the inner and behind it of the middle layer).

Now with regard to unfavorable conditions that increase the risk of endometriosis. These are:

• inflammatory and especially infectious and inflammatory diseases of internal and external genital organs, pelvic organs (a risk factor is promiscuous sexual relations and non-observance of intimate hygiene),
• hormonal imbalance and stressful situations that cause failures in the neuroendocrine system,
• any endocrine diseases that cause hormonal and metabolic disorders,
• disorders of the endocrine glands (in the endometrium, in addition to the ciliated cylindrical epithelium, there are secretory cells),
• any tumor processes in the uterine cavity,
• anemia, disruption of the immune system, a decrease in the body's defenses due to existing chronic diseases,
• malnutrition with a deficiency of vitamins and trace elements,
• bad habits: smoking, alcohol abuse, addiction to beverages containing caffeine, as well as uncontrolled intake of medications,
• complicated pregnancy and childbirth,
• the negative impact of solar UV radiation (if there is a predisposition to endometrial dysplasia, prolonged or frequent exposure to the sun's rays can provoke the development of a pathological process);
• throwing blood with particles of epithelial cells during menstruation to the fallopian tubes, and their subsidence on the ovaries can provoke diffuse changes in the myometrium and ovaries.

Depending on where exactly the endometrial cells come off with menstrual blood and where they begin to actively divide, diffuse changes can cover different parts of the female reproductive system and not only. If the growth of endometrial cells is observed not only inside the uterus itself, but also in its final part, which connects to the vagina, they speak of diffuse changes in the myometrium of the body and cervix.

The entry of such cells into the vagina, the bladder and the peritoneum with their settling on the walls of the organs under appropriate conditions can cause endometriosis of the vagina, bladder or peritoneum. If the endometrial cells germinate in the rectum tissue, they speak of rectovaginal form of endometriosis.

There is another hypothesis, called metaplastic. According to this version of the development of events, the rejected endometrial cells do not settle on the walls of the uterus and other organs near it, but provoke metaplastic changes in other cells. In support of this hypothesis is the fact that in some cases endometritis can degenerate into malignant tumors.

[7]

Symptoms of the diffuse changes in the uterine myometrium

As you can see, the prospect for young women with frequent abortions and cleansings is unpleasant. At some point, they can hear a frightening diagnosis without even suspecting that they are not all right with the reproductive system. The fact is that diffuse changes in myometrium can not for a long time remind us of themselves, because until a certain time they are not considered pathology.

We have already said that such changes in uterine tissues are considered the norm during menopause, and some healthy young women have a heterogeneous structure of the myometrium that is inherited. In the latter case, it is a weakly expressed heterogeneity, in which the difference between the layers is negligible, and other parameters of the uterus (the size of the organ and the thickness of its walls) are within the normal range. Such changes in the tissues of the uterus are usually not felt by women.

But the pathological changes caused by provoking factors, can make themselves felt. However, for such nonspecific symptoms a woman may simply not pay attention or write off their appearance for other reasons. So the first signs of endometriosis can be:

• unpressive pulling or contracting pain in the lower abdomen, which most often appear during ovulation, and also on the eve of menstruation (this symptoms is often generally ignored by women),
• quite strong pain during menstruation (the cause may also be low pain threshold, endometritis, congenital anomalies of the uterine structure),
• soreness during intercourse, which many attribute to the discrepancy between the size of the genital organs of a man and a woman, the inexperience of the sexual partner, the incorrect disposition of the uterus (its bend),
• Uncertain pain during the act of urination and defecation,
• too heavy menstrual bleeding,
• disorders of the menstrual cycle (this symptom is characteristic not only for pathologies of the genitourinary system),

Later, there appear smearing discharge and small bleeding between menstruations, which cause the young woman to become alert, especially if they are repeated many times.

Unexpressive pains in the lower abdomen as the endometriosis of the uterus progresses can become longer and more intense, giving off in the groin and lower back. Often the appearance of chronic pelvic pains is just the reason for going to the doctor, although with regular gynecological examination changes in the size and condition of the uterus can be detected much earlier.

[8], [9], [10], [11], [12], [13]

Stages

Diffuse changes in myometrium according to the doctors themselves are not considered a full-fledged diagnosis. Under the notion of heterogeneous myometrium, they imply a deviation from the norm, which does not necessarily have to be considered a pathology. Minor changes in the structure of the endometrium and myometrium can equally be an innate feature, or acquired pathology.

But the moderate diffuse changes in the myometrium are already talking about the initial stages of a serious pathology - endometriosis. Since endometriosis originates in the uterus, in the first stages of the disease, when only the tissues of the organ grow, it is necessary to speak more about adenomyosis.

Diffuse changes in myometrium by type of adenomyosis - this is the destruction of tissues inside the uterus. At the first stage of this disease, there are certain changes in the endometrium, and its individual cells can be found in the submucosal layer of the myometrium. The second stage is already characterized by the defeat of almost half of the muscular layer, while in the third stage the penetration of epithelial to a depth of more than half the thickness of the myometrium is noted. The fourth stage of the disease is the defeat of the whole muscular layer and the organs close in position, i.e. Directly endometriosis.

If the cause of changes in the structure of various layers of the uterine wall is mechanical damage during medical-diagnostic measures and abortions, ultrasound can show diffuse focal changes in the myometrium. This suggests that not all of the lumpectrum lining the uterus is subject to change, but only its individual sites of different localization, ranging from 2 mm to 1.5 cm (areas where the uterine wall was damaged).

It is also possible the appearance of multiple individual small foci (up to 5-6 mm) of round shape without clear contours and a surface capsule. In this case, we speak of diffusely nodal changes in the myometrium.

[14], [15]

Complications and consequences

Diffuse changes in myometrium are in themselves normal violations of the structure of the uterine wall, when the elasticity and functionality of the muscle layer are disturbed by the insertion of more friable endometrial cells into it. For a woman who does not plan to become a mother, this situation seems quite safe, especially if there is no discomfort and unpleasant sensations. But after all, the process can gradually cover an ever larger area of the uterus and move to other organs, so leaving such a violation without treatment means bringing on new health problems.

Gradually diffuse changes in the uterine wall will develop into adenomyosis, and even spread beyond the uterus. This will be accompanied by the appearance of various symptoms of the disease (usually the symptoms appear in 2 or 3 stages of the disease). Painful monthly and profuse blood loss often lead to the development of iron deficiency anemia. In addition to weakness, dizziness, increased fatigue, dyspnea and fainting, this disease entails a decrease in the body's resistance to infections. Moreover, such patients are more susceptible to stress factors, so they are more often diagnosed with neuroses.

Pain during menstruation is accompanied by pain during sexual intercourse, which does not allow a woman to get the desired pleasure. Dissatisfaction with sex leads to increased irritability and conflict. Regular refusals of women in sexual intimacy become a frequent cause of discord in the family.

Many young women are worried about the logical question,  can I get pregnant with diffuse changes in myometrium?  It is impossible to answer this question unambiguously. Although there is a lot of information that women with such a diagnosis have great difficulties not only with bearing pregnancy, but even with the conception of a child. With the development of adenomyosis in half the case there is a violation of the structure of the endometrium and the development of the adhesion process preventing the fertilized egg from entering the uterus (often this situation ends with an ectopic pregnancy).

But even if the conception occurred and the egg was implanted into the uterus, there is no guarantee that she will stay there for 9 months and the baby will be born on time. Diffuse changes in myometrium during pregnancy are a major risk factor for miscarriages and premature births. Dysplastic changes in uterus tissues are accompanied by intermenstrual bleeding, which in turn provokes inflammatory processes. Inflammation of the tissues of the uterus and an increase in its tone conceals a threat of early termination of pregnancy.

As for women of the age group and those who do not seem to be in danger, then there should not be any relaxation. The inflammatory process in the area of the regularly bleeding uterus leads to the formation of adhesions that cause chronic pulling pains and fusion of the pelvic organs. If the endometrial cells go beyond the uterus and begin to grow on the walls of other organs, they also begin to bleed. Ovaries on this background can form cysts, the sex of which is filled with menstrual blood.

The proliferation of the tissues of the uterus leads to its increase. The uterus squeezes other nearby organs and can cause neurological pain.

But the greatest danger of such complications as anemia and endometriosis is the transformation of tumor cells into malignant ones. And although the risk of such a transformation is small (no more than 3%), but its consequences are so terrible that it is impossible not to take into account this possibility.

[16], [17], [18], [19]

Diagnostics of the diffuse changes in the uterine myometrium

Since diffuse changes in the myometrium are considered a pathological condition that initially can not give any symptoms, they are usually detected during routine examination or during the passage of ultrasound (for example, during pregnancy or the inability to become pregnant for a long time). It is clear that visually when looking at the chair the gynecologist can not see such changes, but the proliferation of the uterus tissues is accompanied by its enlargement and shape change (it takes the form of a ball), which the specialist will discover.

Gynecologic examination, which is better performed on the eve of menstruation, can show the presence of tubercles and nodes on the surface of the organ and in nearby tissues. If such a picture is also confirmed by the patient's complaints about painful and profuse periods that last for 6-7 days, pain during sexual intercourse, the appearance of symptoms of anemia, the doctor can make a preliminary diagnosis - adenomyosis. If there are no complaints, a borderline condition is suspected, which can pass into the disease or remain in the same stage.

To assess the condition of vital organs and the appointment of a woman, a standard set of laboratory tests is prescribed: a general urine test and a clinical blood test. These same tests will help to identify and assess the degree of inflammation in the body of a woman (without determining its localization) and the presence of malignant cells. To assess the hormonal background, which directly affects the development of diseases with diffuse changes in the myometrium and endometrium, a blood test for hormones is prescribed.

Obligatory is also a smear from the vagina, the microscopy of which will allow not only to detect infection (bacteria, viruses, fungi, etc.) in the reproductive system, but also to detect a large number of cylindrical epithelium that is released from the uterus during inflammatory and dysplastic processes.

And yet the analyzes, although they complement the existing picture, do not in themselves make it possible to confirm the diagnosis. But in this, instrumental diagnostics is doing well. Ultrasound diagnostics comes to the fore here. If suspected diffuse changes in the myometrium, the patient is prescribed ultrasound of the uterus or pelvis. On the computer screen, the doctor can not only see the changes in the size of the uterus, but also take measurements of the thickness of its walls, carefully consider pathological foci.

Echographic signs of diffuse changes in the myometrium allow the doctor not only to diagnose with 90% confidence, but also to assess the degree of development of the disease. Different tissues of the body have a different ability to reflect ultrasonic waves, so echogenicity is an important criterion for ultrasound diagnosis. The increased echogenicity of the tissue site indicates the presence of diffuse changes in it. Blurriness of contours and heterogeneity of myometrium also indicate such changes.

Sites of hyperechoinality in the uterus indicate seals in her tissues. In the diffuse form of adenomyosis (endometriosis), small seals occur throughout the entire surface of the uterus, i.e. Myometrium has a cellular structure. Hyperechoic inclusions are scattered throughout the body area and have limited dimensions (up to 5 mm).

The size of the uterus plays an important role in the diagnosis of pathology. So in nulliparous women, the cervix can have a width of 2-2.5 cm, and the length and thickness will be within 2.5-3.5 cm. The uterus body: length and thickness within 3.8-5 cm, width 2, 7-3,7 cm. Pregnancy and childbirth have a small effect on the size of the organ, however, like the age changes in the menopause period.

But still a normal noticeable increase in the uterus can be noted only during pregnancy as the fetus grows and develops inside it. During the first 2 months of pregnancy, the uterus increases in size 3 times. In endometriosis, the size of the uterus will be approximately the same as that of a future mother, whose gestation period is from 5 to 9 weeks. It turns out that the uterus will be increased in size in 1,5-3 times.

At the initial stage of endometriosis, ultrasound may not show significant changes in myometrium. Minor hyperechoic inclusions may even remain uninfected. BUT the more the thickness of the endometrium becomes, the more clearly the echoes of diffuse changes appear.

Diffusive changes in myometrium by type of adenomyosis at any stage of pathology can be established with the help of endoscopic examination - laparoscopy. The study also allows you to assess the extent of tissue proliferation and even take material for histological examination for the presence of malignant cells. With the help of laparoscopic equipment, it is also possible to perform therapeutic manipulations, for example, to cauterize pathological foci. Hysteroscopy has similar possibilities.

[20]

Differential diagnosis

Differential diagnosis, which consists in comparing the results of various studies and anamnesis of the patient, makes it possible to differentiate the congenital anomaly of the structure of the myometrium from:

• diffuse changes in the muscular layer observed in adenomyosis, endometriosis, endometritis (inflammation of the uterine mucosa),
• cysts of the cervix,
• diffuse form of chronic metritis, which is an inflammation of the inner and middle layers of the uterine wall,
• endometrial hyperplasia,
• polyposis of the uterus,
• proliferation of the follicular apparatus,
• oncological diseases of the reproductive system.

If the diagnosis is difficult, use MRI. This study gives 99% accuracy of diagnosis.

Treatment of the diffuse changes in the uterine myometrium

Details about the traditional treatment of diffuse changes in myometrium read in this article. Also use folk remedies and herbs.

Prevention

As it usually happens, to our so unloved doctor, we usually turn when we are disturbed by the pains in the lower abdomen, incomprehensible smearing bleeding, regular soreness during sexual intercourse. While the woman does not worry, she does not hurry to go to the doctor. Unless it is forced to do this delayed menstruation, indicating the onset of pregnancy or menopause.

But the diffuse changes in the tissues of the uterus appear gradually and just as gradually progress. A woman may not suspect such violations for years, until unusual and alarming symptoms appear. A regular visit to a gynecologist 1-2 times a year would help to identify these changes much earlier in order to take measures to prevent the spread of the pathological process and to preserve the childbearing function of a young woman.

But the prevention of diffuse and focal changes in the tissues of the myometrium is not only a regular visit to a gynecologist. Most women want to look even more beautiful by flashing a uniform bronze tan that can be obtained in a solarium or on the seashore. But does everyone know what is the price of this tan?

Negative exposure to ultraviolet rays is experienced not only by the skin on which melanoma foci can subsequently be detected, but also internal tissues. Under the influence of active UV radiation, hyperplastic processes are activated in the female reproductive system. And a tan lover may soon experience infertility caused by adenomyosis or endometriosis.

It is necessary to understand that a beautiful smooth tan can be obtained at a lower price by resting on the sea in the "velvet season" or basking in the low-active spring rays of the sun. In the summer, sunbathing is recommended only in the morning and evening. Of course, such a sunburn will not be noticeable so quickly, but its consequences will not be so sad.

Since hyperplastic pathologies are associated with a violation of the hormonal background of a woman, it is worth taking care of him. If the hormonal disturbances are not hereditary, then they arose due to certain life situations: stress and experience, reduced immunity, metabolic disorders, infectious diseases, parasites. If you treat such diseases on time, maintain your immunity at the height and take care of your nervous system's health (learn how to respond correctly to stressful situations), hormonal failures can be prevented, and thus violations in the field of reproductive organs (and not only!) Can be avoided.

Preventing all kinds of pathologies caused by hormonal disorders will be the maintenance of normal weight, proper nutrition, adequate treatment of medication, full sleep, and the rejection of bad habits.

If it was not possible to avoid the development of the pathological process, it is important to begin treatment as early as possible of the illness revealed during the gynecological examination. Since adenomyosis and endometriosis are prone to frequent relapses, the woman will later have to continue taking oral contraceptives or putting a hormonal intrauterine device for prophylactic purposes. The spiral will protect it not only from pregnancy, but also from hyperplastic processes in the uterus for 5 years.

For women who are not averse to becoming a mother, there is good news. It turns out that pregnancy significantly reduces the risk of proliferation of endometrial tissue and casting them on the walls of other organs, because in this period there are no monthly and hormonal background of the woman is somewhat altered, which does not contribute to hyperplastic processes. We can say that pregnancy is the prevention of endometriosis.

But you can not say about abortions and other surgical interventions on the uterus. Women who plan to kill an unborn child need to think a thousand times about the consequences of cleaning or premature birth, whether they will get pregnant again and create a full-fledged family.

Prevention of pathological processes in the female reproductive system seemed too difficult for the reader, since it requires abandoning the habitual way of life? Probably, if we discuss the prognosis of diseases developing against the background of diffuse changes in the tissues of the uterus, the view of prevention with all its complexities can change significantly.

We will not talk about the difficulties that a young woman will have to endure if she ignores the problem or refuses treatment. This issue we already discussed in the section "Consequences and complications". But what can threaten a woman who underwent appropriate treatment with preservation of the uterus and its functions?

It should be said that about 20 percent of women in the first year after finishing the course of hormonal therapy or sparing removal of foci of hyperplasia are treated again to a gynecologist with the same problem. Over the next 4 years, 70-75% of women turn to the doctor, and only 25% can forget about the illness for a long time, reaching for the onset of menopause.

The best prognosis is observed after removal of the uterus, but the woman considers herself inferior and will never be able to have her own children (unless the surrogate mother takes them, and then in the case of preservation of the function of the ovaries). It turns out that any methods of treatment of endometriosis and adenomyosis do not provide a guarantee of complete cure while preserving the ability to have children. Is this not a serious reason to take a different look at the difficulties of disease prevention?

Diffuse changes in myometrium are not yet a verdict, but the normal functioning of the uterus is no longer the case. The sooner the pathological process is revealed, the more likely it is that the winner will be victorious and preserve the function assigned to the woman by nature, to experience the joy of motherhood and to protect oneself from pain and suffering, both physical and psychological. The understanding of this comes gradually, and the earlier a woman realizes the need to maintain her body healthy, the more chances she has to become a happy mother, and perhaps more than once.

[21], [22], [23], [24], [25]

Forecast

Diffuse changes in myometrium, if they are not a hereditary feature, are considered a pathological process. And although in the initial stage they are not yet considered a disease, they may well lead to it in the case of progression of the hyperplastic process.

Adenomyosis, endometriosis, uterine myoma and some other violations of women's health are the consequences of untimely detection of pathological changes in the tissues of the uterus. And this suggests that the woman later turned to the gynecologist.

[26], [27], [28], [29], [30]