People with severe dysmenorrhea may cause infertility

People with severe dysmenorrhea may cause infertility. Dysmenorrhea is an experience that most women have. General dysmenorrhea will be relieved by taking some painkillers. Drinking more hot water is also a little bit useful, but some people have dysmenorrhea that is so painful every time, almost nothing is useful.

This kind of severe dysmenorrhea needs to be careful, which may be a reflection of physical illness. Frequent dysmenorrhea may be adenomyosis, and it can make it difficult to get pregnant.

Patients with traditional adenomyosis surgery generally require strict contraception for one year. Because of adenomyosis, long-term heavy menstruation, chronic anemia, hypercoagulable state. Pregnant women themselves are high-risk groups of thromboembolic diseases. If they are not detected and treated in time, they may have serious complications or even sudden pulmonary embolism and sudden death.

What is adenomyosis?

Adenomyosis is a benign uterine disease, which is characterized by the presence of ectopic endometrial glands and stroma in the myometrium, and reactive hyperplasia of smooth muscle cells around the myometrium.

Adenomyosis is similar to endometriosis. Both endometrial tissues “run away from home” and are formed after planting in abnormal uterine cavity.

Adenomyosis tends to occur in women of childbearing age, with an incidence rate of 7% to 23%.

What are the symptoms of adenomyosis?

The main clinical symptoms include: severe dysmenorrhea, menorrhagia (even causing severe anemia) and infertility, which will have a serious impact on the patient’s physical and mental health.

Studies have shown that adenomyosis is related to infertility, which may not only interfere with normal embryo implantation, but also cause abnormal embryo implantation and early and late abortion.

How is adenomyosis treated?

(1) Medication

Non-steroidal anti-inflammatory drugs (NSAID)

Mainly used to relieve the pain of adenomyosis and reduce menstrual flow.

Side effects: Mainly gastrointestinal reactions, occasionally abnormal liver and kidney function. Long-term application should be alert to the possibility of gastric ulcer.

Oral contraceptives

Mainly used to relieve the pain of adenomyosis and reduce menstrual flow.

Side effects: Fewer, occasional gastrointestinal symptoms or abnormal liver function. Patients over 40 years of age or with high-risk factors (such as diabetes, hypertension, history of thrombosis, and smoking) should be alert to the risk of thromboembolism.

Oral progesterone drugs

It can relieve the pain of adenomyosis and reduce menstrual flow. Among them, dienogest is a new type of synthetic progesterone. Its mechanism of action is to moderately inhibit the secretion of gonadotropins through negative feedback, resulting in a low-estrogen endocrine environment; inhibit endometrial hyperplasia and inhibit intrauterine Inflammation in the membrane and inhibition of intimal angiogenesis.

Side effects: mainly irregular uterine bleeding.

Gonadotropin releasing hormone agonist (GnRH‑a)

It can effectively and quickly relieve pain, treat menorrhagia, and reduce the size of the uterus. However, after stopping the use of GnRHa, the uterus will quickly increase after menstruation is restored, and symptoms such as dysmenorrhea will appear again.

Levonorgestrel Intrauterine Sustained Release System (LNG‑IUS)

LNG‑IUS is easy to place and can continue to release levonorgestrel for 5 years. Clinical application shows that LNG‑IUS is effective for adenomyosis, dysmenorrhea, chronic pelvic pain and menorrhagia.

(2) Surgical treatment

Total hysterectomy

The radical treatment for patients with symptomatic adenomyosis is total hysterectomy, which can be done laparoscopically, openly, or transvaginally. The selection of the surgical route is based on the size of the uterus, pelvic adhesions and other factors.

Fertility preservation surgery

From the perspective of relieving symptoms and promoting fertility, patients with adenomyosis should first choose drug treatment; for patients of childbearing age who cannot tolerate long-term drug treatment and fail drug treatment, they can choose uterine preservation surgery, that is, fertility preservation surgery. The timing of surgery to preserve fertility should be considered based on ovarian function and the type of adenomyosis.

(3) Other

For patients who do not need childbirth, uterine artery embolization, high-intensity focused ultrasound, ablation therapy and other treatments can also be selected.

(sourceinternet, reference only)

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