Adenomyosis

ʻO ka adenomyosis (ad-uh-no-my-O-sis) ka ulu ʻana o ka pūnaewele e uhi mau ana i ka ʻōpū (pūnaewele endometrial) i loko o ka paia muscular o ka ʻōpū. Ke hoʻomau nei ka pūnaewele i hoʻoneʻe ʻia i ka hana maʻamau - ke mānoanoa, ke haki a ke kahe koko - i kēlā me kēia pōʻai menstrual. Hiki ke hopena i ka ʻōpū nui a me nā manawa kaumaha a me ka ʻeha.

ʻAʻole maopopo i nā kauka i ke kumu o ka adenomyosis, akā hoʻōla pinepine ʻia ka maʻi ma hope o ka menopause. No nā wāhine e loaʻa ana ka ʻeha nui mai ka adenomyosis, hiki i nā lāʻau hormonal ke kōkua. Hoʻōla ka wehe ʻana i ka ʻōpū (hysterectomy) i ka adenomyosis.

I kekahi manawa, ʻaʻole hōʻike ka adenomyosis i nā hōʻailona a i ʻole nā ​​hōʻailona a i ʻole ka ʻoluʻolu iki wale nō. Eia naʻe, hiki i ka adenomyosis ke kumu i kēia mau mea:

• Ke kahe nui a lōʻihi paha o ka menstrual
• ʻEha nui a ʻoi paha, ʻeha ʻoki paha i ka pelvis i ka wā o ka menstruation (dysmenorrhea)
• ʻEha mau pelvic
• ʻEha ka moekolohe (dyspareunia)

Hiki ke ulu nui kou uterus. ʻOiai ʻaʻole paha ʻoe e ʻike inā nui kou uterus, hiki iā ʻoe ke ʻike i ka palupalu a i ʻole ka kaomi ma kou ʻōpū lalo.

Inā loaʻa iā ʻoe kahe koko lōʻihi a nui a i ʻole ka ʻeha nui i kou mau manawa, e hoʻopilikia ana i kāu mau hana maʻamau, e hana i kahi kūkā me kāu kauka.

ʻAʻole maopopo ke kumu o ka adenomyosis. He nui nā manaʻo i loaʻa, me kēia mau mea:

• Ke ulu ʻana o nā pūnaewele komo. Manaʻo kekahi poʻe akamai e komo nā sela endometrial mai ka papa o ka uterus i loko o ka ʻiʻo e hana i nā paia o ka uterus. Hiki i nā ʻoki ʻana o ka uterus i hana ʻia i ka wā o kahi hana e like me ka ʻoki caesarean (C-section) ke hoʻoikaika i ke komo pololei ʻana o nā sela endometrial i loko o ka paia o ka uterus.
• Nā kumu hoʻomohala. Manaʻo kekahi poʻe akamai ʻē aʻe ua waiho ʻia nā pūnaewele endometrial i loko o ka ʻiʻo o ka uterus i ka wā i hana mua ʻia ai ka uterus i loko o ka fetus.
• Ka mumū o ka uterus e pili ana i ka hānau keiki. Ke kuhikuhi nei kekahi manaʻo ʻē aʻe i kahi pilina ma waena o ka adenomyosis a me ka hānau keiki. Hiki i ka mumū o ka papa o ka uterus i ka wā postpartum ke hoʻokumu i ka haki ʻana i ka palena maʻamau o nā sela e hoʻopuni ana i ka uterus.
• Nā kumu o nā sela kumu. Ke manaʻo nei kahi manaʻo hou e komo paha nā sela kumu o ka iwi kuamoʻo i loko o ka ʻiʻo o ka uterus, e hoʻokumu ana i ka adenomyosis.

Me ka nānā ʻole i ke ʻano o ka ulu ʻana o ka adenomyosis, hilinaʻi kona ulu ʻana i ka estrogen e holo ana i ke kino.

Nā kumu pilikia no ka adenomyosis:

• Nā hana ʻoki kino ma mua i ka ʻōpū, e like me ka ʻoki ʻana o ka C-section, ka wehe ʻana i nā fibroid, a i ʻole ka dilatation and curettage (D&C)
• Hānau keiki
• Waena o ke ola

Loaʻa ka hapa nui o nā hihia o ka adenomyosis—ka mea e hilinaʻi ana i ka estrogen—i nā wāhine i ko lākou mau makahiki 40 a me 50. Hiki ke pili ka adenomyosis i kēia mau wāhine i ka lōʻihi o ka hōʻike ʻana i ka estrogen i hoʻohālikelike ʻia me nā wāhine ʻōpio. Eia naʻe, ke hōʻike nei nā noiʻi o kēia manawa ua hiki ke maʻamau ka maʻi i nā wāhine ʻōpio.

Inā pinepine ʻoe i ka kahe koko lōʻihi a nui i ka wā o kāu mau manawa, hiki iā ʻoe ke loaʻa ka maʻi koko nele mau loa, kahi e hoʻoulu ai i ka luhi a me nā pilikia olakino ʻē aʻe.

ʻOiai ʻaʻole ia he mea ʻino, hiki i ka ʻeha a me ke kahe koko nui e pili ana i ka adenomyosis ke hoʻopilikia i kou ola. Malia paha ʻoe e pale aku i nā hana āu i leʻaleʻa ai ma mua no ka mea ʻeha ʻoe a i ʻole e hopohopo paha ʻoe e hoʻomaka paha ʻoe e kahe koko.

Hiki i kekahi mau kūlana ʻē aʻe o ka ʻōpū ke hōʻike mai i nā hōʻailona a me nā hōʻailona like me nā mea o ka adenomyosis, ka mea e paʻakikī ai ka ʻike ʻana i ka adenomyosis. ʻO kēia mau kūlana e komo pū ana i nā ʻōpū fibroid (leiomyomas), nā sela uterine e ulu ana ma waho o ka ʻōpū (endometriosis) a me nā ulu ma ka papa o ka ʻōpū (endometrial polyps).

Loaʻa paha i kāu kauka ke hopena he adenomyosis kāu ma hope o ka nānā ʻana i nā kumu ʻē aʻe no kāu mau hōʻailona a me nā hōʻailona.

Hiki i kāu kauka ke kānalua i ka adenomyosis ma muli o:

I kekahi mau manawa, hiki i kāu kauka ke ʻohi i kahi laʻana o ka ʻiʻo uterine no ka hoʻokolohua (endometrial biopsy) e hōʻoiaʻiʻo ʻaʻole ʻoe i loaʻa i kahi kūlana koʻikoʻi loa. Akā ʻaʻole e kōkua ka endometrial biopsy i kāu kauka e hōʻoia i ka adenomyosis.

Hiki i ka pelvic imaging e like me ka ultrasound a me ka Magnetic resonance imaging (MRI) ke ʻike i nā hōʻailona o ka adenomyosis, akā ʻo ke ala wale nō e hōʻoia ai, ʻo ia ka nānā ʻana i ka ʻōpū ma hope o ka hysterectomy.

• Nā hōʻailona a me nā hōʻailona
• Kahi nānā pelvic e hōʻike ana i kahi ʻōpū nui a palupalu
• Ultrasound imaging o ka ʻōpū
• Magnetic resonance imaging (MRI) o ka ʻōpū

Hoʻomaha pinepine ka adenomyosis ma hope o ka menopause, no laila, e hilinaʻi paha ka lāʻau lapaʻau i ka kokoke ʻana i kēlā pae o ke ola.

ʻO nā koho lāʻau lapaʻau no ka adenomyosis e komo pū me:

• Nā lāʻau anti-inflammatory. Hiki i kāu kauka ke ʻōlelo aku i nā lāʻau anti-inflammatory, e like me ka ibuprofen (Advil, Motrin IB, a me nā mea ʻē aʻe), e kaohi i ka ʻeha. Ma ka hoʻomaka ʻana i kahi lāʻau anti-inflammatory hoʻokahi a ʻelua mau lā ma mua o ka hoʻomaka ʻana o kāu manawa a lawe ʻia i loko o kāu manawa, hiki iā ʻoe ke hoʻemi i ke kahe koko o ka menstrual a kōkua i ka hoʻomaha ʻana i ka ʻeha.
• Nā lāʻau hormone. Hiki i nā pīni hoʻopili estrogen-progestin a i ʻole nā ​​​​papa a i ʻole nā ​​​​apo vaginal e hoʻemi i ke kahe nui a me ka ʻeha e pili ana i ka adenomyosis. Hoʻokumu pinepine nā mea pale ʻana i ka progestin-wale nō, e like me kahi mea hana intrauterine, a i ʻole nā ​​​​pīni hoʻopili mau i ka amenorrhea — ka nele o kāu mau manawa menstrual — kahi e hāʻawi paha i kekahi kōkua.
• Hysterectomy. Inā koʻikoʻi kou ʻeha a ʻaʻohe lāʻau lapaʻau ʻē aʻe i hana, hiki i kāu kauka ke ʻōlelo aku i ka ʻoki e wehe i kou uterus. ʻAʻole pono ke wehe ʻana i kāu ovaries e kaohi i ka adenomyosis.