Adenomyosis

Ko te adenomyosis (ad-uh-no-my-O-sis) e puta ana ina tipu te kiko e whakakapi ana i te kopu (kiko endometrial) ki te pakitara uaua o te kopu. Ka haere tonu te mahi noa o te kiko i nekehia – ka mātotoru, ka pakaru, ka toto – i ia huringa o te marama. Ka taea e te kopu nui me nga wa o te marama mamae, nui te toto te puta.

Kāore i te tino mōhio ngā tākuta he aha te take o te adenomyosis, engari ka ora te mate i te nuinga o te wā i muri i te menopause. Mō ngā wāhine e mamae nui ana i te adenomyosis, ka āwhina ngā rongoā horomona. Ko te tango i te kopu (hysterectomy) te rongoā mō te adenomyosis.

I etahi wā, kaore te adenomyosis e pā te tohu, te tohu ranei, te mamae iti noa iho rānei. Heoi, ka taea e te adenomyosis te tupu:

• Te toto nui, te roa rānei o te toto o te marama
• Te mamae nui o te kopu, te mamae koi ranei, te rite ki te maripi i te wa e toto ana te marama (dysmenorrhea)
• Te mamahe o te kopu mo te wa roa
• Te mamae i te wa e moe tahi ana (dyspareunia)

Ka taea e tō kopu te nui ake. Ahakoa ka taea pea te kore e mōhio koe ki te nui ake o tō kopu, ka taea e koe te kite i te ngawari, te pehanga ranei i raro i tō puku.

Mēnā he toto nui, he roa rānei te toto, he mamae kino rānei ōu wā, ā, e āwangawanga ana i ō mahi noa, whakaritea he wā ki te tūtaki ki tō tākuta.

E kore e mohiotia te take o te adenomyosis. He maha nga whakaaro kua puta, tae atu ki enei:

• Te tipu o te kiko e rere atu ana. E whakapono ana etahi tohunga ko nga pūtau endometrial mai i te papanga o te kopu e rere atu ana ki te uaua e hanga ana i nga pakitara o te kopu. Ko nga wahi tapahia o te kopu i mahia i te wa o te mahi tahi, penei i te wahi tapahia o te ketihia (C-wahi tapahia), ka taea te whakatairanga i te rerenga tika o nga pūtau endometrial ki te pakitara o te kopu.
• Te timatanga o te whanaketanga. E whakapae ana etahi atu tohunga ko te kiko endometrial ka whakatakotoria ki te uaua o te kopu i te wa e hangaia ana te kopu i roto i te peepi.
• Te mumura o te kopu e pa ana ki te whanautanga. E whakaaro ana tetahi atu whakaaro he hononga kei waenga i te adenomyosis me te whanautanga. Ko te mumura o te papanga o te kopu i te wa i muri i te whanautanga ka taea te pakaru i te rohe noa o nga pūtau e raina ana i te kopu.
• Te timatanga o te pūtau pakiaka. E whakaaro ana tetahi whakaaro hou ko nga pūtau pakiaka o te wheua ka taea te rere atu ki te uaua o te kopu, ka puta te adenomyosis.

Ahakoa te ahua o te whanaketanga o te adenomyosis, ko tona tipu ka whakawhirinaki ki te estrogen e rere ana i roto i te tinana.

Ngā take morearea mō te adenomyosis e whai ake nei:

• Ngā pokanga o mua o te kopu, pēnei i te wahi C, te tango i ngā wheori, te whakangawhatanga me te whakakorenga (D&C)
• Te whānautanga
• Te tau waenganui

Ko te nuinga o ngā keehi o te adenomyosis—e whakawhirinaki ana ki te estrogen—ka kitea i ngā wāhine kei roto i ō rātou tau 40 me ō rātou tau 50. Ka taea te hono atu o te adenomyosis i ēnei wāhine ki te roa o te whakamahinga o te estrogen ki te whakataurite ki ngā wāhine kōuri. Heoi, ko ngā rangahau o nāianei e kī ana pea ka noa hoki te āhuatanga i ngā wāhine kōuri.

Ki te maha te roa o te toto nui i o wā, ka taea e koe te whanake i te mate toto koretake, e arahi ana ki te ngenge me ētahi atu raruraru hauora.

Ahakoa ehara i te mea kino, ko te mamae me te toto nui e hono ana ki te adenomyosis ka raru ai tō noho. Ka karo pea koe i ngā mahi i pai ai koe i mua nā te mamae rānei, kei te manukanuka rānei koe kei tīmata te toto.

Kaore he uauatanga

Ko ētahi atu āhuatanga o te kopu e taea te whakaoho i ngā tohu me ngā tohu rite ki te hunga o te adenomyosis, e whakamahia ai te adenomyosis kia uaua te whakatau. Kei roto i ēnei āhuatanga ngā pūngāwerewere o te kopu (leiomyomas), ngā pūtau kopu e tipu ana i waho o te kopu (endometriosis) me ngā tipu i roto i te papanga o te kopu (endometrial polyps).

Ka mutu pea tō tākuta i te whakaaro he adenomyosis koe i muri i te whakakore i ētahi atu take pea mō ō tohu me ō tohu.

Ka whakaaro pea tō tākuta he adenomyosis koe i runga i:

I ētahi wā, ka kohikohi pea tō tākuta i te tauira o te kiko kopu mō te whakamātautau (endometrial biopsy) kia mohio ai koe kei te kore koe i te āhuatanga kino ake. Engari e kore te endometrial biopsy e āwhina i tō tākuta ki te whakau i te whakatau o te adenomyosis.

Ka taea e te whakaahua pelvic penei i te ultrasound me te Magnetic resonance imaging (MRI) te kite i ngā tohu o te adenomyosis, engari ko te huarahi anake ki te whakau ko te tirotiro i te kopu i muri i te hysterectomy.

• Tohu me ngā tohu
• He whakamātautau pelvic e whakaatu ana i te kopu nui, ngawari
• Te whakaahua ultrasound o te kopu
• Te whakaahua Magnetic resonance (MRI) o te kopu

Ko te adenomyosis te nuinga ka ngaro i muri i te menopause, na te rongoā pea ka whakawhirinaki ki te tata atu rātou ki taua wāhanga o te oranga.

Ko ētahi o ngā whiringa rongoā mō te adenomyosis ko:

• Rongoā anti-inflammatory. Āta whakaaro pea tō tākuta ki ngā rongoā anti-inflammatory, pēnei i te ibuprofen (Advil, Motrin IB, me ētahi atu), hei whakahaere i te mamae. Mā te tīmata i te rongoā anti-inflammatory i te rā kotahi, rua rā i mua i te tīmatanga o tō wā, ā, mā te tango i taua wā, ka taea e koe te whakaiti i te toto o te marama, ā, ka āwhina i te whakaora i te mamae.
• Rongoā hormone. Ko ngā pire whakahaere whānau estrogen-progestin, te kāpeka, te mowhiti whakauru ranei e mau ana i te hormone pea ka whakaiti i te toto nui me te mamae e hono ana ki te adenomyosis. Ko te whakahaere whānau progestin-anake, pēnei i te taputapu intrauterine, te pire whakahaere whānau ranei e whakamahia tonu ana, ka tino puta mai te amenorrhea—te kore o ō wā marama—ka āwhina pea i te whakaora.
• Hysterectomy. Ki te kaha rawa tō mamae, kāohore hoki ētahi atu rongoā i mahi, pea ka kōrero mai tō tākuta ki te tango i tō kopu. Kāohore he mea tika te tango i ō ovaries hei whakahaere i te adenomyosis.

Hei whakaheke i te mamae o te upoko me te mamae o te kopu e pā ana ki te adenomyosis, whakamātauria ēnei tohutohu:

• Tāpirihia ki roto i te kaukau wera.
• Whakamahia he papatahi wera ki runga i tō kopu.
• Tangohia he rongoā anti-inflammatory kore-tuku, pēnei i te ibuprofen (Advil, Motrin IB, ētahi atu).