The Difference Between Adenomyosis and Endometriosis

When a woman experiences painful periods, heavy bleeding, and chronic pain in the pelvic region, this constellation of symptoms could suggest endometriosis, a condition in which endometrial tissue spreads and implants beyond the uterus. During every menstrual period, this misplaced endometrial tissue can shed blood into the pelvic region and beyond, causing cysts, scar tissue, and adhesions to form over time.

But if the endometrial tissue burrows deep into the muscle of the uterus, and not outside the uterus, the diagnosis is actually adenomyosis, a condition that is related to endometriosis but has a few key differences.

In endometriosis, the endometrial tissue escapes from the uterus and might implant on the surface of the bladder, bowels, or other organs throughout the body. In adenomyosis, the endometrial tissue gets pushed into the myometrium muscle of the uterus, which is located between the inner and outer layers of the uterus organ. Once embedded in the muscle, this endometrial tissue sheds when the rest of the endometrium sheds during a period, which causes extra bleeding, pain, and cramping.

Adenomyosis vs. endometriosis symptoms

Both diseases can cause pain, Sanjay Agarwal, MD, director for the Center for Endometriosis Research and Treatment at the University of California, San Diego, tells Health. But women with adenomyosis generally tend to have pain related to their periods, while women with endometriosis might also feel pain with bowel movements and at other times in the cycle.

“With adenomyosis, the main impact on quality of life is a painful period,” Dr. Agarwal says. “Perhaps this is because endometriosis goes further afield.”

These two conditions don’t cause symptoms for everyone, however. It’s estimated that about one-third of women with adenomyosis experience no symptoms at all. And when it comes to asymptomatic endometriosis, it’s estimated that as many as 43% of women who end up undergoing sterilization for other reasons also show signs of mild endometriosis and were completely unaware of it.

Diagnosing adenomyosis vs. endometriosis

While more doctors are beginning to treat endometriosis based on symptoms like pelvic pain and painful periods, the most definitive diagnosis is made during a surgery called a laparoscopy, which is when doctors insert a thin tube with a light and camera into a small incision in the abdomen. With the tube, they can see endometrial lesions, cysts, and adhesions that make up endometriosis.

Diagnosing adenomyosis is much less invasive. Magnetic resonance imaging can help doctors see whether the myometrium is thicker than normal—one sign of the condition. MRIs and transvaginal ultrasounds can also help doctors identify cysts in the walls of the uterus, as well as myometrium with an abnormal texture. If the growths are limited to just a few cysts, the adenomyosis is classified as focal, while abnormal myometrium throughout the uterus is called diffuse adenomyosis.

Infertility in adenomyosis and endometriosis

Both conditions can also raise the risk for impaired fertility, or the inability to either conceive or carry a pregnancy to term.

When it comes to adenomyosis specifically, embryos can struggle to implant in the enlarged and “hard” uterus. Pregnancy losses are also more common. One study showed that women with adenomyosis undergoing in vitro fertilization had double the rate of miscarriages compared to women with both adenomyosis and endometriosis.

Adenomyosis also puts women and their babies at a higher risk of preterm birth and the premature rupture of the amniotic sac, as well as intrauterine growth restriction, pregnancy-related hypertension, and uterine infection.

If IVF doesn’t work, doctors might suggest a drug protocol called a gonadotropin-releasing hormone agonist, which suppresses the production of reproductive hormones like progesterone and estrogen in order to reduce the size of the uterine growths. Doctors may also attempt a surgery to remove the growths, known as adenomyomas, and reconstruct the uterus. These two alternative treatments have been shown to increase the chances of spontaneous pregnancy among women with adenomyosis, while the drug protocol may also help make IVF more successful.

However, depending on the size and spread of the condition, women with extensive adenomyosis might end up needing a surrogate to carry their pregnancy, Dr. Agarwal says.

Adenomyosis vs. endometriosis treatment

Treatment options for both conditions are similar and escalate in intensity from birth control pills to suppress the release of reproductive hormones to surgery to remove endometrial cysts, scar tissue or implants, adenomyomas, or even the entire uterus.

In between those two ends of the spectrum, women can try other hormonal medications to drive down the production of estrogen, a hormone that makes both adenomyosis and endometriosis worse. These drugs, delivered through injections, hormonal IUDs, or pills, have been shown to reduce menstrual cramping, pain during sex, and chronic pelvic pain in both conditions.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement

When I Told My Doctor I Thought I Had Endometriosis, He Said, 'Stop Practicing Google Medicine'

I always considered myself to be in relatively good health. I had annual checkups, maintained a healthy diet, and tried to exercise. Overall, I was happy to be completely average. True, I had very heavy and lengthy periods, along with bad cramps. But so did my mom. So does my daughter. I thought that’s just how it is.

Then in 2011, after two previously healthy pregnancies, I suffered a miscarriage when I was four months pregnant. Soon after, I started having severe back and leg pain. At first, I blamed it on getting older or the fact that, as a lawyer, I sat so much during the day. When the pain didn’t go away, it seemed likely that it was due to sciatica or a pinched nerve. After a normal pelvic exam and ultrasound, my ob-gyn agreed. So did the chiropractor I consulted.

Mysterious, worsening pain

But despite physical therapy appointments and Pilates classes, the pain never completely cleared up. Not until 2014 did I realize that it worsened during and after my period. I also began suffering from other symptoms like frequent urinary tract infections, constipation, and high blood pressure. Even sex became painful. I felt so confused. If nothing unusual was showing up on my exams and tests, then what was causing my pain?

My ob-gyn suggested that I consult doctors who specialized in uterine issues, but I didn’t do so right away. I couldn't imagine that anything I had could be that bad. Plus, by this point, I’d learned to live with the two weeks on, two weeks off pain. (It required carefully timed Ibuprofen, which dulled the pain so I could function but didn't eliminate it.) It was hard to take time off from my demanding job—not to mention find a good specialist who not only took my insurance but was accepting new patients. I waited 14 months to see a specialist. In hindsight, that was a big mistake.

"Stop practicing Google medicine"

In 2015, while researching my symptoms online, I came across endometriosis, a disorder in which uterine tissue grows outside the uterus. It seemed like a possible cause of my symptoms, yet neither of the two specialists I saw that year mentioned it. When I did, I felt like I was irritating them. In fact, one of the doctors told me to “stop practicing Google medicine.”

Although both said they could treat my symptoms with various medications, they blamed the 20 or so extra pounds I was carrying at the time as the cause. I did try going on birth control pills, which they had suggested. But I had to stop because it made me throw up all the time and gave me bad headaches.

I remember walking out of the second specialist’s office on a hot August day. I had to walk several blocks to the train station, and as I walked, I tried to process my frustration. I decided I’d had it with these so-called “specialists.” No more appointments with doctors who didn’t listen to me. I’d simply deal with my two weeks on, two weeks off pain cycle until menopause.

But the pain kept getting worse. In 2017 my ob-gyn, knowing how exasperated I was, suggested I have another ultrasound. I have a habit of looking at techs’ faces when I get tests. They’re not allowed to say anything, but don’t have the best poker faces. As the tech prodded my left side, I saw her whole face drop. I found out later that she couldn’t find my left ovary.

An abdominal ultrasound was ordered, as well as a CT scan. The results showed that I had a condition called hydronephrosis [kidney swelling, caused by a backup of urine.] It was so severe that my kidney had stopped working. I was astonished. Upset. Scared. And I was at a loss about what to do, since doctors didn’t know the cause.

I went back to Google for answers. This time, I found an obscure blog, where a woman described how her kidney had been impacted by endometriosis. I knew I had to have the condition, too. I began searching for an endometriosis specialist near me.

The right diagnosis—and extensive treatment

Three months later, I met with Tamer Seckin, MD, a New York-based gynecologist laparoscopic surgeon. He'd already taken the time to read all my medical files—and he was horrified that no one spotted what he said were classic endometriosis symptoms, such as back pain and pain during sex.

Besides endometriosis, I had adenomyosis (similar to endo, it's when the uterine lining grows into the muscle of the uterus). Dr. Seckin also diagnosed me with a frozen pelvis, a severe complication of endometriosis that caused my pelvic organs to adhere to my bones. In addition to excision surgery [in which abnormal growths and scar tissue are destroyed], my uterus, both my ovaries, and fallopian tubes would all need to be removed.

The surgery took nine hours; it involved not just Dr. Seckin but also a urologist and colorectal specialist. During the procedure, they discovered that my kidney was infected and swollen to four times its normal size. They had no choice but to take it out as well.

No one feels great after this type of surgery, but truthfully, I was happy. The pain was gone. I vividly remember sitting in the waiting room before the operation, signing paperwork, and being unable to put weight on my left side because of the intense pain shooting down my leg. After the surgery, I was achy and groggy, but the pain on the left side of my body had disappeared.

Recovery was not easy—I was home on disability leave for three months—but the mental peace I finally had was worth it.

Putting dismissive doctors on notice

I agreed to open up about my story because I want other women to not wait for years to get diagnosed. Listen to your body. Believe your symptoms. Do your research and come to your doctors prepared.

We need to put medical professionals on notice that they cannot continue to ignore millions of women who have endometriosis. I want insurance companies to hear this, too, and start covering excision surgeries, which are currently out of pocket and very expensive. I don't want anyone else to lose major organs to endo.

Looking back, I didn’t live—I survived between pain cycles—for seven years. Now, I feel I have a life again.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement

Second-trimester miscarriage attributed to a coronavirus infection of placenta

A second-trimester miscarriage in a Covid-19 patient was attributed to a placental infection of the virus, according to new research, as some obstetricians notice an uptick in still births since the coronavirus pandemic hit the U.S.

Reports of newborns with fetal distress and stillbirth after maternal contraction of the virus during the third trimester suggest that there may be a Covid-19 induced placental infection, according to the research published Thursday in the Journal of the American Medical Association.

“This case of miscarriage during the second trimester of pregnancy in a woman with COVID-19 appears related to placental infection with SARS-CoV-2, supported by virological findings in the placenta,” the researchers said.

A pregnant woman in her second trimester was seen at Lausanne University Hospital with a fever of 102.5 degrees, muscle pain, fatigue, mild pain with swallowing, diarrhea and dry coughs after contracting the coronavirus. Two days after she tested positive and was prescribed pain relievers, she returned to the hospital with severe uterine contractions, a fever and no improvement of her symptoms.

After 10 hours of labor, she delivered a stillborn baby on March 20. While her nasopharyngeal swab had been previously tested positive for Covid-19, her blood and vaginal swabs sampled during labor were both negative.

The doctors also collected swab samples from the infant’s mouth, armpit, feces and blood within minutes of birth and their results also came out negative.

However, two swabs and biopsies obtained from the fetal surface of the placenta close to the umbilical cord were tested positive for Covid-19. These findings suggest that the miscarriage in this Covid-19 patient may be attributed to placental infection of the virus.

Researchers concluded that the fetus wasn’t infected, but the mother and placenta were. They also could not identify any other possible causes of miscarriage.

“Absence of the virus is not surprising given the stage of fetal development and short time of maternal infection,” the researchers said. “Whether SARS CoV-2 crosses the placental barrier warrants further investigation.”

The report from JAMA also noted that infection of the maternal side of the placenta resulting in miscarriage or impediment of fetal growth was observed in 40% of cases of pregnant patients with MERS and SARS, or severe acute respiratory syndrome, which are both coronaviruses.

A separate study published in The Lancet showed that in a review of 12 pregnant women who were infected with SARS during the 2002 to 2003 pandemic, 57% of women in their first trimester had a miscarriage. In the second to third trimester, 40% had fetal growth restriction and 80% had preterm birth.

As the global pandemic continues to infect tens of thousands of people across the world, pregnant mothers are increasingly put at risk.

U.S. obstetricians have been seeing an increased rate of miscarriages in their patients, according to Dr. Jane van Dis, MD, board certified OB-GYN practicing in La Cañada, California.

Van Dis told CNBC that one of her colleagues recently witnessed 18 spontaneous miscarriages in three weeks, while another practitioner saw five miscarriages in two weeks. She added that these physicians were finding increased terms in fetal demise, meaning pregnant mothers in their third trimester were experiencing miscarriages.

Van Dis said researchers and doctors are seeing more cases of blood clots in lungs, hearts and kidneys of coronavirus patients.

“The placenta is made up of miles and miles of blood vessels. Anything that causes clots in the placenta is going to diminish oxygen for the embryo or the fetus and put the fetus at an increased risk of demise,” she said.

Van Dis conducted her own informal survey, asking 210 obstetricians if they’ve observed a higher number of miscarriages with regards to the coronavirus.

The results showed 42% increase in first trimester loss, 20% increase in second trimester loss and 21% increase in third trimester loss. They aren’t sure whether Covid-19 played a role in the miscarriages because many of their patients didn’t have symptoms and weren’t tested.

She said doctors need to test more pregnant women for Covid-19 as there is “a huge number of asymptomatic positive cases.”

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement

Oral antifungal drug to treat vaginal yeast infection raises risk of miscarriage

Using a common medication to treat vaginal yeast infections during pregnancy could be associated with an increased risk of miscarriage, researchers warned. While topical treatments are used as the first line for pregnant women with fungal infections, oral drug fluconazole is also used during pregnancy. The study,  showed pregnant women who took an oral version of the drug fluconazole were more likely to experience miscarriage than those who did not. 

"Our study shows taking oral fluconazole during pregnancy may be associated with higher chances of miscarriage," said a researcher.

Higher doses of oral fluconazole (over 150 mg) during early pregnancy may also be linked with higher chances of giving birth to a baby with a heart defect, she added. 

The study re-emphasises safe practices during pregnancy, which include correct diagnosis and choosing the safest medication with the largest body of data. For the study, researchers studied data on 441,949 pregnancies. During pregnancy women often get thrush -- a yeast infection caused by the Candida species of fungus, usually Candida albicans -- because of changes going on in the body, especially during the third trimester. 

Thrush during pregnancy can be treated with cream or a tablet inserted in the vagina (a pessary) that contains clotrimazole or a similar antifungal drug. While thrush can also be treated with fluconazole, it should not be taken during pregnancy, or even those trying to get pregnant or breastfeeding, according to the doctors.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                    PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/                                                                                                                                                         FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-                                                  https:// kneereplacement-stickclub.blogspot.com/           

                                                                           FOR CROCHET DESIGNS                                                                                                                                                                                                  https://gscrochetdesigns.blogspot.com