What is the difference between adenomyosis and endometriosis?

Adenomyosis and endometriosis are two different gynecological diseases. The main differences lie in the location and pathological characteristics of the lesions. Adenomyosis is when endometrial tissue invades the myometrium, while endometriosis is when endometrial tissue grows outside the uterine cavity.

1. Diseased area

The lesions of adenomyosis are limited to the myometrium, and the endometrial tissue directly invades the uterine muscle wall, resulting in a uniform increase in the uterus. Endometriosis lesions can occur in any part of the pelvic cavity, and are commonly found in the ovaries, fallopian tubes, recto-uterine recesses and other areas, and rarely may involve distant organs such as the lungs and intestines.

2. Pathological characteristics

In adenomyosis, endometrial glands and stroma can be seen deep into the myometrium under a microscope, accompanied by proliferation of surrounding muscle fibers. Endometriosis manifests as endometrium-like tissue outside the uterus, which can form chocolate cysts or adhesion lesions, but does not cause hyperplasia of the myometrium of the affected organs.

3. Symptoms

Adenomyosis mainly manifests as progressively worsening dysmenorrhea, increased menstrual flow, and uterine enlargement. Common symptoms of endometriosis include pelvic pain, dyspareunia, infertility, etc. The degree of pain is closely related to the menstrual cycle, and some patients may be asymptomatic.

4. Imaging examination

Ultrasound examination of adenomyosis shows thickening of the myometrium, heterogeneous echogenicity, and small cystic areas. Ovarian chocolate cysts or pelvic nodules may be observed under ultrasound for endometriosis, but small lesions may be difficult to detect, and laparoscopy is the gold standard for diagnosis.

5. Treatment methods

Treatment of adenomyosis focuses on relieving symptoms, and drugs such as levonorgestrel sustained-release intrauterine system and dienogest tablets can be used. In severe cases, hysterectomy is required. Depending on the condition, endometriosis can be treated with progesterone drugs, gonadotropin-releasing hormone agonists such as leuprolide microspheres, or surgery to preserve fertility.

Both diseases may affect fertility function. It is recommended to seek medical advice from a gynecologist as soon as possible when related symptoms occur. You should pay attention to menstrual hygiene every day, avoid strenuous exercise, and maintain a regular schedule. In your diet, you can appropriately increase foods rich in omega-3 fatty acids, such as deep-sea fish, and reduce your intake of red meat. Regular gynecological examinations can help with early detection and treatment.