What should I do if uterine adenomyosis is detected by gynecological ultrasound?

Gynecological ultrasound can detect adenomyosis, which can be intervened through medication, intrauterine device placement, interventional therapy, surgical treatment, traditional Chinese medicine regulation, and other methods. Adenomyosis is usually caused by endometriosis, abnormal hormone levels, multiple pregnancies or uterine procedures, genetic factors, inflammatory stimuli, and other reasons.

1. Drug therapy

The drug therapy for uterine adenomyosis mainly includes nonsteroidal anti-inflammatory drugs, steroid drugs, and traditional Chinese medicine preparations. Ibuprofen sustained-release capsules can alleviate dysmenorrhea symptoms, levonorgestrel intrauterine sustained-release system can locally release progesterone to inhibit endometrial hyperplasia, and Guizhi Fuling capsules can help promote blood circulation and remove blood stasis. Drug therapy is suitable for patients with mild symptoms or those who wish to preserve their fertility, and should be used regularly under the guidance of a doctor.

2. Placement of intrauterine contraceptive system

Levonorgestrel intrauterine sustained-release system continuously releases low-dose progesterone, causing endometrial atrophy and thinning, effectively reducing menstrual flow and pain symptoms. This method is suitable for patients without fertility needs and whose uterine volume has increased by less than 12 weeks of pregnancy, and needs to be replaced every 5 years. Side effects such as spotting may occur, and most of them gradually improve within 3-6 months.

3. Interventional therapy

Uterine artery embolization causes necrosis and atrophy of ectopic endometrial tissue by blocking the blood supply of the lesion, and is suitable for patients who have failed drug treatment but wish to preserve the uterus. After surgery, it is necessary to use gonadotropin-releasing hormone agonists such as leuprorelin microspheres in combination to prevent lesion recurrence. This treatment may lead to temporary suppression of ovarian function, and patients over 40 years old should choose carefully.

4. Surgical Treatment

Conservative surgery such as lesion resection is suitable for patients with localized adenomyosis and fertility needs, while total hysterectomy is suitable for patients with severe symptoms, no fertility needs, or concomitant uterine fibroids. Laparoscopic surgery has minimal trauma and quick recovery, but diffuse adenomyosis may require open surgery. After surgery, estrogen should be supplemented to prevent menopausal symptoms, and those at high risk of osteoporosis should use estrogen and progesterone in combination.

5. Traditional Chinese Medicine Conditioning

Traditional Chinese medicine believes that adenomyosis belongs to the category of "mass syndrome". It can improve pelvic blood circulation through acupuncture and moxibustion at Guanyuan, uterus and other points, and regulate qi and blood with Shaofu Zhuyu Decoction. Moxibustion of Sanyinjiao can warm the meridians and dispel coldness, but it should be used with caution for those with excessive menstrual flow. Continuous treatment is required for at least 3 menstrual cycles, during which one should avoid eating raw, cold, spicy food and maintain a relaxed mood. Patients with adenomyosis should avoid vigorous exercise and heavy physical labor in their daily lives. During menstruation, warm water bags can be used to apply heat to the lower abdomen. It is recommended to choose salmon and flaxseed rich in omega-3 fatty acids for diet, and to supplement with vitamin E and zinc in moderation. Follow up gynecological ultrasound monitoring every 3-6 months to monitor changes in the condition. If there is a sudden increase in menstrual flow or worsening anemia, seek medical attention promptly. Maintaining a regular schedule and optimistic attitude can help control symptoms.