How are diffuse changes in the myometrium manifested? Diffuse changes in the myometrium by the type of adenomyosis, endometriosis, focal, nodular: what does this mean? Moderate diffuse changes in the myometrium.

It is difficult to give a definitive answer to the question of what diffuse changes in the area of the uterus. First of all, you need to find out what constitutes "myometrium". What is it, what can its growth and much more depend on?

If we talk about what the myometrium is, then this is a layer of muscles located in the uterus, which has three layers of smooth muscle fibers in its composition at once. If we talk about the structure of this kind of layers, then they differ from each other and are in a certain sequence that you need to know:

Subserous outer layer, incorporating muscle fibers of a round and longitudinal type. The serous membrane covers this layer from the outside;
The middle layer of muscles, which has circular muscle fibers in its composition. Of all three layers, it is considered to be the most powerful. It is in the middle layer of muscles that the passage of the main vascular highways is observed, with the help of which the uterus is trophic;
Longitudinal inner layer, containing only fibers of the longitudinal type.

During pregnancy, it is the presence of such functions that allows the uterus to expand to the required size to accommodate a large enough fetus. During the growth of the child, it is the muscles that contribute to the protection against ruptures. As a result, the organ can expand to the required size, and after the birth of the baby, return to its original state. During childbirth, it is the muscles that help push the baby through the birth canal.

Symptoms and signs of diffuse overgrowth of the endometrium, endometriosis

Among the most characteristic symptoms of abnormal growth of the inner mucous layer of the uterus, the following can be distinguished:

heavy painful menstruation;
uterine bleeding in the middle of the cycle;
spotting discharge that occurs a few days before the onset of menstruation, and after it ends;
impossibility of conception;
discomfort during sexual contact;
painful sensations of a pulling nature in the lumbar region;
malfunctions of neighboring organs, which manifest themselves in the form of constipation, increased urge to urinate, or blood impurities in the urine;
pain during bowel movements.

It should be noted that at the initial stages, the pathology does not manifest itself in any way, so a woman may not even know about it for a long time.

Causes of changes in the myometrium, why do they occur?

Modern science tends to conclude that the main reasons for the development of endometriosis are several factors:

Heredity.
Hormonal imbalance. In favor of this theory are characteristic changes in the foci of the disease that occur during the menstrual cycle. In addition, endometriosis is able to independently regress during menopause and childbearing.
Movement of endometrial cells and their subsequent fixation on the outer surface of the uterus and other reproductive organs. This can happen both during menstruation and against the background of surgical intervention, complicated childbirth, the introduction of intrauterine devices and other things.
Reducing the body's defenses and associated neuro-endocrine pathologies. This condition can be provoked by regular stressful situations, malnutrition, various somatic diseases, sexually transmitted infections, etc. Proven link between endometriosis and dysfunction thyroid gland, autoimmune thyroid and malfunction of the pituitary gland.

Due to the abundance of various causes of the development of endometriosis, its treatment is always complex and is aimed at restoring the body's defenses, endocrine system and reproductive organs. In some cases, changes in the structure of the endometrium are asymptomatic and they can be detected quite by accident during an ultrasound scan or a planned gynecological examination.

Sonographic changes

Sonographic signs of pathological growth of the endometrium are its uniform or local thickening, which does not correspond to the day monthly cycle, as well as structural heterogeneity.

The term echogenicity refers to the property of tissue human body reflect ultrasonic waves.

Healthy internal organs and various glands have normal echogenicity or, as it is also called, isoechogenicity. If the ultrasound sensor detects an increase in echogenicity and heterogeneity of the tissue structure, then this may be evidence pathological changes in the lining of the uterus.

Confirm the diagnosis of endometriosis can identify foci with abnormal density, which are able to perfectly reflect ultrasonic waves. In addition, with the help of ultrasound, the thickness of the uterine walls is determined and in the case of endometriosis this indicator may vary within 4-5 cm.

What are echo signs and types of endometriosis?

In medical science, there are three main forms this disease:

diffuse. It is characterized by the presence of foci of the endometrium located on the mucous membrane of the uterus.
Nodal. Enough a rare event in which nodular lesions of the endometrium are diagnosed. Treatment in this case, as a rule, is surgical, since taking medication does not bring the expected result.
External or genital. It is an overgrowth of endometrial tissue on the surface of the reproductive organs, with the exception of the uterus. In the vast majority of cases, this form of endometriosis affects the fallopian tubes and ovaries.

The most common form of endometriosis is diffuse, and when diagnosed, an ultrasound specialist may notice the following changes:

cellular structure of the inner mucous layer of the uterus;
foci of endometriosis, which can be both small in size and quite large (about 0.5 cm). They are located on the entire surface of the uterus;
change in the size of the uterus. Sometimes this organ increases to a size corresponding to the 9th week of pregnancy. The shape of the uterus in a woman with endometriosis becomes spherical;
heterogeneity of the structure of muscle tissue;
uneven surface of the uterus. This leads to pain during palpation.

It should be noted that in the initial stages of the disease, even an experienced specialist may not notice the signs of endometriosis, since they are very small and insignificant.

Endometriosis - the cause of changes in the myometrium

The detection on ultrasound of an uneven structure and thickness of the endometrium in most cases means the development of endometriosis - a benign process, as a result of which tissue grows outside the uterine mucosa, resembling the structure of the endometrium. During the study, peculiar focal growths in the myometrium can also be detected.

Clinically, this disease is manifested by irregular menstruation and pain in the lower abdomen and in the lumbar region. One of the serious complications of endometriosis is the impossibility of conception, since the most important reproductive organs are affected: the ovaries, fallopian tubes and uterus. At the same time, the absence of pregnancy is not caused by the focus of endometriosis itself, but by its complications, for example, the lack of ovulation, a large number of adhesions in the small pelvis, or the impossibility of implanting a fertilized egg. The treatment of endometriosis is quite long and it is aimed primarily at eliminating its cause, if it can be accurately established. Complex therapy consists in taking hormonal drugs, conducting physiotherapy procedures and surgical intervention, if necessary.

Adenomyosis and changes in the myometrium

The appearance of diffuse changes in the myometrium can be triggered by adenomyosis, one of the varieties of endometriosis. It is characterized by heterogeneity of muscle tissue with foci of the endometrium. Distinctive feature adenomyosis is the ingrowth of the endometrium into the body of the uterus, while in endometriosis the lesions are more extensive and superficial.

In some cases, adenomyosis is completely asymptomatic and can only be detected during a routine examination. However, in most women, this disease manifests itself in the form of painful and heavy periods, menstrual irregularities, pain during intercourse, and other things. The causes of adenomyosis have not been fully identified, however, most scientists are inclined to believe that mechanical intervention in the uterine cavity, for example, during curettage or abortion, can provoke its occurrence.

Treatment for this disease includes taking painkillers and anti-inflammatory drugs. medicines, as well as hormonal drugs aimed at regulating the work of the ovaries. In some cases, the disease can only be defeated by introducing the patient into an artificial drug-induced menopause. If the previous treatment does not bring the expected results, the attending physician may offer the woman to solve her problem. surgical method, as a result of which a hysterectomy is performed - amputation of the uterus. Most doctors try to avoid surgery if the patient is still planning to have a baby in the future.

Anemia and diffuse changes in the myometrium

Changes in the structure of the endometrium can occur against the background of anemia - a decrease in the concentration of hemoglobin in the blood.

As a result of this disease, there is insufficient blood supply. internal organs, which leads to a violation of the proper nutrition of the uterus and a violation of the structure of its muscle layer. However, in some cases, the cure for anemia does not lead to the restoration of the proper functioning of the uterus, which may indicate a mixed pathology provoked by several factors.

To normalize the condition of a patient with signs of anemia, complex therapy including taking iron supplements, healthy lifestyle life and adherence to the principles of proper nutrition.

What complications can occur when changing the myometrium?

Timely diagnosis of the disease and its competent treatment in most cases has a favorable outcome. The fastest way to cope with the problem is women in reproductive age. However, the main treatment in this case should be aimed precisely at getting rid of the cause of endometriosis, otherwise the risk of recurrence of the disease is very high. The most serious complications in this case are:

inability to conceive and bear a child;
active growth of fibroids;
severe form of adenomyosis;
degeneration of neoplasms into a malignant form;
refusal of sexual intercourse due to pain;
disruption of the menstrual cycle;
profuse bleeding, etc.

It is impossible to detect the disease at home, but a woman may suspect something is wrong characteristic symptoms. At the same time, it should be understood that only a timely visit to a doctor will help restore reproductive function, otherwise it will be extremely difficult to get rid of the problem.

Diagnosis of endometriosis, diffuse changes in the structure of the myometrium

It is as a result of the presence of endometriosis in a woman that leads to infertility. The share of this disease accounts for a third of all cases when a woman is not able to conceive a baby. You can determine the presence of the disease as a result of diffuse changes that can be seen during an ultrasound scan. If we talk about the symptoms of the disease, then they include the occurrence of pain during menstruation and urination, pain may appear during sex, bloody issues also possible in the intervals between menses.

In most cases, there is a mismatch in terms; by mistake, endometriosis can be called endometritis, but in fact it is various diseases. If we talk about the forms of endometriosis, then they can be different, in this case everything will depend directly on the location of the tissues subjected to pathological changes. There are such forms of the disease, during which diffuse changes are observed in the myometrium:

A form during which one can observe the merging of the two forms optimizable below. It is called - combined form;
The genital form, which in most cases affects the ovaries and uterus, endometriosis of the tubes of the uterus, vagina and other genital organs is observed;
Extragenital form, during which the lesion extends to the organs of the urinary and urinary systems, intestines, lungs and many others.

In some cases, endometriosis can cause damage directly to the uterine body itself. This type disease is called adenomyosis. It also refers to diffuse changes in the myometrium. If we talk about the stages of development of this kind of disease, then it has four forms:

At the first stage, damage to the mucous membrane of the uterus is observed, the process reaches the endometrium.
In the second stage, damage to the deeper layers can be observed, which can affect the middle layer.
In the third stage of the disease, the lesion reaches the serous cover of the uterus.
The last final fourth stage is accompanied by a lesion of the parietal peritoneum.

Differential diagnosis of pathological changes in the uterine wall, what is it and how does it go?

Often, this disease is detected simultaneously with a number of other pathologies. Most often, a woman is faced with a disease, in the presence of such problems as a cyst in the cervical region, metritis in chronic stage, proliferation of the follicular apparatus and other diseases in the female genital area. In the presence of each of your mentioned diseases, you can note the presence of changes that occur in the area of \u200b\u200bthe uterus and other genital organs.

What to do, how to treat endometriosis?

If a woman has been diagnosed with such a diagnosis, then it is necessary to begin timely treatment.

Therapy is necessary not only to eliminate unpleasant symptoms, but also if there are problems with conceiving a child. If we talk about therapy options, then in this case it may turn out to be waning:

Treatment with hormonal drugs. This action is necessary in order to restore the balance of hormones that were disturbed as a result of the disease. Unfortunately, such therapy does not always boast an effective result;
To prevent the disease from spreading further to the uterine mucosa, the affected areas are cauterized. This therapy is the most in an efficient way getting rid of the disease.

When choosing one or another method of therapy, in this case it is very important to exclude the likelihood of certain complications. These pathologies can occur as a result of diffuse changes in the myometrium. In any case, you should not postpone treatment, because this can lead to very negative consequences.

Myometrium is the middle muscular layer of the uterus, consisting of three different layers of muscles.

Structure of the uterine myometrium:

Three layers of smooth muscle fibers

The outer subserous layer is a muscle fiber located longitudinally and circumferentially. Outside, the serous membrane is visible;
The middle layer of the myometrium - the strongest - is a circular muscle, in the cellular structure of which there are vessels and veins that provide the uterus with useful substances;
The inner layer includes longitudinal fibers.

Due to the presence of different layers of myometrium, the uterus acquires the ability to contract, which is necessary for exit menstrual blood outside during menstruation.

Thanks to the myometrium, the uterus acts as a repository for the fetus during pregnancy, it grows with the growth of the baby. And when the gestation period is over, it expels the fetus from the mother's body with the help of the same muscles.

The causes of pronounced or moderate diffuse changes in the myometrium are varied and can be traumatic (abortion) and less traumatic (natural childbirth).

Most of the causes of diffuse changes are:

endometriosis;
Adenomyosis;
stress;
Anemia;
Bad heredity;
C-section;
abortion and various mechanical cleaning uterus;
Infectious diseases;
Penetration of infection into the uterine cavity during menstrual bleeding;
Hormonal disruptions in the body.

Signs of diffuse changes in the myometrium:

Heavy and excessively painful monthly bleeding;
Pain during sex;
Pain when urinating;
Drawing pains in the lower abdomen on the 12th-16th day of the cycle (during ovulation);
Isolation of blood in the middle of the cycle;
Inability to conceive a child.

Diagnosis of diffuse changes in the myometrium is performed using:

Endoscopic study.

The presence of echo signs during diagnostic measures is the most important sign of myometrial heterogeneity.

Sonographic signs are detected during ultrasound, if the echo reveals any anomalies or focal abnormalities, the diagnosis of endometriosis or adenomyosis is suspected.

Adenomyosis

With adenomyosis, the inner layer of the uterus (endometrium) grows into the muscle tissue - the myometrium and only into it, unlike endometriosis.

The case count is low because it is often difficult to distinguish from endometriosis. It is not uncommon for women to be diagnosed with both diseases.

Sometimes adenomyosis is completely asymptomatic, but there are the following signs:

Painful periods (pain lasts all days) with the release of blood clots;
Unpleasant sensations during intercourse;
Spontaneous bleeding from the genital tract;
Noticeable enlargement of the uterus;
Pain in the lower abdomen on palpation.

There are 4 stages of adenomyosis:

The uterine mucosa is affected;
The endometrium is included in the affected areas;
The tumor grows to the serous uterine layer;
Damage to the organs of the peritoneum.

Doctors consider the causes of adenomyosis to be:

Entry of endometrial cells into the muscular layer of the uterus (during surgical intervention);
congenital pathology;
Inflammation of the uterus after childbirth.

Diagnosis is carried out using ultrasound of the pelvic organs, during which the echo will determine diffuse changes.

Most often, patients are women "over 40" or during menopause.

Treatment for adenomyosis:

Medical:

Non-steroidal anti-inflammatory drugs (Ibuprofen);

Hormonal drugs (oral contraceptives);

Surgery consists of removing the uterus (hysterectomy);
Taking warm baths.

endometriosis

Endometriosis is the ingrowth of the mucous membrane of the inner layer of the uterus into the muscular layer with the appearance of benign neoplasms.

Ultrasound diagnoses endometriosis in a third of women with diffuse changes in the myometrium.

Symptoms of endometriosis are in many ways similar to those of adenomyosis:

Pain during trips to the ladies' room and sex;
Painful periods, irregular bleeding.

There are several forms of the disease:

Genital endometriosis, in which the ovaries and uterine cavity, fallopian tubes, vulva and even the external genital organs of a woman are affected;
Extragenital - when the number of affected organs, in addition to the genital ones, includes the lungs, intestines and other closely spaced components of the human body;
Combined endometriosis is a mixture of the two forms described above.

Treatment for endometriosis consists of the following:

Treatment hormonal drugs, which implements the mandatory blood donation for hormones;
Cauterization of foci of the disease to prevent its further spread.

Diffuse changes in the myometric layer of the uterus may well occur against the background of constant stressful situations.

Signs of stress:

Headaches that appear with an enviable frequency;
General impotence;
Nausea;
Vomit;
diarrhea;
Chronic constipation;
sleep disorders;
Lack of sexual desire;
Tachycardia;
sweating;
Trembling of hands;
Lump in the throat;
Nervous excitability;
Low self-esteem of the patient.

If, against the background of stress, a woman has infertility, pain during menstruation, then you need to contact a qualified specialist.

Treatment of stress or how to get rid of depression:

Eat a balanced diet, avoid diets;
Sleep 8-9 hours a day;
Do not be nervous over trifles;
Talk about how you feel;
Do not drink alcohol or use drugs;
Leave time for yourself;
Communicate with family and best friends;
Exercise regularly (there is a release of endorphin - the hormone of happiness).

Anemia

If the red blood cells do not provide enough oxygen to the tissues of the body, anemia develops. It can also cause diffuse changes in the myometrium.

Anemia is caused by a lack of hemoglobin or red blood cells.

Signs of anemia are:

pale skin;

Cardiopalmus;

Problems with hair and nails;

Pain in the head;

Craving for eating non-traditional foods.

Doctors believe the causes of anemia are:

Poor nutrition (you need to eat meat, liver, pomegranates and apples);
Pathology of the absorption of iron by the body (for example, with celiac disease or Crohn's disease);
Sharp growth spurts in babies (especially under the age of 3 years). With growth retardation, anemia resolves on its own;
Pregnancy;
Great loss of blood (during menstruation or injury).

Treatment for anemia is as follows:

Include the following foods in your daily menu:

Beef;
Liver;
Dried fruits;
Nuts;
legumes;
Seafood;
Greens;
Kashi;

Taking iron supplements for several weeks. Such tablets are drunk during a meal, washed down with water. After discontinuation of the drug, if the diet has not been adjusted, anemia will quickly return again. Frequent side effect- diarrhea, this should be reported to the attending physician to change the drug.

Diffuse changes in the myometrium and related diseases should be treated in the initial stages: this will help to avoid "female" problems and problems with pregnancy in the future.

In order to understand the phenomenon of changes in the structure of the uterine wall and understand what diffuse changes in the myometrium are, you first need to decide on the very concept of "myometrium". What it is?

The myometrium is the muscular layer of the uterine wall, which consists of three layers of smooth muscle fibers. These layers have the following structure and are arranged in a certain sequence:

The outer subserous layer, which consists of longitudinal and circular muscle fibers. It is covered on the outside with a serous membrane.
The middle muscle layer consists of circular muscle fibers and is the most powerful. In the middle layer are the main large main vessels that carry out trophism of the uterus.
The inner longitudinal layer, which consists exclusively of longitudinal fibers.

The uterus, through all of the above muscle layers, performs the function of a fetus during pregnancy. Muscles protect the organ from ruptures during the intrauterine growth of the baby. And after the expiration of the gestational age, thanks to the muscle fibers, the process of expulsion of the fetus occurs.

Changes in the structure of the myometrium occur for a number of reasons and have their own causal mechanism. During the period of fertility, the uterus of a woman is exposed to various influences. According to the strength of influence and the level of traumatization of the structures of the uterine tissue, these factors can be divided into traumatic and low-traumatic.

For example, abortion is a traumatic factor influencing the tissues of the uterus and carries with it subsequent diffuse-focal changes. And childbirth, due to their physiological nature, with a benign course of the birth process, is no longer such a traumatic factor. Also leads to diffuse focal changes completed miscarriage.

In fact, diffusely heterogeneous myometrium can result from the following conditions:

Anemia
Experienced severe stress
Hormonal failure in the body of a woman
endometriosis
Transferred infectious disease.

In all of these cases, ultrasound examination determines diffuse changes in the myometrium.

Endometriosis and its diagnosis

One third of infertility cases in women occur in patients with endometriosis. When this diagnosis is made on ultrasound, diffuse changes are detected. Symptoms of this condition are most often pain during urination and before menstruation, pain during physiological intercourse, and bleeding between periods is also possible.

If the ultrasound reveals a discrepancy between the thickness of the endometrium and the period of the menstrual cycle, and the structure of the myometrium is changed, then the conclusion is “endometriosis”. Endometriosis is a polyetiological disease that is characterized by the growth of the endometrium, which lines the inside of the uterus. Sometimes with endometriosis, the growth of endometrial cells occurs outside the organ itself.

In rare cases, menstruating endometrium may appear outside the organs of the genital area, for example, on the bronchial mucosa or the gastrointestinal tract. This will be manifested by cyclic bleeding of varying degrees of intensity from these organs. The main indicator in ultrasound diagnostics for endometriosis is a diffusely heterogeneous structure of the myometrium. Due to the thickening of the endometrium, the implantation of a fertilized egg becomes impossible and in such a case we can talk about infertility.

Some of the most common causes of endometriosis include:

Hormonal disorders - in this case, the balance between steroid hormones is disturbed, there is a high level of follicle-stimulating hormone and luteinizing hormone in the woman's body.
Menstruation - It is believed that in women of childbearing age during menstruation, menstrual blood may be thrown into the tissues surrounding the uterus. This is a predisposing factor for the germination of endometrial cells into the abdominal cavity.
Genetic predisposition: if the patient's myometrium is diffusely heterogeneous, it is possible that the same pattern is observed in several generations along the female line within the same family.
Violation of the body's immune response - with this violation, the role of the internal protective mechanism is reduced, due to which endometrial cells cannot take root outside the uterine cavity.
Metaplasia of endometrial cells - the transformation of one type of cell into another. It is noted that the structure of the endometrium is changed.

There is often confusion in terminology, and endometriosis is erroneously referred to as endometritis. From the position of nosology, endometritis is inflammatory disease endometrium (inner lining of the uterus) of a specific or non-specific nature. And endometriosis is a diffuse heterogeneity of the myometrium against the background of structural changes in the inner layer of the uterine wall.

Endometriosis has various forms depending on the location of the pathological tissue. These are the following forms in which moderate diffuse changes in the myometrium are observed:

Genital form with a primary lesion of the uterus and ovaries, endometriosis of the vagina, fallopian tubes and other genital organs.
Extragenital form with damage to the intestines, organs of the urinary and urinary system, lungs and other organs.
A form in which the two forms are merged. It is called the combined form.

There is also a lesion of the body of the uterus with endometriosis. This disease is called adenomyosis. This is also a diffuse change in the myometrium. According to the stages of the process, adenomyosis is classified:

The first stage - damage to the uterine mucosa to the endometrial layer
The second stage is a deeper lesion of the endometrium, up to the middle of its layer
The third stage - when the lesion reaches the serous cover of the uterus
The fourth stage is already a lesion of the parietal sheet of the peritoneum.

In addition, the treatment of this pathology is described in the video:

Diagnosis and differential diagnosis of pathological changes in the uterine wall

The differential diagnosis of endometriosis is established with such diseases as chronic metritis, cervical cyst, proliferation of the follicular apparatus and other diseases of the female genital area. In all these diseases, similar changes in the uterus and other genital organs are observed.

Treatment for diffuse changes in the myometrium

Treatment is mainly in the nature of the following actions:

Hormone therapy to correct the imbalance of hormones in a woman's body. Such treatment, unfortunately, rarely gives a stable result.
Cauterization of affected areas to prevent further dissemination diseases. It's more radical and more effective method treatment.

When choosing a treatment, it is important to exclude all possible complications that arise due to diffuse changes in the myometrium.

Normally, the myometrium is homogeneous, there are no foreign inclusions in it. In this state, it is observed in healthy women. When the structure of the uterus changes, a heterogeneous myometrium appears, one can suspect the development of pathology. It is possible to determine the state of the muscle layer using ultrasound. At the same time, diffuse changes are not an independent disease. This is just a symptom of an ailment that develops in the genitourinary system.

To identify the exact cause of the diffusely heterogeneous structure of the muscle layer, a whole complex is carried out clinical research. Among the factors provoking such changes are the following:

surgical intervention in which the walls of the uterus were damaged;
disorders of the endocrine system;
curettage for diagnostic purposes, excision of polyps, fibroids and cysts in the uterus;
violations in the activity of the sex glands;
fluctuations in hormone levels;
genetic predisposition;
susceptibility to stress;
genital infections;
inflammation of the organs of the reproductive system;
excessive exposure to ultraviolet rays.

It is impossible to ignore changes in the muscle layer. Often they cause infertility.

Symptoms with diffuse changes

Myometrium of a heterogeneous structure often does not show any symptoms. Hormonal failure, anemia, severe stress and sexual infections can provoke such changes. In this case, the following clinical manifestations are noted:

excessively heavy menstruation;
pronounced;
discomfort when urinating;
discomfort during intimacy;
pain observed during ovulation;
meager brown discharge in the second half and middle of the cycle;
impossibility of conception.

Myometrium during pregnancy

Inhomogeneous myometrium is often detected in pregnant women during routine ultrasound and often indicates the presence of pathology. In this case, the doctor constantly monitors the condition of the muscle layer. This is due to the fact that local thickening causes serious problems. Hyperechogenicity (the presence of abnormal seals) can lead to rupture of the uterine mucosa.

In this case, the doctor registers the pregnant woman and systematically examines. Diseases that provoke such changes in the uterine layer can cause serious complications during childbirth. With the growth of fibroids, the course of pregnancy will be difficult.

During labor, insufficient contraction of the organ, as well as the onset of bleeding, is not ruled out. In the absence of therapy, fibrosis often develops and scars form, leading to rupture of the birth canal.

In the first trimester, a change in the structure of the muscular tissues of the uterus can cause its excessive tone. In this case, the risk of spontaneous miscarriage increases significantly. On the late term childbirth before the due time is not excluded.

The appearance of deviations from the norm

The homogeneous structure of the muscle tissue of the genital organ is an indicator of the norm. Minor changes are allowed in certain phases of the menstrual cycle, but only in the absence of concomitant symptoms, inflammatory and infectious diseases.

There are no clear boundaries between layers. Their thickness increases towards the bottom of the uterus. Due to this, the body can fully contract during labor.

A heterogeneous structure is observed both for physiological and pathological reasons. Natural changes in this case occur at the time of menopause.

The pathological state of the myometrium is detected during an ultrasound examination. This takes into account such indicators as echogenicity, size of the uterus, tone and thickness of the layers. Thanks to the data obtained, it is possible to identify the cause that provoked such structural changes.

Why does the breach occur?

Homogeneous myometrium is normal. A change in the structure of the muscular and mucous layer of the uterus can occur due to the development of various pathologies. Most often, these symptoms are observed with adenomyosis and fibroids.

Adenomyosis

This pathology is characterized by excessive growth of the endometrium and damage to the muscular layer of the uterus. The development of the disease is due to hormonal fluctuations that can be observed in women of all age categories.

Treatment of changes in the myometrium

The treatment regimen for diffuse changes in muscle tissue largely depends on the severity of the disease, the age of the woman and the presence of concomitant pathologies. In this case, both surgical and medical methods can be used.

The main goals of therapy are the following:

preventing the development of complications;
suppression of the process of estrogen production in order to prevent the further development of pathology;
preservation of reproductive function;
prevention of cell degeneration into cancer;
elimination of associated symptoms.

Drugs used during treatment various forms. These could be funds local action, which are inserted into the vagina, and tablets. Use them begin only as directed by a doctor.

Hormonal therapy of heterogeneous myometrium is carried out in courses. Taking drugs begins after menstruation and continues for three weeks, then take a break for seven days and continue treatment. The following groups of drugs are used:

estrogen-progestin contraceptives (Diana-35, Non-Ovlon, Demulen, Yarina or Jess). With their help, the process of ovulation and the production of estrogen are suppressed. The drugs are effective in the initial stages of the development of the disease;
gestagenic agents (Norkolut, Byzanne or Utrozhestan). Medicines of this group are prescribed for various degrees of tissue damage;
agonists of gonadotropic releasing hormones (Danogen, Danol or Nemestran).

Hormonal therapy gives a pronounced effect. When combined with surgery, the risk of recurrence is minimized.

Surgical treatment involves the removal of lesions. In this case, methods such as:

laparoscopy;
laser vaporization;
cryodestruction.

After surgery, the body needs time to recover. After a few months, successful fertilization is possible.

Prevention

In order to prevent diffuse changes in the myometrium and the development of pathologies that provoke this process, it is necessary to systematically undergo an examination by a gynecologist and conduct an ultrasound scan every six months. This is especially true for girls adolescence, women who underwent surgical intervention in the organs of the genitourinary system. In addition, you need to follow the rules of hygiene and wash your intimate areas twice a day.

If suspicious symptoms appear, you should immediately contact a gynecologist. Timely detected diseases are much easier to treat.

The diffusely heterogeneous structure of the muscular layer of the uterus indicates the beginning of a pathological process that must be eliminated as soon as possible. It is possible to identify such changes only during an ultrasound examination. Immediately after this, a course of therapy is prescribed.

Article plan

Many women, having heard the expression "diffuse changes", wonder what it is? It should be noted that diffuse changes in the body are not a disease. They are a sign by which it is possible to determine the development of a particular pathology using ultrasound.

The myometrium is a vital layer of the uterus that provides the organ with the ability to contract. Diffuse changes in the myometrium primarily affect the ability of the uterus to cope with the removal of menstrual blood along with the upper layer of the endometrium. If the diagnosis showed the presence of this symptom, then the woman may experience problems with delivery.

Features of the structure of the layers of the uterus

There are three components in the structure of the muscle layer:

Internal, which consists of longitudinal fibers;
Medium, which is a circular muscle. This layer is the strongest. Due to the presence of blood vessels, the uterus is provided with the necessary useful elements;
External, consisting of longitudinal muscles and covered with a serous membrane.

The ability to contract is provided precisely due to the presence of different layers of the myometrium. This ability is necessary to ensure the release of menstrual flow. In addition, this structure of the myometrium helps the uterus to perform the function of the so-called "storage" during pregnancy. As the fetus grows, the uterus also increases in size, and after the end of the gestation period, with the help of all the same muscles, the fetus is expelled from the woman's body.

Causes of changes in the myometrium

The exact reason for the appearance of such a sign as diffuse changes is unknown to science. It is believed that endometriosis appears and progresses due to hormonal failure in the body, when the level of estrogen rises, and progesterone, on the contrary, decreases.

First, hormonal disorders lead to diffuse changes in the myometrium of a moderate type, then rejection of the endometrium can occur and, as a result, profuse uterine bleeding.

In general, the main causes of myometrial heterogeneity are:

Difficult childbirth with trauma to the wall of the organ;
C-section;
Curettage of the uterine cavity for diagnostic indications;
Surgical interventions in the uterine cavity (abortion);
Violations in the work of the endocrine system;
Genetic predisposition to gynecological diseases;
Experiences and stresses;
Inflammatory diseases and infections.

How to identify

When discomfort and the first signs characteristic of endometriosis, the patient is prescribed a thorough diagnosis. A visit to the gynecologist and the passage of ultrasound is necessary in order to correctly diagnose. It is possible to assume the presence of endometriosis at a gynecologist's appointment by the increased size of the uterus. But the most accurate result can only be given by ultrasound diagnostics, which makes it possible to identify diffuse changes in the myometrium, determine the degree of heterogeneity of the echostructure and the depth of endometrial growth.

Sonographic changes

The main indicator that allows you to diagnose is diffuse changes of the echographic type. When conducting an ultrasound, an indicator such as echogenicity is evaluated - the ability of tissues to reflect ultrasound.

If the functions and structure of the uterus are normal, then the echogenicity will be low. An increase in echogenicity indicates the development of adenomyosis varying degrees severity, which is characterized by a heterogeneous echostructure of the organ and blurred contours. This pathology is also characterized by a noticeable thickening of the walls up to 4-5 cm, which occurs due to the growth of the endometrium.

Echosigns and types of endometriosis

There are three forms of endometriosis, in which diffuse changes in the muscle layer occur: nodular, focal and diffuse. With a diffuse form, slight changes in the structure are noted. They are endometriotic growths on the entire surface of the endometrium and myometrium.

The features of the diffuse form of the disease include:

Damage to the muscle layer by endometrioid cavities with a cellular structure;
The presence of minor hyperechoic inclusions;
There are characteristic echoes of diffuse changes, i.e. an increase in the size of the uterus and a change in its shape;
In the presence of dotted endometrioid areas, heterogeneous heterogeneity in the structure of muscle tissue is visualized;
The surface of the uterus becomes heterogeneous, pain is felt on palpation.

In the nodular form of the disease, there is an overgrowth of formations from endometrial cells, which have a rounded shape with a diameter of up to 6 mm and fuzzy contours.

Focal endometriosis is characterized by the formation of endometrioid formations up to 1.5 cm in size in separate areas. This reduces the mobility of the uterus, and its displacement leads to severe pain.

Endometriosis as a common cause

Clinical manifestations of the disease can be of a different nature. It all depends on the severity of diffuse changes. Diagnosis allows you to identify three degrees of development of pathology according to the type of adenomyosis:

1 degree: myometrium has a heterogeneous structure with slight changes;
2 degree: germination of the endometrium reaches the middle of the muscle layer;
Grade 3: endometrial tissue completely grows into the myometrium, while it can reach the serosa.

At first, the course of endometriosis is asymptomatic, so women may not even be aware of the changes taking place in the body. When the disease passes into a difficult stage, there are characteristics. The main symptom is uterine bleeding and strong pain. Smearing discharges appear in the middle of the cycle, and menstrual cycle elongated in most cases.

The neglected form of the disease often causes anemia, drowsiness, frequent dizziness and fainting. Until treatment is carried out, these symptoms will not disappear.

Symptoms

The initial stage of the disease often has a latent (asymptomatic) course. However, further germination of the endometrium is more pronounced. The main signs of diffuse changes in the myometrium include:

Abundant bleeding during menstruation, accompanied by severe pain;
Aching pain in the lower abdomen in the middle of the cycle;
Spotting a few days before the onset of menstruation;
A marked increase in the size of the uterus;
Feeling of discomfort during sexual contact;
Pain when pressing over the uterus and when urinating;
Problems with conception and gestation.

Treatment Methods

If a woman is diagnosed with diffuse changes in the myometrium, it is necessary to choose the most appropriate therapy. To do this, the severity of the pathology and the presence of associated symptoms are first determined. To get rid of the effects of endometriosis, the following methods are used:

Medicinal (drug) treatment;
Surgery.

Medicinal

Drug therapy is based on the use of hormones: gestagens, antigonadotropins, estrogen-gestogens and other groups. All these drugs are very effective in combating diffuse changes only at the initial stage of pathology development. When endometriosis is diagnosed in a neglected form, it is not always possible to achieve a result.

Surgical

If the conservative method of treatment with hormonal drugs did not bring the expected effect, surgery comes to the rescue. Previously, women who were diagnosed with diffuse changes in the myometrium underwent surgery to remove the uterus, but now modern medicine allows the use of surgical intervention with preservation female organ- laparoscopy.

Such an operation allows you to remove foci of endometriosis, while restoring the reproductive function of a woman. However, after surgical treatment, there is a risk of relapse - the re-development of pathology. To reduce this likelihood, patients are prescribed hormone therapy in combination with herbal preparations to normalize hormonal levels.