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How is Adenomyosis Differentiated From Endometriosis?

Under normal circumstances, the endometrium grows in the inner wall of the uterus. Due to various reasons, it grows in other parts of the uterus, causing a series of symptoms which is also known as endometriosis. If the endometrium grows in the uterine muscle layer, it is adenomyosis.

There are three layers of the normal uterus, the endometrium, the myometrium and the serosa (the outer envelope of the uterus). The endometrium is affected by the fluctuation of hormone level every month, there is a periodic change of proliferation, thickening, and eventual exfoliation. When the endometrium exfoliates, it is accompanied by bleeding, which is menstruation.
What are the differences between adenomyosis and endometriosis?
1. Different pathogenesis
First of all, we must bear in mind that both of them are caused by the Ectopic growth of endometrium and can coexist. Secondly, the pathogenesis, clinical manifestations and hormone sensitivity of endometriosis and adenomyosis are different. The former is more sensitive to the hormone, while the latter is not sensitive to the hormone. Therefore, drug treatment has a better effect on endometriosis.
2. Different sites
Endometriosis usually occurs in the ovary. It refers to the active endometrial tissue that should have grown in the uterine cavity grows other parts outside the uterus because of certain conditions, such as the ovary, pelvic peritoneum, rectal wall, and other organs. With the hormone changes in the menstrual cycle, the repeated hemorrhage of the lesion leads to adhesions, nodule proliferation, and ovarian ectopic cysts (the chocolate cysts), causing pain and infertility.
Endometriosis usually occurs in ovaries, the typical symptoms are progressively aggravated dysmenorrhea, infertility, sexual discomfort, prolonged menstruation heavy menstrual flow. The endometriosis is related to menstrual reflux. Therefore, women should avoid menstrual operation and menstrual sexual contact.
And adenomyosis is caused by the invasion of endometrial glands into the myometrium of the uterus. The typical symptoms are prolonged menstruation and progressive aggravation of dysmenorrhea, there will be pain usually one week before menstruation and disappears until the end of menstruation. Through gynecological examination, there is usually uniform enlargement or localized eminence of the uterus, which was hard and tender. 
The treatment of adenomyosis is aimed at relieving pain and other symptoms with drugs for those women with mild symptoms. Patients can also be treated conservatively, such as taking natural medicine Fuyan Pill, it has great effects of alleviating the abdominal pain and the heavy menstrual flow. In some cases, complete hysterectomy can also be considered for those women without fertility requirements.
The etiology of adenomyosis is still unknown. The current consensus is that the uterus lacks the submucosa, so the basal layer cells of the endometrium proliferate and invade the myometrium of the uterus, accompanied by compensatory hypertrophy and proliferation of the surrounding myometrium cells, causing pathological changes.
Among the hazards of adenomyosis and endometriosis, infertility is common. However, not all patients will have infertility. In the clinic, there are also some patients with endometriosis complicated with pregnancy, but due to the impact of endometriosis, women who may be pregnant will have an abortion, wrong fetal position and so on.
Therefore, it is suggested that patients with endometriosis who want to be pregnant should be cured thoroughly before proceeding. Which is not only conducive to their health but also good for babies’ health.
About 30% to 50% of patients with adenomyosis will have infertility, it is mainly because that adenomyosis will hinder sperm passage and fetal development. Adenomyosis can also affect the extent, duration and frequency of uterine contraction, interfere with fertilized egg implantation, and cause abortion after implantation.
Of course, not all of the patients with adenomyosis will have pregnancy problems, depending on the growth site, size and number of symptoms. If the symptoms can cause infertility, women should be treated in time. Treatment of adenomyosis is very crucial, patients who already have infertility problems, if they are treated in time and properly, they can still be able to get pregnant normally, so patients don't need to worry too much about the disease.
It is relatively easy to differentiate endometriosis from adenomyosis, but attention should be paid to the difference between adenomyosis and uterine leiomyoma, because the clinical manifestations of the two are more similar, which can be diagnosed by B-ultrasound, laboratory or pathological examination.

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