Decreased menstruation – watch out for uterine adhesions
If you used to have normal periods and then you have a secondary decrease in menstruation or even amenorrhea, beware of uterine adhesions.
Currently, there are more and more patients with decreased menstruation. The causes of decreased menstruation can be endocrine disorders, low ovarian function, life stress, uterine dysplasia, damage to the endometrium to uterine cavity adhesions.
Etiology of uterine adhesions.
The cause of uterine adhesions is caused by damage to the endometrium. The following factors may damage the endometrium: abortion, curettage, purging, placental adhesions, placental implantation, endometritis, after uterine artery embolization interventions, endometrial tuberculosis, etc.
If you have had any of the above procedures or medical history and have existing reduced or even amenorrhea, it is recommended that you go to the hospital as soon as possible to rule out the possibility of uterine adhesions.
Diagnosis of uterine adhesions.
Uterine adhesions can be initially diagnosed by ultrasound, hysterosalpingography, but only hysteroscopy can confirm the diagnosis, which can also assess the severity of adhesions. Depending on the severity of the adhesions, the adhesions are usually classified as mild, moderate or severe.
Treatment of cervical adhesions.
1, Mild hysterine adhesions are usually cut directly by the surgeon with scissors during hysteroscopy, without the need for further elective surgery.
2. For moderate and severe uterine adhesions, hospitalization is usually required to perform electrodesiccation, laser dissection, and scissor clipping under hysteroscopy.
Surgical results of uterine adhesions.
The surgical results are good for mild adhesions, poor for moderate to severe adhesions, only a few can resume normal menstruation and a few can have normal pregnancies, which is one of the main causes of infertility today.
Factors affecting the surgical effect.
1. The more serious the adhesions are, the worse the results.
2. The effect varies with the etiology of adhesions. The effect is worst for uterine adhesions after uterine artery embolization intervention and from endometrial tuberculosis.
3, the surgeon’s skills, the better the skills, the less intraoperative re-injury to the endometrium, the better the effect.
4, postoperative care, the application of anti-adhesion measures.
Measures to prevent re-adhesion.
1. Application of postoperative uterotonin
2. postoperative placement of intrauterine device
3. Intrauterine placement of balloon
4. intrauterine placement of anti-adhesion drugs, such as chitosan, cinchonine, etc.
5. Intrauterine placement of amniotic membrane, bio-membrane, etc.
6. Repeat hysteroscopy every 1-2 months.
Although there are many methods to prevent re-adhesion, the results are not certain, among which repeated hysteroscopy is a relatively good method because it can assess the uterine cavity for re-adhesion in time, and if adhesions are found, the adhesions can be dislodged with instruments as early as possible when the adhesions are not strong, so as to reduce the possibility of re-injury to the endometrium due to re-electrolysis.
Methods of endometrial repair.
1.Supplementation of estrogen
2. Increase the blood supply to the uterus: local physiotherapy, thermomagnetic therapy, etc.
3. Chinese medicine treatment.