Pan Junheng (Dean of Obstetrics and Gynecology, Alison, Director of Taiwan Province Women's Health and Urology Foundation) The causes of hysteromyoma, also known as adenomyoma, adenomyosis and adenomyosis, mean that the endometrium grows into the myometrium, which makes the myometrium thicken and proliferate and makes the whole uterus swell symmetrically. Its etiology is related to estrogen secretion, which is also commonly known as endometriosis. Myoadenoma of uterus mostly occurs in 40? A 50-year-old woman with multiple births has symptoms of menorrhagia and menstrual pain. Menstruation is caused by endometrial hyperplasia and ovarian dysfunction, while dysmenorrhea is caused by endometrial swelling and uterine contraction. Patients can find that the uterus is spherical, the uterine wall (especially the posterior wall) is thick and uneven, the serosal surface is irregular, and there will be local tenderness before menstruation. Uterine myoma is not a complete tumor, but endometrial tissue directly penetrates into myometrium from uterine cavity, and new endometrial tissue is derived from myometrium. The reason for its formation is still unclear. Because the patient's endometrium is usually scattered throughout the myometrium, especially in the myometrium of the posterior wall of the uterus, it sometimes concentrates in one place, forming a tumor-like appearance, so it is called "hysteromyoma". Because of the similar symptoms, hysteromyoma is often differentiated from hysteromyoma, endometriosis, functional uterine bleeding, chronic involution of uterus, benign hypertrophy of uterus, uterine cancer, etc., and differential diagnosis is made. About half of patients with hysteromyoma will have hysteromyoma, about 10% will have endometriosis, and 7.3% will have endometrial polyps, but they will not deteriorate into endometrial cancer. What is the difference between box myoma and adenoma? Generally speaking, fibroids are long and hard, like tribute pills, and the bigger ones are like Liu Ding. However, there are many myoadenomas, sometimes dozens or hundreds, one after another, like adzuki bean or millet, scattered in the myometrium of the patient's uterus to dilate the uterus, but it is impossible to clearly find out the location of myoma growth. Normal uterus, anterior and posterior wall diameter is about 3? 4 cm, fibroids are generally as big as 6 cm, which means that symptoms will appear when the uterus is twice as big as the original, such as backache. The symptoms of fibroids are similar to those of adenomas. On the one hand, there is much menstrual blood, and on the other hand, the menstrual period is long, sometimes it will take 7 days or 10 days to end. Moreover, menstruation will be accompanied by backache and blood clots. Some patients may have both fibroids and adenomas, or only one of them, but in either case, the physique of these patients is the same. The main symptoms of hysteromyoma The typical symptoms of hysteromyoma include menstrual pain, uterus enlargement, pelvic pain and menorrhagia, among which menstrual pain is the most common, but patients may have no symptoms. Clinically, if a 40-year-old woman who is not pregnant complains of dysmenorrhea, menorrhagia and symmetrical hypertrophy of the uterus, it may be suffering from uterine fibroids. There are also some patients with uterine fibroids who will have frequent urination, constipation and pain; During menstruation, some patients will suddenly lose constipation and even have mild diarrhea, which usually means that the posterior wall of uterus has adhered to the large intestine or complicated with endometriosis. Pan Junheng (Dean of Obstetrics and Gynecology, Alison, Director of Taiwan Province Women's Health and Urology Foundation) The causes of hysteromyoma, also known as adenomyoma, adenomyosis and adenomyosis, mean that the endometrium grows into the myometrium, which makes the myometrium thicken and proliferate and makes the whole uterus swell symmetrically. Its etiology is related to estrogen secretion, which is also commonly known as endometriosis. Myoadenoma of uterus mostly occurs in 40? A 50-year-old woman with multiple births has symptoms of menorrhagia and menstrual pain. Menstruation is caused by endometrial hyperplasia and ovarian dysfunction, while dysmenorrhea is caused by endometrial swelling and uterine contraction. Patients can find that the uterus is spherical, the uterine wall (especially the posterior wall) is thick and uneven, the serosal surface is irregular, and there will be local tenderness before menstruation. Uterine myoma is not a complete tumor, but endometrial tissue directly penetrates into myometrium from uterine cavity, and new endometrial tissue is derived from myometrium. The reason for its formation is still unclear. Because the patient's endometrium is usually scattered throughout the myometrium, especially in the myometrium of the posterior wall of the uterus, it sometimes concentrates in one place, forming a tumor-like appearance, so it is called "hysteromyoma". Because of the similar symptoms, hysteromyoma is often differentiated from hysteromyoma, endometriosis, functional uterine bleeding, chronic involution of uterus, benign hypertrophy of uterus, uterine cancer, etc., and differential diagnosis is made. About half of patients with hysteromyoma will have hysteromyoma, about 10% will have endometriosis, and 7.3% will have endometrial polyps, but they will not deteriorate into endometrial cancer. What is the difference between box myoma and adenoma? Generally speaking, fibroids are long and hard, like tribute pills, and the bigger ones are like Liu Ding. However, there are many myoadenomas, sometimes dozens or hundreds, one after another, like adzuki bean or millet, scattered in the myometrium of the patient's uterus to dilate the uterus, but it is impossible to clearly find out the location of myoma growth. Normal uterus, anterior and posterior wall diameter is about 3? 4 cm, fibroids are generally as big as 6 cm, which means that symptoms will appear when the uterus is twice as big as the original, such as backache. The symptoms of fibroids are similar to those of adenomas. On the one hand, there is much menstrual blood, and on the other hand, the menstrual period is long, sometimes it will take 7 days or 10 days to end. Moreover, menstruation will be accompanied by backache and blood clots. Some patients may have both fibroids and adenomas, or only one of them, but in either case, the physique of these patients is the same. The main symptoms of hysteromyoma The typical symptoms of hysteromyoma include menstrual pain, uterus enlargement, pelvic pain and menorrhagia, among which menstrual pain is the most common, but patients may have no symptoms. Clinically, if a 40-year-old woman who is not pregnant complains of dysmenorrhea, menorrhagia and symmetrical hypertrophy of the uterus, it may be suffering from uterine fibroids. There are also some patients with uterine fibroids who will have frequent urination, constipation and pain; During menstruation, some patients will suddenly lose constipation and even have mild diarrhea, which usually means that the posterior wall of uterus has adhered to the large intestine or complicated with endometriosis. If patients with uterine adenoma are not treated, with the increase of age, the destruction of uterine muscle tissue will become more and more serious, and more fibrotic tissue will be produced, and the uterus will become harder and bigger, resulting in more pain in the next bleeding, showing a vicious circle. Clinical diagnosis mainly depends on symptoms, medical diagnosis, tumor index CA- 125 and ultrasound examination. If the CA- 125 index rises above 42, the patient has obvious menstrual pain and can almost be diagnosed as hysteromyoma. Cystic tumor index CA- 125 CA- 125 is a glycoprotein with high molecular weight (200~2000kD), which can be detected by OC- 125 monoclonal antibody. CA-65433 can be found in many organs such as peritoneum, pleura, pericardium, oviduct epithelium, endometrium and cervical internal neck. The most common reasons for the increase of CA- 125 in premenopausal women are endometriosis and adenomas. The normal value of CA- 125 is less than 35U/ml, and only 1% healthy adults will be more than 35U/ml. If the CA- 125 value of postmenopausal women increases, further examination is necessary, because if the CA- 125 value of postmenopausal women increases and ovarian tumors are found, the probability of ovarian cancer is as high as 90%. The value of CA- 125 will increase under the following conditions: hysteromyoma and endometriosis, pelvic inflammatory disease and pelvic adhesion, ovarian benign tumor and partial hysteromyoma; In addition, the value of CA- 125 will also increase in the first stage of normal pregnancy, 8 ~ 10 weeks of pregnancy and ectopic pregnancy. The blood test of CA- 125 is best 2 ~ 3 days after the end of menstruation, because the value of CA- 125 is usually greater than 35U/ml when blood is drawn during menstrual cycle. You ask me and answer questions: What are the symptoms of uterine adenomyoma? A: Menstrual pain, uterus enlargement, pelvic pain and menorrhagia are the most common, but patients may have no symptoms. Patients with hysteromyoma should have a light diet. In terms of diet, patients with hysteromyoma should eat less food such as burning, roasting, frying, spicy food and * * *, while ice products, cold drinks and cool fruits will lead to poor pelvic blood circulation, increase menstrual blood clots and aggravate dysmenorrhea symptoms, and should not eat more. Also be careful not to eat blood-enriching Chinese medicine indiscriminately, which will cause uterine congestion, abnormal hyperplasia of endometrium and aggravate symptoms. This article is taken from The Devil Behind Dysmenorrhea (full color)/Pan Junheng (Dean of Obstetrics and Gynecology, Alison, Director of Taiwan Province Women's Health and Urology Foundation)/Gold nugget culture.