Cos’è un’adenomiosi? Ed è pericolosa per la gravidanza? Con questo termine medico si indica una condizione caratterizzata da una “invasione” dei tessuti dell’endometrio, che normalmente rivestono l’utero, nei muscoli dell’utero stesso. Ciò provoca ispessimento delle pareti uterine e conseguente ciclo mestruale doloroso e/o abbondante, oltre che dispareunia. Vediamo meglio quali cause e gli altri sintomi da non trascurare.
Cause
La causa esatta di questa condizione è sconosciuta. Tuttavia, è prevalente nelle donne con alti livelli di estrogeni, e di solito scompare dopo la menopausa quando fisiologicamente questi ormoni in circolo diminuiscono.
Esistono comunque diverse teorie circa la causa di adenomiosi ed includono:
- Tessuti aggiuntivi distribuiti all’interno della parete uterina prima della nascita che si sviluppano durante l’età adulta
- Crescita invasiva dei tessuti anormali (chiamati anche adenomioma) da cellule endometriali forse a causa di un incisione fatta in utero (come avviene durante un parto cesareo)
- Cellule staminali che occupano la parete muscolare uterina
- Infiammazione uterina che si verifica dopo il parto, che può rompere i confini abituali delle cellule che rivestono l’utero
Fattori di rischio per adenomiosi
Mentre la causa esatta di adenomiosi è sconosciuta, ci sono fattori che mettono le donne a maggior rischio di sviluppare questa condizione e sono i seguenti:
- Età inferiore ai 40/50 anni (prima della menopausa)
- Avere avuto figli
- Aver subito un intervento chirurgico all’utero, come ad esempio per un taglio cesareo o per rimuovere fibromi
Sintomi di adenomiosi uterina
I sintomi di questa condizione possono essere di varia entità, da lievi a gravi. Alcune donne possono essere totalmente asintomatiche. Quando invece i segnali ci sono, comunemente sono questi:
- crampi mestruali intensi e prolungati
- spotting tra i cicli
- sanguinamento mestruale abbondante
- cicli mestruali più lunghi del normale
- coaguli di sangue durante le mestruazioni
- dolore durante il sesso
- zona addominale tenera
Diagnosi di adenomiosi
Quando si è in presenza di questi sintomi che si identificano come fastidiosi o addirittura gravi ed invalidanti è importante rivolgersi ad uno specialista per individuare la causa precisa ed avviare una terapia. Una visita fisica dal ginecologo con ecografia è già determinante (donne con adenomiosi hanno in genere l’utero che è il doppio o il triplo delle dimensioni normali), anche per escludere il rischio maggiore che è quello di un tumore. Il medico può ordinare una risonanza magnetica (MRI) per ottenere un’immagine più chiara dell’utero se l’ecografia non è abbastanza chiarificatrice.
Adenomiosi e gravidanza
Non ci sono dati scientifici certi e determinanti per stabilire come questa condizione possa influenzare negativamente la gestazione e la fertilità. La tendenza però è quella di ritenere che vi sia effettivamente una maggiore difficoltà non solo nel concepire, ma anche nel portare a termine una gravidanza (sembra che tale condizione sia collegata ad un aumento di parti pretermine). Questo può dipendere dall’ispessimento dell’utero, ma anche al fatto che l’adenomiosi è spesso collegata alla diversa endometriosi, che invece ha questi effetti negativi sulla possibilità di avere un bimbo, scientificamente documentati.
Leggi anche i seguenti post:
Adenomiosi utero, sintomi, cura, sterilità e gravidanza
L’endometriosi aumenta il rischio di parto prematuro
Fibromi e polipi dell’utero: cause
Foto: Thinkstock
Fonte: www.healthline.com
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