GynoFiles

In a medical review today, published on line ahead of print, t he treatments of for the least known aspect of endometriosis, the condition adenomyosis, is reviewed . Adenomyosis, a name of Greek origin , is a condition whereby the glands of the uterus become trapped deep within the wall of the uterus and produce symptoms. The symptoms of adenomyosis can be variable, but most likely will at least cause heavy painful periods. The diagnosis of adenomyosis used to just be made at hysterectomy, but we have gradually recognized that ultrasound and MRI examinations can determine whether a woman has adenomyosis as the cause of her heavy periods. The condition of adenomyosis could be asymptomatic, and if a woman has no symptoms she does not need treatment. But in a large percentage of cases adenomosis causes the uterus to be enlarged. The uterine enlargement can be from the endometrial glands filling the walls, but also due to blood within those glands. Many treatments have been tried, includi...

The lining of the uterus needs to be ready to have an embryo implant. What really makes the best uterus for pregnancy has been a topic of hot research. The uterus has the myometrium , or muscle layer, and an inner lining layer called the endometrium . Gynogab has pointed out that the hormone estrogen and the fact that it is necessary, at least, for that lining to be prepared . And we've discussed that the lining can be disrupted by polyps, endometriosis, lack of proper hormone stimulation, and fibroids, and that might not make the best environment for uterine implantation or more accurately  the best place for egg implantation to occur  . And we've discussed that in order to know if a pregnancy has gotten established it's important to watch hormone levels rise, but for most that just means watching the level of placental hormones.  But there is so much more to having a healthy lining, and a whole section of the September 2011 issue of Fertility and Sterility, the jo...

The baby bed may not be ready when you go to have a baby. there are many issues: have you had a prior pregnancy, miscarriage, have been told you have an abnormal uterus or just unsure? When you are tying for pregnancy the obvious question is 'do I have a fertile uterus?' This might mean a normal shaped cavity, or the absence of any tumors like fibroid tumors, but the lining itself needs to be healthy for a embryo to implant and grow and form it's placenta. Trying to figure out if the uterus is ready for implantation of the embryo, should it manage all those negotiations of fertilization and leaving the fallopian tube, to finally show up to implant in the endometrium or lining tissue  has been tricky business. Pelvic examinations, pap smears and just the normal cycles of a woman can show that a lot is working well but they do not accurately predict the health of the uterine lining. We shed our lining each month, but stem cells from the base layer of the uterus regenerate ...

Much discussion in the gyno office is about how thick or thin the lining layer of the uterus should be. Normal measurements have to be considered based on your age, where you are in a menstrual cycle if you still have periods, and what hormonal medication you are on. Other factors such as prior c-sections or surgeries will play a part in this as well. Mulling over the varied colored sage from the garden I am reminded that there are many shades to "normal" when it comes to lining thickness. Experts have published  the newest meta-analysis of studies that looked at normal and abnormal endometrial thickness measurements, and I see many patients who have been told conflicting advice about their lining tissue and they come in to see their gyno and are wondering what to do. Although clinical factors mentioned above were always a consideration, we gynos heavily have relied on the objective measurements and certain cut off points of endometrial thickness when evaluating patients w...