How exercise could help fight drug addiction

The siren call of addictive drugs can be hard to resist, and returning to the environment where drugs were previously taken can make resistance that much harder. However, addicts who exercise appear to be less vulnerable to the impact of these environmental cues. Now, research with mice suggests that exercise might strengthen a drug user’s resolve by altering the production of peptides in the brain, according to a study in the journal ACS Omega.

Re-exposure to drug-related cues, such as the location where drugs were taken, the people with whom they were taken or drug paraphernalia, can cause even recovered drug abusers to relapse. Prior studies have shown that exercise can reduce craving and relapse in addicts, as well as mice. Although the mechanism was unknown, exercise was thought to alter the learned association between drug-related cues and the rewarding sensations of taking a drug, possibly by changing the levels of peptides in the brain. Jonathan Sweedler, Justin Rhodes and colleagues at University of Illinois at Urbana-Champaign decided to explore this theory by quantifying these peptide changes in mice.

Mice were given cocaine injections over four days in special chambers with a distinctive floor texture to produce a drug association with that environment. The animals were then housed for 30 days in cages, some of which included a running wheel. The researchers found that mice that exercised on these wheels had lower levels of brain peptides related to myelin, a substance that is thought to help fix memories in place. Re-exposure to the cocaine-associated environment affected running and sedentary mice differently: Compared with sedentary mice, the animals with running wheels showed a reduced preference for the cocaine-associated environment. In addition, the brains of re-exposed runners contained higher levels of hemoglobin-derived peptides, some of which are involved in cell signaling in the brain. Meanwhile, peptides derived from actin decreased in the brains of re-exposed sedentary mice. Actin is involved in learning and memory and is implicated in drug seeking. The researchers say these findings related to peptide changes will help to identify biomarkers for drug dependence and relapse.

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Rest easy: Insomnia does NOT cause an early death

Rest easy: Insomnia does NOT cause an early death, finds largest study ever into lack of sleep

  • Review of more than 36m people found no evidence it affects mortality
  • But critic argues while most can cope with insomnia, it is serious for some
  • Insomnia is the most common sleep disorder; affects 10-to-30% of people 
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Insomnia sufferers should rest easy as the largest ever study into the lack of sleep found it does not cause an early death.

A review of more than 36million people revealed there is no evidence struggling to nod off or waking in the night affects mortality.

But a critic argues that while the majority may be able to cope with a few sleepless nights, for some the health consequences can be devastating.


The largest ever study into lack of sleep found insomnia does not cause an early death (stock)

In the first review of its kind, researchers from Flinders University, Adelaide, analysed 17 studies investigating a possible link between insomnia and mortality.

The studies were carried out all over the world for an average of 11 years. Most were made up of patients who self-reported insomnia, while some were officially diagnosed.

Insomnia was defined as either being frequent – struggling to nod off on three or more nights a week – or ongoing – sleeplessness lasting more than a month.

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Results suggest that while insomnia may lead to everything from depression and anxiety to diabetes and dementia, it does not actually affect a person’s lifespan.

The study was published in the journal Sleep Medicine Reviews. 

The researchers, led by Dr Nicole Lovato, believe this should reassure those who toss and turn at night that they are not more likely to pass away prematurely.

WHAT IS INSOMNIA?

Insomnia means you regularly have problems sleeping. It usually gets better by changing your sleeping habits.

You have insomnia if you regularly: find it hard to go to sleep, wake up several times during the night, lie awake at night, wake up early and can’t go back to sleep, still feel tired after waking up

Everyone needs different amounts of sleep. On average, adults need 7 to 9 hours, while children need 9 to 13 hours.

You probably don’t get enough sleep if you’re constantly tired during the day.

The most common causes of insomnia are: stress, anxiety or depression, excessive noise, an uncomfortable bed or alcohol, caffeine or nicotine.

Insomnia usually gets better by changing your sleeping habits. For example, going to bed and waking up at the same time every day, and only going to bed when you feel tired.

Source: NHS

But, they stress, only 17 studies were analysed, which all had a relatively short follow-up time. Longer trials are therefore required to confirm the findings.

They also note cognitive behavioural therapy, which aims to help insomniacs develop coping skills, correct attitudes about sleep and modify poor habits, remains the gold standard of treatment.   

But Dr Russell Foster, head of the Sleep and Circadian Neuroscience Institute at the University of Oxford, argues insomnia can be serious for some.

He told The Times: ‘We recently did a study on teenage sleep. If you just took the average, you would think, “What is all the fuss about?”.

‘However, if you look at the spread of the data you can see 30 per cent are showing really poor sleep.’

For these select few, insomnia may be extremely serious, he added.  

Insomnia is the most common sleep disorder, affecting between 10 and 30 per cent of people. 

It is generally defined as difficulty nodding off, staying asleep or feeling exhausted during the day. 

Previous studies have suggested a lack of sleep increases a person’s heart rate and the time between beats, which was thought to lead to an early death.

However, the current study’s authors argue evidence supporting this is limited, with many studies being small and not adjusting for factors such as smoking or obesity. 

This comes after scientists discovered a ‘sleep switch’ that may be essential to a decent night’s shut eye last month.

A cluster of cells in the region of the brain responsible for sleep become activated as mice are nodding off, according to a study by the Beth Israel Deaconess Medical Center.

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5 rules that will not let diabetes

The incidence of diabetes can be prevented in 80% of cases, it was stated by the acting Minister of health Suprun. According to her, 50% of cases of type 2 diabetes people living with him, not knowing that they are sick, for this disease characterized by long duration without showing critical symptoms.

The expert said about what rules are necessary to avoid getting diabetes.

Rule 1: balanced diet. According to the doctor, is particularly at risk with respect to the risk of diabetes is the consumption of high-calorie foods that are high in sugar and different additives. In addition, you should abandon or minimize the quantity of processed food – sausages, products made from white flour and rice.

Not to diabetes, it is important to eat fiber – vegetables and fruits. The expert was advised to eat regularly legumes – they are a regular presence on the table allows you to eat less calories not to gain weight and to have the minimum risk of developing diabetes.

Rule 2: maintain a healthy weight. Suprun stressed that obesity and a larger waist is the evidence of insulin resistance, which is developing prediabetes and then diabetes. Fat affects the maintenance of levels of sugar and cholesterol in the blood, so it is important to stay at one weight and not to gain weight. The greater the share of body fat, the higher the risk of diabetes.

Rule 3: be physically active. You must use any possibility for movements. Weekly body should get about 150 minutes of aerobic activity of moderate character or 75 minutes of intense exercise.

Rule 4: do not smoke. Scientific evidence suggests that smokers are 30-40% more likely to develop type 2 diabetes than non smokers. The risk of diabetes in smokers is higher due to the fact that substances from cigarette smoke getting to them in the body, causing inflammation, damage and oxidation of cells.

Rule 5: be examined. If some people in my family are diabetics, it is vital to check the blood sugar level and seek treatment if increasing. The concentrations of sugars from 5.7 to 6.4 is a serious reason for such appeals.

Renamedialog wrote about what foods can lead to diabetes.

Hands must be protected at any cold

First in the cold and suffer in the cold hands. If the hands are nipped by the frost, it may lead to the exacerbation of chronic pathological processes in the body. Hands must be protected by any degree of cold, and even when zero not to be lazy to wear gloves or mittens, said the doctor, Victoria Savitskaya.

According to Savitskaya, the cold skin is expose to the wind and flakes, making them more vulnerable to harmful influence of cold. Should be aware of this and protect hands in cold weather, recommended the expert.

“On the palms and the hands are bioactive points associated with the head and respiratory system. Freezing hands can worsen chronic inflammation of the nose, bronchi, begin headaches,” – said the expert.
She also added that the cold is dangerous to hand that down to the cold they may experience inflammation of the small joints of the fingers and hands. Savitskaya urged to protect hands from the ravages of cold, at a temperature of from minus 10 to be sure to wear thick warm mittens, and don’t forget the gloves when the temperature is 0 degrees. She said: after a single freezing hands in them impaired thermoregulation for the whole cold season.

Earlier Magicforum wrote about what measures can save health with a sharp cold.

“I was obsessed with exercise I didn't realise I had a problem”

When fitness Instagrammer Sarah Rav, 20, was pulled aside by the dean of the hospital where she was studying, she never thought it might be because of her weight.

“Obviously I knew I was underweight but when I looked in the mirror, it didn’t click that I was unhealthily underweight. I’ve always been on the small side,” explains Sarah.

What happened next would change Sarah’s approach to health and fitness dramatically. Sarah explains that her medical supervisor took her aside:

“He said, ‘look, there’s been concerns about your health from your tutors, your fellow students, your friends and from your teachers. They’ve reached out to me, and they said they noticed that you look really unwell and that you’ve just been really down.”

The dean went on to advise that she take some time off from university and come back once she’d seen her GP and got a medical clearance.

“Initially I thought that’s kind of weird but if that’s what I need to do, then I’d do it. I didn’t realise I had a problem at the time,” explains Sarah. “But when I saw my GP, she was pretty shocked. She weighed me (I weighed30kg at the time), and she said, ‘You need to go to the hospital tonight’.”

It was hearing the diagnosis of Orthorexia (an obsession with exercising) that made Sarah realise that she had to make some changes. Up until that point she had been running 15-20km a day, returning with her feet bleeding and exhausted, and had a ‘fear of food’ she felt were unhealthy.

After a week in hospital, however, where they monitored her because they were worried her heart might stop, she set about on a six-month program to bring her back to being a normal weight for her height and build.

“In my mind, after I was diagnosed, I was like ‘I am obviously doing things wrong. This is not the way that I should be thinking. This is unhealthy,’ ” explains Sarah.

“Given that I got into health and fitness to be healthy, it made a lot of sense that I had to fix myself.”

On the advice of experts, she stopped working out for three months and followed a pretty strict meal plan. “Something that was challenging but ultimately rewarding,” says Sarah.

“It was hard [on the meal plan] because I hadn’t had bread or carbs in three to four months maybe; I had to eat white rice with meatballs. And I was like ‘oh my God’,” remembers Sarah. “But then, at the same time, I knew that I needed to do it to get better.”

That was a year ago and now for Sarah, she’s more aware than ever how easy it is to become obsessed with being healthy and fit to the point that you become sick. Her approach to life now is all about balance.

“I don’t follow any sort of set diet anymore. No calorie counting. It’s literally ‘eat what I want to eat’. Eat when I’m hungry. If I want white bread over wholegrain bread, I’ll go for it. If I want pancakes, I’ll go for it. And then, with exercise, it’s just only for my enjoyment,” she explains.  

It’s an approach she’s careful to share with her 1.7 million followers every day.

“Before all this happened, I was posting about fitness transformations and fitness info about ‘girls with abs’,” Sarah remembers. “But now I shy away from all of that and I post things that don’t focus on appearance so much as what your body can actually do, as well as other aspects [of health and fitness] that aren’t weight or appearance.”

The feedback from this shift and from Sarah’s health journey has been nothing but positive – something that she was worried about when she was first diagnosed.

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“The secret to having it all is knowing you already do” 💖 – Not gonna lie. It’s been a tough couple of weeks. Kinda been feeling like I’ve been getting no where. Kinda been feeling like I’ve been stuck in a rut. Kinda been feeling like nothing I do makes a difference. 😓 – But you know what? I took a moment today to write down every single thing that I am grateful for & 2hrs later, I’m still going 📝 . Essentially I realised I have SO MUCH to be grateful for and even though things aren’t going my way right now, that doesn’t mean that I haven’t already achieved and have been given SO MUCH. 🌟🎁 – So when things get tough, or you feel that life is treating you unfairly, take a little moment to think about just how much you actually have! 🙏🏽 (friends, family, your health, enough clothes, enough food & water….) . I could go on and on, but hopefully this makes you lift your head a little higher and smile a little brighter ☺️💖🤟🏽

A post shared by Previously @fitandfiesty (@sarahrav) on

“At first, I was really, really worried about coming out about it on Instagram because, in my mind I was like I can’t believe I have this [issue]. I didn’t want to tell anyone because I thought people are going to blame me for doing this to myself,” explains Sarah. “But once I came out, the reactions were so positive. Everyone has been so supportive and it just makes me realise that [struggling with] mental health isn’t as bad as what we perceive it to be. It’s definitely something that should be talked about more often, more openly.” 

And that’s why Sarah would like to share her story with others.

“My ultimate goal from this arduous journey is to help even just one single person with an eating disorder or mental illness – to make them understand that they are not alone, that they can get through this… and that they deserve recovery and happiness. If I can do that, then it makes everything I’ve been through worth it.”

If you are worried about yourself or someone in your care, the best thing you can do is talk to someone. Please contact the Butterfly Foundation 1800 33 4673 or chat online.

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Autism behaviors show unique brain network fingerprints in infants

A new study has identified unique functional brain networks associated with characteristic behaviors of autism spectrum disorder (ASD) in 12- and 24-month old children at risk for developing ASD. The study is published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

The findings help pinpoint brain regions involved in particular aspects of ASD and provide clues as to how the characteristic behaviors — known as restricted and repetitive behaviors — develop in the brain from an early age.

“This study is the first to investigate which patterns of brain functional connectivity underlie the emergence of these behaviors in infancy,” said co-first author Claire McKinnon, a lab technician in the laboratory of John Pruett, MD, PhD, Washington University School of Medicine, a lead researcher of the study.

Although the behaviors assessed in the study are important for typical development during infancy, increased prevalence of the behaviors at 12 months old is one of the earliest signs that an infant might later develop ASD. Few studies have managed to examine what is happening in the brain at this time because of the difficulty of using brain imaging techniques — such as functional magnetic resonance imaging (fMRI) — with infants and toddlers. The new study provides an important window into the brain during this critical time when brain circuits and ASD behaviors are developing.

“The study contributes to the growing body of evidence that changes in brain function, that can be measured in infants and young children using resting state fMRI, can reflect emerging differences in cognition and behavior that are associated with the autism spectrum and seen in children at increased risk for the disorder,” said Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

“Functional connectivity correlates of repetitive behaviors observable in infancy could be candidates for biomarkers that predict features of ASD before a clinical diagnosis, which typically is only possible after 24 months,” said Ms. McKinnon. In addition to potential as an early prediction tool, the authors also hope that the results may have use for treatments in ASD. “There is currently a lack of effective interventions targeting repetitive behaviors, and the specific neural correlates identified in this study could also be studied as potential targets for measuring response to future treatments,” said Ms. McKinnon.

The study divided the behaviors into three subcategories — restricted behaviors (e.g., limited interests), stereotyped behaviors (e.g., repetitive movements), and ritualistic/sameness behaviors (e.g., resistance to change). The abnormal functional connections associated with these subcategories involved several brain networks, including the default mode (a network typically most active at rest), visual, attention, and executive control networks. The unique associations between these networks and specific behaviors reinforces the subcategories, whereas overlapping associations indicate that some aspects of the behaviors may share common origins.

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The first frost is dangerous for the body

In the first season the days of negative temperatures especially dangerous to health, said the doctor, Victoria Savitskaya. For the body the first frosts can be a real stress and adversely affect the internal organs, warned the specialist.

According to Savitskaya, the most comfortable for the body is room temperature. The need to adapt to the first frosts, which replaced the zero temperature perceived by the body as acute stress.

The doctor noted that under the influence of frost in the brain aktiviziruyutsya kontrinsuljarnye production of hormones that belong to the category of stress hormones. To move this change without disruption, a healthy person in General can. But who today is not a chronic disease?

“The body gradually begins to narrow the blood vessels external, but also dilates blood vessels of internal organs to warm. In the presence of chronic heart disease or problems with the vascular tone, it creates additional risks,” said the expert.
The doctor believes that the first frost is additionally useful to maintain health and to avoid hypothermia. Savitskaya recommended to wear clothing in several layers, at least three, as the layer of air between layers of clothing increase heat. In addition, the first frosts have definitely should wear warm socks made of natural materials. In footwear, you can put warm insoles. In addition, it should not be close, otherwise the blood circulation will slow, and the legs will start to freeze.

Magicforum previously wrote about what steps should be taken to save the health at the sharp cold.

11 Signs Your Headache Is Actually a Migraine

If you think your “really bad headaches” aren’t migraines, you may want to take a closer look at your symptoms—especially if you’re a woman.

More than half of all migraine sufferers are never diagnosed, according to the Migraine Research Foundation. And according to the National Institute of Neurological Disorders and Stroke, migraines are three times more common in women than in men. Crazy, right?

By taking a few minutes to learn about migraines, you can get an idea if you’re dealing with the condition and get treatment that will actually give you relief. Read on for all the signs and symptoms you may be overlooking, plus background on why migraines happen in the first place.

So, what exactly are migraines, and why do people get them?

According to the National Institute of Neurological Disorders and Stroke, a migraine is a brain disease that causes various uncomfortable symptoms that can last anywhere from four hours up to three days. (Yup, three freakin’ days!)

While the exact cause of migraine headaches is unknown, the Migraine Research Foundation says that both genes and environmental factors likely play a role. We also know that the symptoms are brought on by a change in chemical activity that impacts both the central and peripheral nervous systems, explains Jessica Ailani, M.D., director of the MedStar Georgetown Headache Center in Washington D.C.

Eek! How can I tell if I’m having a migraine or just a tension or sinus headache?

Migraine headaches can cause various symptoms before, during, and after the attack. Not all people experience all symptoms, and your migraine may be entirely different than a friend’s.

Symptoms can come on gradually or suddenly. Sometimes they start overnight, causing people to wake up with a migraine, but not always, the Mayo Clinic notes. Basically, every migraine headache is slightly different, and there’s no cut and dry list of symptoms that pertain to everyone. (Annoying, we know!)

All that said, there are a number of ways migraines differ from regular headaches. If you experience any of these symptoms, you’re likely suffering from a migraine and not something that’ll go away by popping some Advil.

Common migraine symptoms you should definitely know about

1. Debilitating throbbing

“Patients will tell me, ‘I can feel my heartbeat in my head,’ or talk about touching their temple and feeling the vein throbbing, or feeling like their head will explode,” Ailani says. A run-of-the-mill headache, however, causes a dull, aching pain that’s more of an annoyance versus something that throws a wrench in your daily life.

2. Pain on only one side of your head

While migraines can be experienced on both sides of the head, the pain is typically only on one side. A tension headache, however, typically presents as pain all over, and a sinus headache presents as pressure around the cheeks, eyes, and forehead.

It’s still unclear why migraines may present as one-sided. One theory has to do with the trigeminal nerves. (There’s one on each side of the brain.) However, only one may be activated when a migraine begins, and as this continues to happen with repeated migraines over time, that one nerve becomes the “quickest, easiest path for the brain,” Ailani explains.

3. Seeing sparking lights or flashes

“When a migraine happens, there’s a slow wave of electrical activity from the back to the front of the brain,” explains Adelene Jann, M.D., a neurologist at NYU Langone Health. “When that happens, there’s also decreased blood flow to the brain, and everything slows down.” In turn, about 25 percent of suffers experience an aura either before or during their migraines, according to the Migraine Research Foundation.

A visual aura causes various forms of distorted vision, including sparkling lights, different colors, pixelated vision, flashes on one side of the visual field, or colorful zigzag lines. These types of vision changes don’t usually happen with a tension or sinus headache.

4. Weakness and tingling

Vision isn’t the only thing impacted by the decreased brain speed. Migraines can also present with a sensory aura, which causes numbness, tingling, or even weakness on one side of the body. Some people may have a speech aura and have trouble finding their words, which is eerily similar to what happens during a stroke, the Mayo Clinic notes. (But to be clear, is totally unrelated.)

5. Next level nausea

Many people who experience migraines feel nausea, dizziness, or even vomit. “Our gut has a nervous system,” Ailani explains. “When you activate the brain nerves, it’ll activate the gut as well.” Experts believe that the gut slows down during a migraine headache, which can lead to nausea. Studies have also found an association between migraines and gastrointestinal disorders, but the connection remains unclear.

6. A heightened sense of smell

When you get a migraine, the brain is hyperexcited, Jann says. “Everything is ramped up, so people notice noises, lights, and smells more.” That’s why you may be able to smell your coworker’s lunch all the way down the hall or hear your roommate’s music through multiple closed doors, according to a Therapeutic Advances in Chronic Disease study. It’s also why many migraine sufferers seek refuge in a dark, quiet, cool room when the pain is at its worst.

7. You’re totally out of it—even after the pain is gone

Everything from depression to irritability to euphoria has been reported before, during, and after migraine headaches, and some people have reported difficulty concentrating, notes a Journal of Neuroscience study. “Before a migraine, you may notice you’re struggling to get through the document you’are reading, and even during and after, you can feel out of it for a little bit,” Jann says. “It has to do with the slowing of the brain.”

8. The throbbing derails your entire life

A migraine is not just a headache. “A migraine is disabling; it interferes with your life,” Jann says. The severity is too intense that you cannot go about your normal day, and you may miss work or social obligations. “You’re trying to do other things, but your brain is like, ‘Sorry, I won’t let you,’” Ailani says. A typical headache, on the other hand, doesn’t usually leave you down for the count.

9. You get crazy fatigued

During all phases of a migraine, “your brain is busy having a party, and that party can be exhausting,” Ailani says. The feeling that no amount of coffee could help perk you up can last a day or two after a migraine passes. “Your brain is trying to clean up the mess, and it takes energy to do that,” Ailani explains.

10. Your neck is stiff

The trigeminal nerve is thought to play a role in migraines, the Mayo Clinic notes. When it’s activated, it communicates with a major pain pathway in the upper region of the spinal cord, Ailani explains. “When that center gets activated, it sends signals upward to the brain, and possibly sends signals into the upper neck, causing pain.”

11. The pain seems like it lasts forever

Migraines can last from four hours up to three days. You may have several a year, a few a month, or even migraines half the month, Ailani says. Regular headaches just aren’t that frequent.

When to seek medical attention

Ailani recommends seeing a health care provider if any of the following rings true to you:

Talk to your primary care provider first. She or he may refer you to a neurologist, who may refer you to a headache specialist. “Either can help you get your migraines under control so as not to run into problems in the future,” Jann says.

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Adenomyosis causes pain, heavy periods and infertility but you’ve probably never heard of it

Adenomyosis is a condition of the uterus (womb), where the tissue that grows on the lining of the uterus (also known as the endometrium) is also present on the inside muscular wall of the uterus. Adenomyosis can cause symptoms such as heavy bleeding during your period, bleeding when you are not due for your period, period pain (dysmenorrhea), pain during or after sex (dyspareunia) and infertility.

Although women with adenomyosis often also have endometriosis, they are different conditions. With endometriosis, cells similar to those that line the uterus are found in other parts of the body such as the fallopian tubes, the ovaries or the tissue lining the pelvis (the peritoneum).

The area of the uterus affected by adenomyosis is known as the endometrial-myometrial junction, which is where the endometrium and the myometrium (the muscular part of the uterus) meet.

Disruption in the endometrial-myometrial junction is now considered an important contributor to reproductive problems such as recurrent implantation failure, a condition that can prevent women falling pregnant. Adenomyosis can either be quite spread out, known as generalised adenomyosis or localised in one place, also known as an adenomyoma.

Adenomyosis can have a number of causes though none have been definitively identified. There is an association between the presence of adenomyosis and the number of times a women has given birth: the more pregnancies, the more likely you are to have adenomyosis. Women with adenomyosis have also often had a trauma to the uterus such as surgery in the uterus, like during a caesarean section.

How common is adenomyosis?

Like endometriosis, we don’t know exactly how many women may be affected by the condition. What makes the impact of adenomyosis so tricky to determine is that it is quite commonly found during regular screening tests, even when women are not complaining of any symptoms, which means many women may have it and not know about it.

Because it’s often found in women with other conditions like endometriosis, it’s difficult to determine which condition caused the symptoms. We don’t currently know why some women with adenomyosis have symptoms and others don’t.

There are also a number of different criteria for diagnosing adenomyosis, which can differ in important factors. For instance, the number of sections of adenomyosis that need to be affected for a diagosis when looking at tissue samples under a microscope. This makes it a problem when we try to work out how common adenomyosis is.

There can also be differences of opinion among the experts who look at these tissue samples. Experts can look at the same slides and come to very different conclusions.

How is it diagnosed?

Unlike endometriosis, which can only be definitively diagnosed through a key-hole surgery, a diagnosis of adenomyosis can be done through both invasive and non-invasive methods. The most common invasive method is a uterine biopsy (tissue sampling). A biopsy of the uterus can also be performed to make the diagnosis by an abdominal key-hole surgical procedure (laparoscopy) but this remains limited to clinical trials.

Biopsies going through the vagina up to the uterus may have a role in the diagnosis of adenomyosis, but can potentially damage the uterus and therefore are avoided in women wishing to fall pregnant. The ultimate biopsy is a hysterectomy (the removal of the uterus). This is the most accurate method but is obviously a significant surgical procedure and will prevent women having children. A diagnosis of adenomyosis has been made in between 10-88% of hysterectomy specimens showing how common this condition is.

Non-invasive diagnosis can be made by different types of imaging. Ultrasound is commonly available and can be done either using the probe on the abdomen or, preferably, placing the probe in the vagina.

However, ultrasound isn’t always the best choice as it only detects adenomyosis about 50-87% of the time. Magnetic resonance imaging (MRI) is a better choice as there are a number of typical features seen during MRI. These vary throughout the cycle and in response to hormonal therapy but can reliably predict adenomyosis.

What are the treatments?

Management options for adenomyosis include hormonal therapy and surgery. These are mainly targeted at reducing symptoms such as pain. There isn’t much research into whether these increase the chance of getting pregnant.

Hormonal treatments focus on suppressing menstruation. This can be achieved by combined oestrogen and progesterone therapy (such as the combined oral contraceptive pill), progestogen-only treatment (such as a Mirena) or placing women into an “induced” menopause (through GnRH analogs).

Surgical treatment is most effective when the adenomyosis is localised to a smaller area and can be removed, and this type of surgery doesn’t prevent women falling pregnant in the future. If the adenomyosis is spread throughout a larger area then treatments include destroying the lining of the uterus (endometrial ablation) provided adenomyosis is not too deep, and hysterectomy, both of which will prevent further pregnancy.

Other treatment options are interventional radiology such as uterine artery embolisation, where the blood supply to the uterus is cut off and magnetic resonance-guided focused ultrasound where the adenomyosis is destroyed with ultrasound energy.

Does it affect fertility?

There is some evidence adenomyosis can reduce fertility, but this is still controversial. Clinical studies are limited by difficulties and differences in diagnosis and their study designs have problems.

Some MRI studies show changes consistent with infertility, but because patients presenting with infertility in their 30s and 40s are more likely to be diagnosed with adenomyosis, it’s difficult to say if adenomyosis is the cause of their fertility issues.

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