Endometriosis - benign disease in which the uterine lining cells may be detected in other organs/tissues. The process can be genital cover and pelvic organs (fallopian tubes, ovaries, ligaments) or/and extra, with the involvement of the abdominal cavity, bladder, lung tissue. The disease occurs in 10-15% of women aged 25-44 years.
The cause of Endometriosis
The causes of the disease are still not well established. Heredity plays a role. According to many experts, endometriosis, gynecological manifestations of systemic diseases resulting from immune dysregulation and hormonal processes.
Risk factors for the development of endometriosis are obstructed labor and childbirth over the age of 30 years, cesarean delivery, abortion, and cervical diathermy, which is often used for the treatment of erosions. If this intervention is carried out on the eve of menstruation, there is a high probability of introduction of endometrial cells in the wound surface and the subsequent development of endometrial growths in the cervix thicker and pelvic cavity.
Symptoms of Endometriosis
Typical clinical symptoms include painful periods, pelvic pain, infertility, pre- and postmenstrual spotting, uterine bleeding. Less frequent pain during defecation and sexual intercourse. When engaging in the adjacent organs pathological process (rectum, bladder) may experience constipation, frequent urination, etc. and hematuria. The characteristic feature of cervical endometriosis is spotting of the genital tract in the intermenstrual period. When endometriosis vaginal spotting may occur in the genital tract before and after menstruation, and during germination vaginal wall there are pains in the vagina during menstruation, during sexual intercourse.
Abnormally disposed endometrial tissue which developed adhesions can significantly disrupt the function of the affected organ (intestinal obstruction, infertility (in 20-25% cases).
However, endometriosis can occur and almost no symptoms and women may not be aware of their condition. That is why it is so important to undergo regular preventive checkups at the gynecologist, including ultrasound diagnosis and the delivery of various analyses.
In addition, endometriosis diagnosis is complicated by the fact that there is a number of other pelvic pathology, with a similar clinical picture. Therefore, at the slightest suspicion of endometriosis, it is recommended to take a full range of diagnostic procedures, which includes clinical and gynecological examination, ultrasound - diagnosis of endometrial cysts and adenomyosis, hysterosalpingography, laparoscopy and hysteroscopy.
Complications of Endometriosis
Endometriosis is a serious complication of infertility, which occurs in more than 60% of patients. According to medical statistics, endometriosis is defined in every second case of female infertility. While squeezing the nerve trunks may be various neurological disorders. Frequent bleedings may lead to anemia (anemia), which can lead to fatigue, pallor, dyspnea, palpitations, headaches and dizziness, tinnitus, discomfort in the heart, sharp general weakness. The most severe complication of malignancy is endometriosis - degeneration of endometrial tissue into a malignant tumor.
What can the doctor do?
It is safe to say the diagnosis is possible only on the basis of the results of additional research. According to testimony carried ultrasound, laparoscopy, hysteroscopy/hysterosalpingography, a biopsy (tissue pathological study sites).
The main goals of treatment: pain reduction, suppression of the activity of the process, the restoration of fertility.
The choice of method/correction method depends on the severity of symptoms, severity, the age of the woman and her plans for pregnancy.
In most cases, the dosage is carried out (hormone, immune) therapy directed to the suppression of ovarian activity, growth retardation endometriotic tissue; used as a combination drug and surgical treatment.
For medical treatment using various hormones, which when applied to the treatment of menstrual function observed off. This contributes to the regression of endometriosis different localization. Duration of drugs and their individual choice and depends on the form and stage of disease, the age of the patient, the need for treatment of infertility, treatment efficiency and other factors.
Currently, progestogens commonly used: norethisterone, medroxyprogesterone acetate (Provera, Depo-Provera), dydrogesterone (Duphaston) lynestrenol etc; estrogen-progestin formulations (single oral contraceptives) continuously, and sometimes in a cyclic mode Danazol, gestrinone and agonist of gonadotropin-releasing hormone).
The last group of drugs produces the best results in the treatment of disease. When they are used for more than 2 weeks, they stop the production of estrogens (female sex hormones). This leads to a decrease in the activity of endometriotic lesions and reverses development. Most women stop bleeding within 2 months of starting treatment. However, some of them for 3 5 days after the beginning of treatment may experience vaginal bleeding or spotting for 10 to 14 days. Generally, endometriosis decrease manifestations observed for 4 to 8 weeks of treatment.
Surgical methods of treating endometriosis are used in nodular endometriosis uterus body when combined with endometriosis fibroid uterus at endometrioid ovarian cysts in other cases. After the operation, appointed by the hormonal treatments for a period of 6 months. In some cases, a pre-surgical and hormonal treatment. Important is the use of laparoscopy for infertility and the presence of "small" forms of endometriosis. Produce electrocoagulation endometriosis with subsequent hormone therapy.
Also hormonal and surgical treatment after surgery performed the restorative treatment. It is necessary for the prevention of adhesions, prevention, and correction of possible complications of long-term use of hormone therapy. Use electrophoresis iodine and zinc, drugs affecting the function of the gastrointestinal tract, liver and pancreas, Diet therapy, vitamins. In the combined therapy include anti-anxiety, pain relievers, anti-allergic drugs.
What can you do?
Early treatment of medical care, timely treatment/performance of medical recommendations to make forecasts favorable, the probability of pregnancy is increased to 40-70%.
The earlier the disease is diagnosed, the greater the chance of successful treatment. Therefore, the most important regular visits to the gynecologist and pass routine inspections.
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