Endometriosis: Treatment and Symptoms

Obstetrician-gynecologist, doctor of the highest category "ON CLINIC" Maria Georgievna Mavropulo

Endometriosis: causes and symptoms

Endometriosis is a hormone-dependent chronic disease prone to recurrence. There are two forms of endometriosis:

• genital;
• extragenital.

In gynecology, we mainly deal with the genital form, which, in turn, is divided into:

• external (damage to the ovaries, cervix, vagina, tubes);
• internal (adenomyosis).

The peculiarity of endometriosis is that it has the ability to invade (i.e. infect) underlying tissues and transfer by blood flow. Thus, proliferation occurs - tissue growth by cell division, and the picture of the disease begins to resemble the course of an oncological disease. Endometriosis is characterized by an imbalance of enzymes that maintain normal levels of hormones - estrogen and progesterone.

The causes of endometriosis can be:

• chronic inflammatory processes;
• genetic predisposition;
• complications during childbirth;
• surgeries, abortions.

This disease requires special attention due to its tendency to frequent relapses and invasion. When detected, a woman should focus on treating the disease and her own health.

The main symptom indicating endometriosis is the presence of chronic pelvic pain.

If we compare them with functional pain that appears during menstruation, they are fundamentally different. In addition, these are chronic pains, they are present constantly, and not only before the onset of menstruation.

An eloquent symptom is a violation of the menstrual cycle, the appearance of spotting before and after menstruation, which in total last up to 7 days.

There may be heavy painful menstruations, causing significant discomfort. Normally, menstruation should not bring any changes to a woman's life. Therefore, mainly patients with a disrupted menstrual cycle come to us, the cause of which may be endometriosis.

Endometriosis can lead to a violation of reproductive function, since it can trigger the adhesion process, which leads not only to pain syndrome, but also to infertility.

It is for this reason that it is extremely important to diagnose and begin treatment in a timely manner. Infertility is also a kind of symptom, and patients may not associate the absence of pregnancy for 1-2-3 years with this disease.

This is especially characteristic of genital endometriosis, which affects the fallopian tubes.

The main methods for detecting endometriosis

Several methods are used to diagnose endometriosis:

• ultrasound, which is best performed in the second phase of the cycle;
• gynecological examination for the external cervical form, that is, the corresponding disorders are detected visually and by palpation;
• for internal endometriosis - hysteroscopy, which is best performed in the first phase of the cycle, or laparoscopy.

4 degrees of endometriosis

• I degree: the appearance of foci of endometriosis without the involvement of other organs in the process.
• Degree II: endometrioid heterotopias plus the involvement of nearby organs, for example, cysts and adhesions in the intestinal area. That is, during the second stage, other organs are affected.
• Degree III: a more extensive process, when nearby organs suffer even more and are completely covered by inflammation.
• Degree IV: this is, for example, inflammation of the peritoneum in adenomyosis. Again, everything depends on the localization.

Prevention and treatment of endometriosis

Conservative and surgical treatment are used. In the early stages, conservative treatment is relevant, surgical treatment is resorted to in case of extensive inflammation, adhesions. First, diagnostics are carried out, and if there are any formations, the same endometrioid cysts that are subject to removal, surgical treatment is carried out followed by conservative treatment.

Prevention of endometriosis includes:

• timely treatment of infectious diseases;
• minimizing stress;
• fighting smoking and other bad habits;
• excluding abortions and surgical interventions.

Of course, lifestyle affects many things: stress, nervous breakdowns, poor nutrition - all this does not pass without a trace.

Unfortunately, endometriosis has a feature - to develop into an oncological disease, that is, already in a severe stage.

In this case, treatment can be started with conservative methods, namely, with the correct selection of contraceptive drugs, preferably single-phase ones.

If necessary, surgical intervention is used. Depending on the severity and wishes of the patient (for example, restoration of reproductive function), conservative therapy can be used after surgery with the transition to contraceptive drugs.

Also during treatment, vitamin, sedative and enzymatic drugs are used, since the production of enzymes that maintain hormonal balance is impaired. Reproductive function is restored after 12 months.

It is important not to delay treatment to avoid complications: infertility, painful heavy menstruation, causing chronic anemia.

Infertility is the main complication of endometriosis

The largest percentage of infertility is associated with endometriosis due to the adhesion process. With the adhesion process, the contractile activity of the fallopian tubes is disrupted and the ocular sections are sealed. Naturally, we get tubal obstruction - one of the characteristic features of infertility.

If you do not treat the source of the woman's initial visit to the gynecologist, that is, acute inflammatory diseases that become chronic, this will inevitably lead to further disruption of the menstrual function and painful menstruation. Which, in turn, will cause a violation of reproductive function - all in a chain.