Endometriosis is the presence of endometrial mucosa outside the uterus. What are the causes, symptoms and what to do?
L’endometriosis it is a benign disease and affects 10% of women of childbearing age. Diagnosis is frequently made between the ages of 25 and 35, although the disease can begin much earlier.
It is also estimated that, approximately, they are affected by endometriosis 16 million women in Europe and 5.5 million in the USA.
But how is it recognized and what are the symptoms?
In this article
Endometriosis: what it is
Endometriosis is the presence of endometrium, a mucous membrane that normally covers only the uterine cavity, outside the uterus and can affect the woman already at the first menstruation and accompany her until the menopause. In Italy, 10-15% of women of reproductive age are affected by endometriosis; the disease affects about 30-50% of women who are infertile or have difficulty conceiving. There are at least 3 million women with full-blown diagnoses. The peak occurs between the ages of 25 and 35, but the disease can also appear in lower age groups.
Typical symptoms of the disease are:
- dysmenorrhea: pelvic pain during the menstrual cycle,
- dyspareunia: pain during sexual intercourse,
- chronic pelvic pain,
- heavy menstruation,
- blood loss between flows,
- difficulty getting pregnant
However, these symptoms resemble those of irritable bowel syndrome or other diseases. This is why there can therefore be a delay in diagnosis. It can also be the consequence of one asymptomatic endometriosis, that is, that it does not have associated symptoms, and that is discovered only following investigations for other ongoing problems.
The causes of endometriosis they are not yet fully known. Among the most accredited hypotheses is that of the “retrograde menstruation“: the passage, caused by uterine contractions that occur during menstruation, of fragments of the endometrium from the uterus into the tubes and from these into the abdomen, with implantation on the peritoneum and on the surface of the pelvic organs, rarely on the liver, diaphragm, pleura and lung .
According to other theories, endometriosis is caused by one fabric modification covering the pelvis. While a third hypothesis supports the thesis according to which the pathology would develop following aalteration of the immune system or to one genetic predisposition.
There diagnosis of endometriosis it is carried out during a gynecological examination and following examinations and investigations.
Among the exams for endometriosis the most common are:
- transvaginal ultrasound
- MRI of the pelvis
There laparoscopy for endometriosis it is the best diagnostic tool, as it allows to identify even the smallest cysts. However, it is hardly chosen as the first exam because it is invasive and is performed under general anesthesia.
There cure for endometriosis it is personalized according to the patient’s condition and may require pharmacological or surgical treatment. There is no cure for endometriosis and it can be difficult to treat. Treatment aims to relieve symptoms so the condition doesn’t interfere with your daily life.
Treatment can be given for:
- relieve pain
- slow the growth of endometriosis tissue
- improve fertility
- stop its return
There are several things to consider:
- your age
- what your main symptoms are, such as pain or difficulty getting pregnant
- if you wish to become pregnant, some treatments may prevent you from getting pregnant
- how do you feel about the surgery
- if you have already tried any of the treatments. Treatment may not be necessary if your symptoms are mild, you have no fertility problems, or are approaching menopause when symptoms can improve without treatment.
Endometriosis sometimes gets better on its own, but it can get worse if left untreated. One option is to keep an eye on symptoms and decide to have treatment if they get worse.
You can try anti-inflammatories, such as ibuprofen or acetaminophen, to see if they help reduce pain. They can be used together for more severe pain. These pain relievers are available for purchase at the pharmacy and don’t usually cause many side effects. Tell your doctor if you have been taking painkillers for a few months and still suffer.
The purpose of hormone treatment is to limit or stop the production of estrogen in the body, as estrogen encourages the endometriosis tissue to grow and shed. Limiting estrogen can reduce the amount of tissue in the body. But hormone treatment has no effect on adhesions (“sticky” areas of tissue that can cause organs to fuse) and cannot improve fertility.
Some of the main hormone-based treatments for endometriosis include:
- the combined oral contraceptive pill
- progestogens, including the intrauterine system (IUS)
- the contraceptive injection
- the plant
- progestin pills.
Evidence suggests that these hormone treatments are equally effective in treating endometriosis, but have several side effects. Most hormone treatments reduce the chances of pregnancy while using them, but not all of them are licensed as contraceptives. None of the hormone treatments have a permanent effect on fertility.
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