Endometriosis

Endometriosis is the process of benign overgrowth outside the uterine cavity of tissue similar to the endometrium (the inner mucous layer of the uterus).

• In atypical locations, this tissue behaves exactly the same as in the uterus: under the influence of hormones produced by the ovaries, it increases in size, then on "critical days" blood is released from it (the basis for adhesions), and then through the phases of the cycle.

All this leads to adhesions, infiltration of tissues, local "aseptic" inflammation of the peritoneum, accumulation of menstrual blood in the foci. This is how endometrioid ovarian cysts arise, blood accumulations in sealed fallopian tubes (hematosalpinxes) and infiltrative foci on the peritoneum.

• Foci of endometriosis can be located in any part of the abdominal cavity: on the fallopian tubes, ovaries, intestines, bladder, in the uterine space and even on the liver and diaphragm. Also, endometriosis can grow into the muscular layer of the uterus – this arrangement is called adenomyosis (endometriosis of the uterus).

Endometriosis is a serious problem of modern gynecology. More than 176,000,000 women between the ages of 15 and 49 suffer from endometriosis worldwide. Most of them do not have an established diagnosis and do not receive treatment.

• Despite numerous scientific studies conducted to study the causes of endometriosis, many questions have not yet been answered.

The location of the foci of endometriosis in most cases determines the symptoms of the disease.

But it should be remembered that with widespread endometriosis, there may be absolutely no complaints and clinical manifestations, and, conversely, with single foci of minimal size, severe discomfort is possible.

So, what are the most significant symptoms of endometriosis and what should you pay attention to?

1. Pain

• Most often, women report painful menstruation (algodismenorrhea). The pain begins before menstruation and accompanies it. It is localized in the lower abdomen, in the pelvic region, in the lumbosacral region. As a rule, it has a bilateral character. Its intensity may not correspond to the severity of the disease. Pain may be absent with widespread endometriosis and be intense with minimal form.
• With a prolonged course of endometriosis, the connection of pain with the menstrual cycle is lost, the pain becomes constant, debilitating, and poorly amenable to the action of painkillers. Scientists have shown that from 50 to 90% of patients with endometriosis suffer from some form of chronic pelvic pain.
• Dyspareunia – soreness during sexual intercourse is a frequent symptom of retrocervical (post-uterine) endometriosis. The cause is the adhesive process, inflammatory and infiltrative changes in the pelvis.

2. Infertility

• In 50% of cases, endometriosis is the cause of infertility. This is primarily due to the adhesive process in the abdominal cavity, which leads to obstruction of the fallopian tubes, a violation of the anatomy of the pelvic organs. In addition, endometrioid foci secrete biologically active substances that change the biochemical environment in the pelvis, which prevents the onset of pregnancy at the biochemical level.
• At the same time, with widespread endometriosis, pregnancy can occur without any problems, and vice versa, with a minor lesion, it does not occur at all. Researchers suggest that some varieties of "small forms" of endometriosis have serious biochemical activity.

3. Menstrual irregularities 

They are characteristic of uterine endometriosis (adenomyosis). It can be long, heavy menstruation, leading to a decrease in hemoglobin, weakness, fatigue. Other options are irregular menstruation, blood discharge in the middle of the cycle, etc.

Thus, endometriosis should not be excluded in all women with infertility, menstrual disorders, dyspareunia and chronic pelvic pain.

All of these symptoms significantly affect a woman's quality of life. Weakness, fatigue and decreased working capacity lead to difficulties at work. The fear of the absence of pregnancy, dyspareunia, anxiety before the upcoming treatment and uncertainty about its results disrupt the harmony of family life.

Diagnostics

Today, the gold standard for diagnosing endometriosis is laparoscopy.

Treatment

There are several treatment options that can be used in the complex. 

• Pain management
• Hormone therapy
• Surgical treatment (removal of endometriosis node)

So, the management of patients with endometriosis requires, first of all, an individual, thoughtful, integrated approach. In some cases, even the participation of several specialists under the guidance of a gynecologist-urologist, surgeon, psychologist is necessary. Treatment should be carried out in a multidisciplinary clinical center equipped with state-of-the-art equipment.

Only a doctor makes a diagnosis and selects a treatment method.

You can consult with the specialists of the MCSC Gynecology laboratory about the need for surgery and jointly choose the right method of endometriosis treatment for you by making an appointment for a consultation by calling the MCSC call center: +7 (495) 304-30-39.