What is endometriosis?
Endometriosis is a chronic disease that affects women. It can cause pain in the lower abdomen and difficulty getting pregnant.
Endometriosis occurs when cells from a tissue called the endometrium, which lines the uterine cavity, grows out of it, developing in other organs. This tissue can break and cause bleeding, most commonly affecting the ovaries, fallopian tubes and intestine.
Areas where endometriosis can be found.
The parts most commonly affected by endometriosis are the ovaries, the fallopian tubes and the intestine. Endometriosis can develop in the front, back and lateral parts of the uterus.
Symptoms of endometriosis.
Some women with endometriosis have no symptoms, but most have pain in the lower abdomen in the following circumstances:
Before or during menstruation.
In intermenstrual periods.
During or after sex.
When urinating or having an evacuation (often during menstruation).
Other symptoms of endometriosis may include:
Problems to get pregnant.
Abnormalities in the ovaries that a doctor can feel in an exam.
All of these symptoms can also appear due to other diseases that are not endometriosis, but if you have these symptoms, you should inform us.
How is endometriosis diagnosed when there are no symptoms?
There is no test to detect endometriosis, but we can suspect it by knowing its symptoms and doing a physical exam. In some cases it may be useful to perform an imaging test (ultrasound or magnetic resonance).
The only way to know for sure if you have endometriosis is to do surgery, look for endometriosis tissue outside the uterus and send it to be analyzed.
Is endometriosis a malignant disease? Can it cause cancer?
Endometriosis is a chronic benign disease dependent on hormones (estrogens). It is associated with a slight increase in the risk of some types of ovarian cancer. This risk is significantly reduced with contraceptive treatment. It is not recommended to perform any screening test because the incidence is very low and there is no effective test.
Complications of endometriosis
In cases of deep endometriosis, there may be involvement of various organs such as the intestines, the urinary system, etc. This can lead to various symptoms such as pelvic pain, pain when going belly, etc. The surgery of endometriosis can be complex in these cases and therefore, the risk of complications higher. If the endometriosis is very serious it can affect neighboring organs and general serious kidney and intestinal problems.
Diagnosis of endometriosis
The diagnosis of endometriosis is suspected due to the clinical features of the patient (chronic pelvic pain, pain with menstruation, urinary and / or intestinal symptoms, difficulty in becoming pregnant), physical examination and in some cases it may be useful to perform a test of imaging (ultrasound, magnetic resonance). The only way to know for sure if you have endometriosis is to do surgery, find endometriosis tissue outside the uterus and send it to be analyzed.
Risk factors for endometriosis
The factors that predispose to endometriosis are not having children, having the first menstruation at a young age, having menopause at a late age, having short menstrual cycles and Müllerian anomalies. Endometriosis also seems to be associated with high height and low weight (Low Body Mass Index). There is also an association with an environmental pollutant called dioxin that is found in some industrialized countries.
Endometriosis and fertility of women
Endometriosis can lead to alterations in reproductive function and alter fertility. It is the cause of infertility in 25% of our patients.
The mechanisms by which endometriosis produces infertility are controversial and depend, in part, on the degree of involvement by the disease.
How can the symptoms of endometriosis be alleviated?
Endometriosis can be treated in different ways. The right treatment for each woman depends on her symptoms and if she wants to get pregnant in the future.
The medications we use to treat it with:
Contraceptives – Some contraceptives can help reduce pain. This treatment is not suitable for women who want to get pregnant.
Hormones that interrupt the monthly period – Most doctors recommend that women continue this treatment for up to a year, as it can have side effects. In addition, this treatment is not suitable for women who want to become pregnant.
* In which cases should you resort to surgery and what sequelae can it cause?
Surgery should be used in cases in which chronic pelvic pain does not improve with medical treatment, when there are large endometriomas and when there are endometriotic implants that compromise the correct functioning of other organs such as the intestines, urinary bladder, etc. Sometimes surgery is performed to improve the reproductive prognosis.
The sequelae that surgery can cause depend in large part on which pelvic structures are affected and the stage of the disease. Chronic pain may persist, genitourinary and intestinal lesions secondary to surgery or generate abdominal adhesions (certain tissues or organs stick to each other).
Can endometriosis be prevented?
Unfortunately, endometriosis can not be prevented. However, treatment with contraceptives or hormones that interrupt the menstrual period can slow down the evolution and alleviate the symptoms of the disease. We also know that women with endometriosis who get pregnant improve the clinical picture significantly.
What is the greatest advance that exists for the treatment of endometriosis?
The most significant advance in recent years is that they have increasingly limited their surgical indications. This helps to preserve the ovarian function and the fertility of the patients who suffer it, since surgery greatly affects the reserve of the ovaries.
There is a long way to go to understand this disease and thus improve its treatment and prognosis.