What is endometriosis?Endometriosis - a benign disease in which cells of the mucous membrane of the uterus can be detected in other organs / tissues. The process can be genital and pelvic organs include (fallopian tubes, ovaries, ligaments) and / or extragenital, 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 endometriosisCauses the disease is still uncertain. Heredity plays a role. According to many experts, endometriosis, pelvic manifestation of systemic disease that has arisen as a result of dysregulation of the immune and hormonal processes.
Risk factors for endometriosis are obstructed labor and childbirth over the age of 30 years, cesarean section, abortion, and diathermocoagulation the cervix, which is often used for the treatment of erosions. If this intervention is made the day before menstruation, the likely introduction of endometrial cells to the wound surface and the subsequent development of endometrial growths in the thickness of the cervix and pelvic cavity.
The symptoms of endometriosisTypical clinical symptoms include painful periods, pain in the pelvic area, infertility, pre-and postmenstrual spotting, uterine bleeding. Less frequent bowel movements and pain during sexual intercourse. With involvement in the pathological process of adjacent organs (colon, bladder) may experience constipation, frequent urination, hematuria, etc. A characteristic feature of endometriosis of the cervix are bleeding from the genital tract in the inter-menstrual period. In endometriosis may experience vaginal bleeding from the genital tract before and after menstruation, and during germination of the vaginal wall there is pain in the vagina during menstruation, during sexual intercourse.
Misplaced endometrial tissue and has developed adhesions can significantly disrupt the function of the affected organs (bowel obstruction, infertility (in 20-25% of cases).
However, endometriosis can occur, and virtually no symptoms, and a woman may not be aware of their condition. That is why it is so important to have regular checkups by a gynecologist, including ultrasound diagnosis and delivery of different types of analyzes.
In addition, the diagnosis of endometriosis is complicated by the fact that there are a number of other pelvic pathology with a similar clinical picture. Therefore, at the slightest suspicion of endometriosis 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.
ComplicationsSevere complication of endometriosis is infertility, which occurs in more than 60% of patients. According to medical statistics, endometriosis is determined in each case, the second female infertility. While squeezing the nerve trunks may experience a variety of neurological disorders. Frequent bleeding can lead to anemia (anemia), which can lead to fatigue, pallor, shortness of breath, heart palpitations, headaches and dizziness, tinnitus, discomfort in the heart, sharp general weakness. The most severe complication of endometriosis is a malignancy - degeneration of endometrial tissue into a malignant tumor.
What can a 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 pathology research sites).
The main goals of treatment: pain reduction, suppression of activity of the process, the restoration of fertility.
Selecting the way / method of correction depends on the severity of symptoms, severity, age of the woman and her plans for pregnancy.
The most common drug spend (hormonal, immune) therapy to suppress ovarian activity, slowing the growth of endometrial tissue, is used as a combination of medical and surgical treatment.
To use a variety of drug treatments hormonal treatments, the application of which is observed during the treatment of menstrual function off. It promotes regression of endometriosis various locations. Duration of the drugs and their choice is individual and depends on the form and stage of disease, age of the patient, the need for infertility treatment, the efficacy of therapy, and other factors.
It is now widely used progestins: norethisterone, medroxyprogesterone acetate, dydrogesterone, linestrenol, and others; estrogen-progestin preparations (single oral contraceptives) in continuous and, sometimes, in a cyclic mode , gestrinone and agonists of gonadotropin-releasing hormone.
The last group of drugs provides the best results in the treatment of disease. In their application for more than 2 weeks, they stop the production of estrogen (female sex hormones). This leads to a decrease in the activity of endometrial lesions and their regression. Most women stop bleeding within 2 months of starting treatment. However, some of them for 3 5 days after the start of treatment may experience vaginal bleeding or spotting for 10 of 14 days. Normally, a decrease symptoms of endometriosis is noted for 4 to 8 weeks of treatment.
Surgical treatment of endometriosis is used for nodal forms of endometriosis, uterine body, in combination with endometriosis fibroids of the uterus, endometrial cysts in the ovaries and in the other cases. After the operation, appointed by the hormonal treatments for 6 months. In some cases, carried out and preoperative hormonal treatment. Important is the use of laparoscopy for infertility and the presence of "small" forms of endometriosis. Produce electrocoagulation of endometriosis, followed by hormone therapy.
In addition to the hormonal and surgical treatment after the surgery is performed restorative treatment. It is necessary for the prevention of adhesions, prevention and correction of possible complications of long-term use of hormone therapy. Electrophoresis using iodine and zinc preparations, affecting the function of the gastrointestinal tract, liver, and pancreas (Festalum, pancreatin, methyluracil, etc.), dietary therapy, vitamins. In the complex treatment includes anti-anxiety, pain killers, anti-allergy medications.
What can you do?Early seeking care, timeliness of treatment / medical recommendations execution make a favorable prognosis, the chance of pregnancy is increased to 40-70%.
The earlier the disease is diagnosed, the greater the chance of successful treatment.