Quite often, women who turn to a doctor withcomplaints of pain in the lower abdomen, diagnose endometriosis. What is this disease, what are its causes, what are the signs of endometriosis of the uterus, and how difficult is its treatment? To date, it is known about endometriosis that the disease is caused by the proliferation of cells of the inner layer of the uterus wall where they should not be normal. Aggravation is cyclical under the influence of the same female hormones that cause monthly bleeding in healthy women of reproductive age - menstruation.
Causes of endometriosis
Among the causes are also called genetic mutations, andparticipation in the process of cellular enzymes, and hormonal changes in the body of a woman. But while there is absolutely no exact data on the causes of the onset of endometriosis. But it is established that the less vulnerable or nulliparous, infertile women of reproductive age from 40 years and older to the onset of menopause are more susceptible to the disease. Approximately 50% of adolescent girls who were operated because of pain in the pelvis, diagnosed endometriosis of the uterus. Therefore, for your own peace of mind and to avoid the onset of the disease, one should listen to the recommendation of gynecologists to visit a doctor for preventive examinations twice a year. The theory of retrograde menstruation (implantation theory) considers as a cause of the disease the accidental ingress of menstrual blood, which inevitably contains the cells of the uterine epithelium, into the fallopian tubes, and from there to the abdominal cavity. Endometrial cells are able to settle down in those organs where they fall. And then they begin to perform their direct function - to grow and prepare for the fact that a fertilized egg will fall on their layer. If there is no appearance of a fertilized egg in the uterus, everything is solved in a known way - the swollen mucous membrane is rejected, a little blood is released from the damaged vessels - a natural process of menstruation occurs. But also the lost endometrioid tissues behave the same way: at the right time they are rejected, but the blood has no outlet to the outside and gets into the internal cavities of the body, where it causes inflammation and pain. Irish scientists have discovered a genetic predisposition to endometriosis. The probability of the disease in close relatives is increased about five times compared to those who do not encounter such a problem in the family. Therefore, studies are under way to create a test that would help determine the predisposition to endometriosis and enable women at risk to follow preventive measures and not to get sick. One of the reasons doctors consider and any operations on the uterus - abortion, cesarean section, etc., as a result of which the epithelial cells can be brought with blood anywhere. Endometrial cells may even accidentally be out of place during intrauterine development of the girl and cause endometriosis in the child or manifest during menarche (the first menstruation). In no case should you blame yourself and not allow yourself to blame yourself to a man in the event that the disease does arise. This is just a coincidence, and there is no one's fault in this.
Species of endometriosis
At the location of the growing endometrial cells, the disease is divided into: Genital endometriosis:
- Internal - proliferation of the endometrium in the muscular layer of the uterus, in the canal and cervix, in the fallopian tubes;
- Outer - localized in the ovaries, in the vagina, external genital organs, that is outside the uterus;
- Peritoneal - in the organs of the abdominal cavity, in the intestine, bladder, postoperative scars, etc .;
- Extraperitoneal - outside the abdominal cavity, on the limbs, in the lungs, etc.
Symptoms of endometriosis
Various localizations of endometriosis have their ownsymptoms and treatment. In some cases, a woman may not even be aware of her illness and find out about it accidentally when she is examined by a doctor. But some manifestations of endometriosis of the uterus all the same usually make themselves felt, and, attentively to their health, you can in time to consult a doctor for advice and treatment. The most characteristic signs of endometriosis are pains of varying strength and localization. Painful menstruation - a signal that in the body of a woman is not all right in any case. More than half of the patients show dysmenorrhea several days before the onset of menstruation (1-5 days), and the maximum reaches the third day of menstruation. The pain can be caused by the fact that blood from the affected organ pours into the cyst and strengthens the pressure in it or enters the cavity of the peritoneum, causing irritation and inflammation. It can also arise because of an increase in the level of prostaglandin hormones in the blood that cause vasospasm, increase uterine contractions, or even because of the contact of neighboring organs with the focus of the disease. The intensity can be different - from pulling or aching pains to sharp ones, which are given to the groin area, anus, legs, waist, etc. After the end of the monthly pain, either significantly weaken or disappear. Caution should also dark brown, brown discharge from the genitals several days before and after menstruation, possibly during sexual contact. Quite often they are combined with heavy bleeding during menstruation. In about a quarter of patients, the pains in the lower abdomen are noted without connection to the monthly cycle. This is usually due to the occurrence of secondary inflammation in the organs where endometrial cells have settled. Pain during sexual intercourse occurs when the focus of the disease is located in the vagina, rectovaginal septum, sacro-uterine ligaments, etc. Unpleasant sensations during sexual intercourse sometimes cause a woman to fear with intimacy from intimacy with the spouse, which causes additional stress for both. But some or even all of the symptoms together should not give rise to self-diagnosis of endometriosis and treat yourself. They should be only an occasion for an urgent visit to a women's consultation.
Complications that causes endometriosis
If the presence of the disease is not determined in time and the treatment is not started, endometriosis can lead to a number of complications associated with the peculiarities of its course:
- Infertility as a result of a violation of patencyFallopian tubes; violation of the maturation of the egg and its release from the follicle, getting into the fallopian tube and moving to the uterus, attaching the egg to the uterus and feeding the fetal egg. This can lead to infertility or ectopic pregnancy, early pregnancy loss - miscarriage in the first trimester of pregnancy.
- Due to the compression of nerves with the growth of the endometrium in the organs, neurological disorders may occur.
- Frequent and profuse bleeding leads to anemia - rapid fatigue, dyspnea and sertsebieniyu, headaches and dizziness, noise in the ears, etc.
- A very serious complication in endometriosis is the degeneration of the overgrown endometrium into a malignant tumor.
How can I diagnose endometriosis?
Diagnostics must be carried outgynecologist after a number of necessary for this research and procedures. Among the ongoing studies, if there is suspicion, the doctor can prescribe ultrasound of the pelvic organs, rectal examination, colposcopy, laparoscopy and hysteroscopy. These procedures are carried out only in clinical settings, and only on the basis of their data the specialist can draw the appropriate conclusions. No self-diagnosis or treatment to healers should not be. The reason for going to the doctor should serve for more than six months of pain in the abdomen. They can intensify in the premenstrual period or during menstruation. There is an opinion of experts that the disease predisposes the bend of the uterus, so that in the presence of such a diagnosis, too, should carefully monitor your body, tracking the most minor violations.
Treatment of endometriosis
As soon as the diagnosis becomes known -endometriosis, - a woman asks the natural question of the need for surgical treatment in her position. The decision is made by the doctor depending on the localization and the severity of the focus of the disease. The only effective methods in the fight against endometriosis at this time are:
- Therapeutic - treatment with hormonal and other drugs;
- Organ saving surgical - with the removal of only the affected areas (laparotomy);
- Radical surgical - with the removal of the uterus and ovaries.
Drug therapy is used in the treatmentendometriosis, the symptoms of which are not expressed or expressed weakly; for young women who need to restore fertility (the ability to conceive and give birth to a child). Her methods are reduced mainly to hormonal, anti-inflammatory, desensitizing and symptomatic therapy. Of the hormonal agents, estrogen-progestin drugs are mainly used, progesterone preparations are oral contraceptives and some others. Their action is aimed at suppressing the production of female hormones in the body and stopping the processes of the monthly cycle in all tissues of the endometrium, wherever they are. Such regression of unnecessary tissues occurs only with very long administration of medications and requires systematic observation by the doctor in case of occurrence of negative reactions of the body to treatment with contraceptives. Symptomatic therapy involves the alleviation of the pain syndrome to improve the quality of life of patients. Primary analgesics such as paracetamol and non-steroidal anti-inflammatory drugs, such as aspirin or ibuprofen, are used. Development of new drugs is conducted in the direction of increasing the effectiveness of therapy and reducing the duration of treatment. New classes of anti-progestogen drugs are more easily tolerated by patients and give fewer side effects. In endometriosis of the outer part of the cervix, the uterine cervix is usually limited to cryodestruction or electrocoagulation of the foci; on the inner part, radiocoagulation or laser vaporization may be prescribed, excision of sites affected by endometriosis. This is also surgery, but it allows you to preserve childbearing functions and avoid removal of the uterus. To prevent the recurrence of the disease, hormone therapy is prescribed for up to six months. Its goal is to suppress the growth of the remaining cells and cause their death. But in some cases, more complex interventions are required. Vaginal endometriosis may require excision of affected areas; Adenomyosis 1 degree may be limited to the removal of the damaged endometrium, but in combination with uterine myoma will require complete removal of the organ. But such radical measures are used only with ineffective drug therapy or with intolerance of some drugs, in especially neglected cases, when the foci reach more than 3 cm in diameter or lead to disturbances in neighboring organs. Indications for surgery may be the progression of the disease after therapy in women older than 40 years. In cases of localization of endometriosis in other organs, a decision on the methods of treatment will require consultations of specialists of the appropriate profile: urologist, ophthalmologist, surgeon, etc.
Prevention of disease
After the above, surgery for endometriosisno longer seem to be empty recommendations on a regular, twice a year, preventive examination in a gynecologist. Detection of the disease at an early stage allows you to bring the patient to a full recovery, to preserve the possibility of a full life of a woman, the ability to give birth to a child. Therapeutic treatment does not require renunciation of a career or personal life. The most careful thing to watch for yourself are nulliparous women aged 40 and older. But girls and young women with the appearance of pain during menstruation should pay attention to your doctor when examining. After any surgical interventions in the uterus, you must carefully follow all the prescriptions of doctors and do not neglect their advice on visiting the consultation on time. Preventive means can be called and treatment of any inflammatory diseases in the genital area, even chronic, so as not to create a risk of uterine surgery, which can lead to the emergence of endometriosis. On preventive measures against endometriosis should pay attention to:
- Changing the duration of the menstrual cycle;
- Change in weight, indicating a metabolic disorder;
- The use of contraceptives;
- All women aged 30-45 years;
- Detection of an elevated level of estrogens.
Adherence to simple recommendations and attentive attitude to your health will help to maintain health and a full life for women for many years. Love yourself, be healthy.