Endometriosis is a common gynecological disease in which endometrial cells (the inner layer of the uterine wall) grow outside this layer. These sites undergo all those changes that occur in the endometrium during the menstrual cycle.
Endometriosis is typical for women of reproductive age (20-45 years) 3. Only the inflammatory diseases and uterine myoma advance in frequency. The most common genital endometriosis (92-94%) 3, in which the endometrium can be located on the genitals – the cervix, vagina, perineum, fallopian tubes, ovaries, peritoneum. In this case, they speak of external genital endometriosis. With internal genital endometriosis, such areas are located in the thickness of the muscular wall of the uterus. This disease has another name – adenomyosis. Extragenital endometriosis is characterized by the fact that the “lost” endometrium grows on other organs – the intestine, the bladder, the lungs; he may appear in the navel and on postoperative scars. There is such an endometriosis much less often – in 6-8% of cases.
Why does endometriosis develop? Scientists are still lost in conjecture. There is an opinion that with the menstrual blood, pieces of the endometrium can get into the fallopian tubes, into the abdominal cavity, to the ovaries and there to gain a foothold. In other organs, they can penetrate the blood vessels. Therefore, the risk of endometriosis is associated with operations on the internal genitalia, abortions, complicated birth. According to another hypothesis, everything begins long before the arrival of the first menstruation – when the female body only develops in the womb of the mother. In this case, we are talking about “mistakes” in development. Some experts blame for the appearance of endometriosis of impaired immunity and changes in the hormonal background. It is also possible the role of heredity, omnipresent stress, bad ecology and fatigue.
How does endometriosis manifest itself? The most typical symptom is pain in the lower abdomen during menstruation. In internal endometriosis (adenomyosis) pain is given to the sacrum and waist. Menstruation can be copious and prolonged, before and after them, possible “smearing” bloody discharge. For endometriosis of the cervix uterus characterized by “smearing” discharge before and after menstruation, and pain and infertility usually does not happen. With endometriosis, the blood that is excreted does not go out, as in the normal menstrual cycle, but can accumulate in various places. When infection of such a focus, serious complications are possible. In addition, the inflammatory process around the sites of the endometrium can lead to the appearance of adhesions, which disrupts the work of surrounding organs. But the main complication of endometriosis is infertility, it is noted in 45-50% of women suffering from this disease.
The main diagnostic method is laparoscopy, ultrasound examination of the small pelvis and oncomarkers. With endometriosis of the cervix, the endometrial segments are visible when viewed with vaginal mirrors. Endometriosis of the vagina and perineum can be manifested by pain in the vagina and rectum, arising or increasing during sexual intercourse. Endometrioid sites in the vagina and cervix, in the bladder, rectum, on the fallopian tubes are found in colposcopy, cystoscopy, sigmoidoscopy and laparoscopy – depending on the affected organ.
Treatment of endometriosis can be operative and hormonal, but in most cases it is combined. Surgical treatment includes various methods, beginning with the excision of individual areas of endometriosis during laparoscopy, ending with the complete removal of the uterus in complicated cases. Currently, there is a wide range of medicines aimed at curing the disease. In some women endometriosis passes after childbirth, as during pregnancy and breast-feeding the hormonal background of the body changes and changes not in favor of endometriosis. Physiotherapy and hyperbaric oxygenation are also sometimes used.
How to avoid endometriosis? First of all, to exclude abortions, and various manipulations on internal organs to perform strictly according to indications. It is also necessary to prevent and timely eliminate tissue damage during childbirth; in time and correctly treat inflammatory diseases of the pelvic organs and hormonal disorders. According to statistics, most rarely endometriosis is affected by smoking women and women taking contraceptives. And if the first method is hardly worth recommending for prevention purposes, then the second method occupies almost the main place in it.