Endometriosis: why it occurs, what threatens and whether it can be cured

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What is endometriosis and why does it occur?

Endometriosis is a disease in which the mucous membrane of the uterus begins to grow into the thickness of its muscular layer (another name is adenomyosis). In addition, endometrioid foci (elements of the uterine mucosa) can appear on the ovaries (endometrioid cysts are formed) and fallopian tubes, on the cervix and in the vagina. Much less often, but still occurs, extragenital endometriosis, when a tissue similar to the endometrium appears in the bladder, rectum and other organs.

To summarize, endometriosis is a systemic disease with local manifestations, which are characterized by the appearance of elements of the uterine mucosa in various organs, but most often in the genitals. According to statistics, the most common options are endometriotic ovarian cysts and adenomyosis.

Why does this disease occur? Until now, the mechanisms and causes of the development of endometriosis are not completely known. Almost 90% of women experience retrograde (reverse) reflux of blood during menstruation. However, not all fragments of the endometrium take root in atypical places. In healthy women, against the general background of hormonal balance, the immune system works easily – it quickly eliminates foreign elements. With endometriosis, an unfavorable hormonal background prevents the immune system from doing its job. There are several reasons for this imbalance.

One of the main ones is atypical inflammation caused by an inadequate immune response. The immune system, instead of eliminating the foci, only maintains a long and sluggish inflammation. Cells of the immune system begin to produce cytokines, prostaglandins and other pro-inflammatory substances. However, the immune system cannot complete the inflammation and eliminate the focus.

Secondly, endometriosis is characterized by abnormal growth of blood vessels. The endometrioid focus secretes growth factors and enzymes, providing itself with deep penetration and comfort for further growth, and for a woman – pain.

The third factor is an increase in estrogen synthesis both in the ovaries and locally in the focus itself. It is estrogens that give the cells the command to further excessive division. At the same time, fibroblasts are also activated, which produce collagen fibers, leading to the development of the adhesive process. And this aggravates reproductive dysfunction and increases the risk of infertility.

Main symptoms

Infertility and pelvic pain are the 2 main companions of endometriosis. Pain can be very different. In some cases, this is painful menstruation or pain before it begins, in others – painful sexual intercourse, and thirdly – diffuse pain in the lower abdomen without a clear localization.

The second symptom is the inability to get pregnant after 1 year of regular unprotected intercourse. Often, with an additional examination of such women, the first stage of diagnosis does not reveal any violations. Ovulation, as a rule, occurs, the fallopian tubes are passable, there are no infections, and the long-awaited conception never happens. However, with a detailed questioning of the patient, an experienced gynecologist will suspect endometriosis and prescribe an examination that will help confirm or exclude this diagnosis, which is important for choosing the right treatment.

How is it treated

To eliminate pain and prevent the progression of the pathological process, hormonal drugs are prescribed. Modern treatment has several goals:

• blocking the inflammatory response and normalization of the immune system;

• suppression of pathological vascular growth processes;

• stopping the growth of nerve endings that lead to pain;

• inhibition of excessive cell division;

• decrease in the activity of estrogen formation in endometriotic lesions.

Such a complex effect on the pathological process makes it possible to stop its further progression, improve the quality of life of a woman and avoid infertility. But not always enough only conservative therapy. Most often, a woman is operated on for the presence of endometrioid cysts in the ovaries. And in world gynecology there is an unspoken rule – you need to operate only once. Therefore, in order to prevent recurrence of the disease, hormone therapy is prescribed after surgical removal of heterotopias.

Consequences of endometriosis

First, endometriosis affects a woman’s quality of life. Pain syndrome reduces performance, leads to irritability and sexual disorders. Against this background, conflicts in the family and at work may appear.

Secondly, endometriosis significantly increases the risk of infertility. And the later the disease is detected and, accordingly, the later treatment is started, the higher the risks of reproductive disorders. Therefore, if your age is under 35 and you cannot become pregnant within a year, then endometriosis must be ruled out as a possible cause. Women over 40 years of age are given even less time for diagnosis – after six months of fruitless attempts at conception, it is worth making an appointment with a qualified gynecologist.

Long-existing untreated endometriosis is insidious with its complications – chronic pelvic pain and critical fertility disorders, and in severe cases, even IVF does not always help solve the problem. Therefore, if you have any suspicious symptoms, consult a specialist.

Photo: Pexels.com

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