Dorothy FarrarEndometriosis
Endometriosis is most common in women between puberty and menopause. Typical symptoms are cramping pains in the abdomen, which are caused by inflammation in the abdomen. If the endometriosis is not treated, this inflammation increases and later leads to adhesions and often to infertility.
What is endometriosis?
Endometriosis is one of the chronic diseases. During menstruation, the lining of the uterus (endometrium) moves with the blood into the abdomen and pelvis, the ovaries, the Douglas space and other internal locations. There it settles as a benign growth and causes inflammation.
Depending on the location of these foci of inflammation, the woman suffers from cramping pains due to hormonal changes in the cyclical rhythm of her menstruation or from infertility if the proliferation is unfavorable .
causes
However, the scientists cannot agree on a uniform, clear cause for the development of endometriosis. According to the transplantation theory, as already mentioned above, endometrium is settled in or on neighboring organs.Another theory of origin states that certain cells change and transform into uterine-like tissue (metaplasia) and therefore endometriosis can also occur in men in rare cases.
It is agreed that genetic causes cannot be ruled out in endometriosis, even if no “endometriosis gene” has been discovered to date. But endometriosis often occurs when there is a family predisposition to it. However, the development of endometriosis is not related to specific lifestyles, environmental influences or a specific diet.
When to the doctor?
In the case of endometriosis, there are three times when you should see a doctor: diagnosis, changed symptoms in the form of increasing pain and a desire to have children. Endometriosis is not easy to diagnose, as many patients initially do not assume that their symptoms are related at all. Finally, abdominal discomfort and heavy menstrual bleeding can also occur without endometriosis.
The diagnosis is therefore usually made because the affected women go to the gynecologist because of one or more symptoms or the doctor addressed them as part of the check-up. After the diagnosis, the doctor treating you usually determines which treatment options are available. Once endometriosis has been diagnosed, it makes sense to see your doctor again if symptoms change or worsen. In most cases, a new focus of endometriosis has then developed, which can either be sclerosed or removed in a small surgical procedure.
Thus, if the procedure is successful, the patient will be symptom-free again for some time. In addition, this can end the situation in which the patient takes strong painkillers for the pain for a short time, because these in turn put a strain on other organs and are therefore not a permanent solution for endometriosis. However, patients will also need medical help if the desire to have children becomes an issue for them. Unfortunately , pregnancy without hormone therapy is very unlikely if not impossible with endometriosis.
symptoms and course
In the case of endometriosis, cramping pains in the abdomen (dysmenorrhea) are regularly associated with menstruation, which can become more intense over the years and become chronic abdominal pain .
In most cases, back pain , headaches and dizziness are also a burden at the same time, so that the woman should give her body enough rest for a while. Since the blood cannot drain away in the abdomen with endometriosis, cysts , which are filled with coagulated blood, occasionally form on the ovaries. Because these appear brownish, they are called “chocolate cysts.”
The ligaments of the fallopian tubes, the vagina, the intestines and the deeper wall layers of the uterus are often also affected by endometriosis foci. Many women therefore also suffer from severe pain during sexual intercourse and pain when urinating or painful bowel movements .
Unfortunately, endometriosis very often results in infertility due to increased uterine peristalsis. In such cases, only a surgical intervention in which these endometriosis foci are removed can give the chance of a spontaneous pregnancy.
Diagnose
To diagnose endometriosis in a patient, doctors use several diagnostic methods. The examination begins with a detailed interview. The doctor finds out about the current symptoms, the medical history and drug and/or surgical therapies in the past as well as the existing desire to have children. The patients also receive a questionnaire to fill out.
The anamnesis is followed by a gynecological examination, whereby the endometriosis can only very rarely be felt. With the help of an ultrasound examination , the findings can be delimited with regard to the position and size of the focus of the disease. However, this study does not provide sufficient results either, because it is not possible to distinguish them from cysts with certainty.
Other imaging procedures such as an X-ray examination of the kidneys, ureters and bladder, magnetic resonance imaging and computer tomography can be used to confirm the diagnosis. Blood tests are used to measure hormone levels or the tumor marker Ca125.
If intestinal endometriosis is suspected, an ultrasound examination of the rectum or a rectoscopy or colonoscopy is carried out to examine the intestinal mucosa. In order to find endometriosis lesions in the bladder, a cystoscopy is also carried out.
If a laparoscopy is necessary for a reliable diagnosis, the laparoscopy is performed under general anesthesia. If the doctor finds suspicious tissue during the examination, it is removed immediately. Some samples of the tissue are then examined under a microscope to confirm the diagnosis
treatment and therapy
Depending on the severity of endometriosis, it is treated with hormone therapy, surgery or combination therapy. The important goal is that as many endometriosis foci as possible are removed or destroyed so that the unpleasant symptoms stop or the longed-for desire to have children is fulfilled.
If possible, the gynecologists try to avoid removing the uterus and ovaries. Even if a “chocolate cyst” has developed, it can be peeled out so that the ovaries can continue to function.However, drug hormone therapy with GnRH analogues or other estrogen progestins only reduces hormone production in the ovaries for the duration of the treatment. It also leads to side effects that are comparable to menopausal symptoms.
A laparoscopy is the most successful method for a more precise diagnostic clarification and at the same time for the elimination of the endometriosis foci. At the same time, it makes it possible to loosen any adhesions that may be present and, if you wish to have children, to check the functionality of the fallopian tubes.
Because endometriosis is a chronic disease, many women often return after initially successful treatment. There is still no way to prevent endometriosis, but gynecological treatment offers pain-relieving options.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.