Today Thursday Nov 26, 2020

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Endometriosis


Endometriosis means the growth of tissue inside the uterus somewhere outside the uterus. The pelvis is the most common site of endometriosis.In this disease, endometrial tissue (the inner layer of the uterus) forms outside its original site (the uterus). This tissue can occur in all tissues of the body except the spleen, but the most common site is the pelvis, where the ovaries are more prone to endometriosis.In endometriosis, the endometrial tissue shifts, but continues to function, and during each menstrual period, the tissue thickens and bleeds. In endometriosis, the surrounding tissues may become irritated, eventually injuring the tissue. And adhesion.Endometriosis can cause severe pain, especially during menstruation. Pregnancy problems can also occur.
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Symptoms of endometriosis:

The first sign of endometriosis is pelvic pain, which is often associated with menstruation. This pain gets worse over time. Pelvic pain and muscle cramps may start before menstruation and continue for several days after menstruation.

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* Painful menstruation dysmenorrhea

* Pain during or after intimacy with a spouse

* Pain during defecation and urination: This pain may be present during menstruation.

* Excessive bleeding: You may bleed excessively during your period or you may bleed between periods.

* Infertility in some women

* Other symptoms include fatigue, diarrhea, constipation, bloating or nausea that may occur during menstruation.

Severe pain is not always a sure sign of the disease. Some women have severe pain, while others have little or no pain. Endometriosis is sometimes confused with certain conditions, such as pelvic inflammatory disease or ovarian cysts. Endometriosis is sometimes associated with Irritable Bowel Syndrome (IBS). This syndrome causes diarrhea, constipation, and abdominal pain.

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Causes of endometriosis:

Reversible menstruation: The most common cause of endometriosis. In this type of menstruation, menstrual blood consists of endometrial cells that enter the pelvic cavity through the fallopian tubes instead of leaving the body. These endometrial cells enter the pelvic wall. They stick and grow there and bleeding occurs during this period.

Embryonic cell growth: These cells cover the pelvic and abdominal cavities and are formed from embryonic cells. When one or more areas of the abdominal covering become endometrial tissue, endometriosis spreads.

Surgical wound: After surgery, such as a hysterectomy (removal of the uterus) or cesarean section, endometrial cells may attach to the surgical incision site.

Endometrial cell transfer: Blood vessels or lymph fluid may transport endometrial cells to other parts of the body.

Immune system disorders: Immune system disorders may prevent the body from recognizing and destroying endometrial tissue that grows outside the uterus.


Factors that increase the risk of endometriosis:

- Not getting pregnant after marriage

- Infection of one or more relatives close to endometriosis

- Blocking the natural outflow of menstrual blood from the body

- History of pelvic infection

- Uterine disorder

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The symptoms of endometriosis disappear temporarily with pregnancy. Also, these symptoms go away completely with menopause, unless you are taking estrogen.


Complications of endometriosis:

Infertility: One of the most common complications of endometriosis is female infertility.To become pregnant, an egg released from the ovary must be fertilized by sperm cells in the fallopian tube (fallopian tube) to form an egg. The egg must attach to the wall of the uterus and begin to grow.Endometriosis may close the fallopian tube and separate the egg and sperm. Endometriosis can also damage sperm or eggs. However, many women with mild to moderate endometriosis can become pregnant. Doctors recommend that married women with endometriosis get pregnant as soon as possible so that endometriosis does not get worse.

Endometriosis tissue is a living tissue and is like a seed that sows and grows in a favorable environment. One way to cause endometriosis infertility is to have this tissue in any area that penetrates, sometimes due to the return of blood. Menstruation from the fallopian tubes into the abdomen or when a person has a genetic factor conducive to the growth of endometriosis, instead of being eaten and destroyed by immune cells, occurs in common areas of endometriosis deposition and causes problems. It is aggressive and grows, if it enters the ovary, it can destroy most of the ovary and gradually leave a thin piece of the ovary and destroy the follicles.

Another route of infertility is damage to the fallopian tubes by the endometriosis, which prevents the tubes from moving in the wave they need to move the egg into the uterus. The tube emerges and cannot pass the egg through itself.

Another way to cause infertility with endometriosis is by the substances that are secreted. A series of endometriosis tissues are secreted that can even affect the quality of the egg, as we see in some IVF patients that even when they are IVF, this method It fails. This is because endometriosis, due to the toxins it secretes, also damages the egg produced in this way and does not allow it to grow. Some endometriosis patients other than the endometriosis tissue outside the uterus. Inside the uterus, the tissue penetrates into the uterus from a certain place and therefore their uterus is not a good place for fetal development and endometriosis patients are often advised to use a rented uterus. Of course, it is important to mention this point. This is not the same for all patients, and endometriosis is a disease that has a wide range of manifestations and ranges from mild to severe, and these should not worry the person with endometriosis, because many patients with spontaneous endometriosis become pregnant. Many people develop endometriosis only after two or three pregnancies, and so on Endometriosis does not always lead to infertility, but the endometriosis patient must be identified to prevent adverse events.

Ovarian cancer: Women with endometriosis are more likely to develop ovarian cancer.


Methods of diagnosing endometriosis:

Pelvic examination by a doctor: To check for a cyst on the genitals or a wound in the uterus

Ultrasound: For the presence of cysts associated with endometriosis

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Laparoscopy: Determines the location, size, and size of the endometrium.


Treatment of endometriosis

- Analgesics and painkillers

- Hormone Therapy: In some cases, this treatment is effective in reducing the pain of endometriosis. Increasing and decreasing hormones during menstruation causes the endometrium to thicken, shed, and bleed. Using this method, the growth of endometrial tissue is reduced.

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- Surgery: If you have endometriosis and want to get pregnant, surgery to remove the endometriosis while keeping the uterus and ovaries healthy is helpful.

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- Reproductive assisted method: In vitro fertilization is better for pregnancy than surgery.

- Hysterectomy: In severe cases of endometriosis, surgery to remove the uterus and ovaries must be performed. But in these cases, a hysterectomy alone is not enough; estrogen can stimulate residual endometriosis and the pain persists. After a hysterectomy, pregnancy is not possible.