Endometriosis

Endometriosis is a common disease of the female reproductive system and is a leading cause of chronic pelvic pain in women.

In women suffering from this disease, tissue similar to the lining of the uterus / endometrium / develops in other areas of the body, most often in the pelvis or abdominal cavity. Endometrial tissue can be “implanted” to: the ovaries, the outside of the uterus, the intestines or other abdominal organs.

Rarely, tissue from the lining of the uterus can end up in the brain or lungs. The disease can also develop as a result of surgical intervention of the pelvic organs. The term “cyst” is used to refer to the area in the body where the endometrial tissue is located.

Most women who are diagnosed with endometriosis are between the ages of 25 and 35. Women may have complaints for years before being definitively diagnosed. Research shows that the disease most often occurs in tall and thin women with a low body mass index.

Women whose mothers have been affected by this disease are at greater risk of developing endometriosis. This suggests that the genes a woman inherits from her parents may also predispose her to the disease.

What are the symptoms?

Symptoms vary depending on the stage of the disease and the timing of the menstrual cycle.

• The disease may not cause any specific symptoms and the woman may not be aware of her condition.
• The most common complaint described by most women is pain in the pelvis, which it increases just before menstruation and weakens towards the end of the monthly cycle.
• Other symptoms are painful menstruation /dysmenorrhea/, pain during intercourse /dyspareunia/ and infertility;
• Infertility is a common symptom of the disease. Although not everyone who has fertility problems is affected by the disease.
• One of the common symptoms is the formation of “chocolate cysts” /endometriomas/. This happens when the endometrial tissue implants to the ovaries and during the menstrual cycle it fills with blood and turns a dark brown chocolate color;

What are the causes?

The exact cause of the disease is not known. It is believed that cells from the endometrium pass through the fallopian tubes in the opposite direction and thus reach other organs in the pelvic area, especially the ovaries.

This process of the reverse movement of endometrial tissue is called retrograde menstruation. The cells then persist in the ovaries, bladder, colon or fallopian tubes.

During each menstrual cycle due to increased estrogen levels, they begin to multiply and swell. But because they are already attached to a certain organ in the pelvic area, they cannot be shed and expelled from the body during the menstrual cycle, as is the case with the endometrium found in the uterus. Thus, in fact, aggregates of cells from the lining of the uterus are formed outside of it.

Treatment of endometriosis

If a woman increases her daily physical activity, the pain associated with the disease will decrease. As with any other chronic condition, lifestyle changes are recommended, and in addition to physical exercise, a balanced diet is also necessary.

In order to stop or slow down the progression of the disease, the gynecologist will initially prescribe drugs. Surgical intervention is applied only if no result is achieved with drug therapy or if the disease is in an advanced stage or there is a suspicion of malignant formations.

Non-steroidal anti-inflammatory drugs such as Ibuprofen or Naproxen sodium are prescribed to control the pain.

If these drugs are not enough to deal with the pain, the gynecologist can prescribe stronger drugs, even opioid analgesics. But great care must be taken with these medications because of the potential for abuse and addiction.

Depending on the degree of development of the disease, the next stage of treatment is to slow down or stop the proliferation of endometrial tissue outside the uterus. Different methods are used to change the levels of hormones that stimulate the growth and swelling of endometrial cells.

Gonadotropin-releasing hormone analogs, such as Zoladex and Differilin, may be prescribed to relieve pain and to limit the growth of endometrial tissue. GnRH analogues are administered by nasal spray or intramuscular injections at intervals of 1 to 3 months.

Hormonal therapy usually lasts between 3 and 6 months. These medications suppress the production of estrogen by the ovaries, which leads to the cessation of the menstrual cycle, as well as symptoms similar to those of the transition to menopause. Such symptoms are:

• Vaginal dryness;
• Irregular cycle;
• Fatigue and loss of bone density;
• Sudden mood swings;

Fortunately, many of these extremely annoying side effects can be avoided by taking progesterone tablets.

1. Oral birth control pills are also used for treatment. Weight gain, breast tenderness, nausea and irregular vaginal bleeding are possible mild side effects.
2. Danazol is a synthetic drug that stimulates high levels of androgens /male hormones/ and keeps estrogen levels low. The drug affects ovulation and the ovaries in the secretion of estrogen. Danazol is an effective pain reliever and shrinks endometrial adhesions, but it has quite a few side effects such as:

• Weight gain;
• Oedema;< /li>
• Breast size reduction;
• Acne and oily skin;
• Hirsutism;
• Headaches and hot flashes;
• Libido and mood changes;
• Voice becomes hoarse;